SIB-IMRT治疗中段食管癌患者不同射野角度与剂量的关系  

Relationship between different firing field angles and dose in mid-course esophageal cancer patients treated with

作　　者：邵尚敏 王玮 宫尚明 梅长文 SIB-IMRTSHAO Shang-min;WANG Wei;GONG Shang-ming(Department of Radiotherapy,Xuancheng People's Hospital,Xuancheng Anhui 242000,China)

机构地区：[1]宣城市人民医院放疗科,安徽宣城242000

出　　处：《临床和实验医学杂志》2023年第18期1957-1960,共4页Journal of Clinical and Experimental Medicine

基　　金：安徽省自然科学基金(编号:1908085MA27)。

摘　　要：目的探究同时整和加量调强放射治疗(SIB-IMRT)治疗中段食管癌患者不同射野角度与剂量的关系。方法回顾性选取2020~2022年来宣城市人民医院就诊的20例中段食管癌患者,对每例病患均采取两种5野调强计划:以入射角度等分(分别为0°、72°、144°、216°、288°)为A计划,调整入射角度,分别为0°、50°、150、210°、310°为B计划。比较两种计划靶区受照剂量,记录其适形度指数(CI)和均匀性指数(HI),比较两种计划对心脏、脊髓及全肺各剂量参数指标。结果两种计划各PGTV指标剂量(D2%、D98%、D50%、HI、CI)及PCTV指标剂量(D2%、D98%、D50%)比较,差异均无统计学意义(P>0.05),A计划PCTV指标剂量中HI水平为0.154±0.008,低于B计划(0.167±0.012),CI水平为0.679±0.021,高于B计划(0.623±0.017),差异均有统计学意义(P<0.05)。A计划心脏Dmean及脊髓Dmax均低于B计划,但差异无统计学意义(P>0.05),A计划心脏V30、V40分别为(28.37±4.86)%、(12.38±7.38)%,均低于B计划[(32.94±3.42)%、(20.36±6.03)%],差异均有统计学意义(P<0.05)。两组全肺V20、V30比较,差异均无统计学意义(P>0.05),A计划全肺V5、V10、Dmean分别为(45.88±8.77)%、(55.15±10.01)%、(1112.68±194.54)cGy,均高于B计划[(34.55±8.73)%、(47.17±9.87)%、(941.25±216.96)cGy],差异均有统计学意义(P<0.05)。结论对中段食管癌患者采用调整入射角度计划时,虽降低适形度指数和均匀性,但是可以明显减少肺部低剂量(V5、V10)照射体积。Objective To investigate the relationship between different field angles and doses of simultaneous integrated boost intensity modulated radiation therapy(SIB-IMRT)for patients with middle esophageal cancer.Methods Twenty patients with middle esophageal cancer from 2020 to 2022 in Xuancheng People's Hospital were retrospectively selected,and two five field intensity modulation plans were adopted for each patient:plan A was based on the equal division of the incidence angle(0°,72°,144°,216°,288°respectively),Plan B was based on the adjustment of the incidence angle(0°,50°,150°,210°,310°respectively),and the radiation doses in the target areas of the two plans were compared,and their fitness index(CI)and uniformity index(HI)were recorded,The dose parameters of heart,spinal cord and whole lung of the two plans were compared.Results There were no statistically significant differences between the PGTV target doses(D2%,D98%,D50%,HI,CI)and PCTV target doses(D2%,D98%,D50%)of the two plans(P>0.05).The level of HI in the PCTV target doses of plan A was 0.154±0.008,which was lower than that of plan B(0.167±0.012),and the level of CI was 0.679±0.021,which was higher than that of plan B(0.623±0.017),and the differences were statistically significant(P<0.05).Plan A cardiac Dmean and spinal Dmax were lower than that of plan B,but the difference was not statistically significant(P>0.05).The V30 and V40 of cardiac in plan A were(28.37±4.86)%,(12.38±7.38)%,respectively,which were lower than those in plan B[(32.94±3.42)%,(20.36±6.03)%],and the differences were statistically significant(P<0.05).There was no statistically significant difference in the whole lung V20,V30 between the two groups(P>0.05).The V5,V10,and Dmean of the whole lung in plan A were(45.88±8.77)%,(55.15±10.01)%,(1112.68±194.54)cGy,which were higher than those in plan B[(34.55±8.73)%,(47.17±9.87)%,(941.25±216.96)cGy],and the differences were statistically significant(P<0.05).Conclusion When adjusting the incidence angle for patients with midd

关 键 词：同时整和加量调强放射治疗 射野角度 中段食管癌 剂量 

分 类 号：R735.1[医药卫生—肿瘤]