脑部小肿瘤射波刀照射与容积调强及固定野调强放疗计划的剂量学比较  

Dosimetric Comparison of CyberKnife Irradiation,Volume Intensity Modulated Radiotherapy and Fixed Field Intensity Modulated Radiotherapy for Small Brain Tumors

作　　者：程涛[1] 陈杰添 陈科权 徐海欢 许耀灿 梁维朝 梁幸 姚红华 梁永 CHENG Tao;CHEN Jietian;CHEN Kequan;XU Haihuan;XU Yaocan;LIANG Weichao;LIANG Xing;YAO Honghua;LIANGYong(CyberKnife Treatment Center of Ruikang Hospital Affiliated to Guangxi University of Traditional Chinese Medicine,Nanning,Guangxi Zhuang Autonomous Region,530000 China;Department of Oncology,Guiping People's Hospital,Guiping,Guangxi Zhuang Autonomous Region,537200 China)

机构地区：[1]广西中医药大学附属瑞康医院射波刀治疗中心,广西南宁530000 [2]桂平市人民医院肿瘤科,广西桂平537200

出　　处：《世界复合医学》2023年第6期31-33,41,共4页World Journal of Complex Medicine

基　　金：贵港市自筹经费科研项目(贵科攻2000017)。

摘　　要：目的用射波刀照射与容积调强及固定野调强放射治疗技术分别对5 cm以下脑部小肿瘤靶区进行计划设计,采取剂量学比较,为临床进行立体定向放射治疗选择个体化的最佳治疗技术提供参考。方法选取2021年6月—2022年12月广西中医药大学附属瑞康医院收治的行立体定向放射治疗技术的15例5 cm以下脑部小肿瘤患者为研究对象,患者均行射波刀照射与容积调强及固定野调强放疗计划,观察剂量跌落梯度、适形指数、靶区剂量不均匀指标,找出3种技术在脑部小肿瘤立体定向放射治疗时的剂量学优劣特点。结果射波刀组梯度指数(gradient index,GI)值低于容积旋转调强放疗(volumetric modulated arc therapy,VMAT)组、固定野调强放射治疗(intensity modulated radiotherapy,IMRT)组,但3组的GI值均接近,差异无统计学意义(P>0.05)。VMAT组和IMRT组CI值比较,差异无统计学意义(P>0.05),但两组CI值均高于于射波刀组,差异有统计学意义(P<0.05)。VAMT组的HI为(1.187±0.038),IMRT组的HI为(1.202±0.023),均优于射波刀组(1.324±0.064),且VAMT组的HI更接近于1,差异有统计学意义(P<0.05)。结论脑部小肿瘤射波刀照射计划与容积调强及固定野调强放射治疗计划比较,射波刀对脑部损伤最小,但靶区均匀性较差,容积调强放射治疗计划剂量适形度和均匀性较好,表明3种技术均能满足立体定向放射治疗的剂量要求,并且各具优势。Objective The target areas of small brain tumors below 5 cm were planned and designed by means of cyberknife irradiation,volume intensity modulation and fixed field intensity modulation radiotherapy,respectively,and dosimetric comparison was carried out to provide reference for selecting the best individualized treatment techniques for stereotactic radiotherapy in clinical practice.Methods A total of 15 patients with small brain tumors below 5 cm treated in Ruikang Hospital Affiliated to Guangxi University of Traditional Chinese Medicine from June 2021 to December 2022 were selected as the study objects.All patients underwent cyberknife irradiation,volume intensity modulation and fixed field intensity modulation radiotherapy plans,and the dose drop gradient,conformal index and target dose uneven index were observed.To find out the dosimetry advantages and disadvantages of three techniques in stereotactic radiotherapy for small brain tumors.Results The gradient index(GI)value of the cyberknife group was lower than that of the volumetric modulated arc therapy(VAMT)group and the intensity modulated radiotherapy(IMRT)group,but the GI values of the three groups were close,and the difference was not statistically significant(P>0.05).There was no statistically significant in CI values between VMAT group and IMRT group(P>0.05),but CI values in both groups were higher than those in cyberknife group,and the difference was statistically significant(P<0.05).The HI of the VAMT group was(1.187±0.038)and the IMRT group was(1.202±0.023),both of which were better than those of the cyberknife group(1.324±0.064),and the HI of the VAMT group was closer to 1,the difference was statistically significant(P<0.05).Conclusion In comparison with the volumetric intensity modulated and fixed-field intensity modulated radiation therapy,the cyberknife irradiation program for small brain tumors has the least damage to the brain,but the uniformity of the target area is poor,and the dose conformal and uniformity of the volumetric intensity mod

关 键 词：射波刀照射 容积旋转调强放疗 固定野调强放疗 

分 类 号：R4[医药卫生—临床医学]