铅门跟随技术在食管癌调强放疗中的应用研究  

Study on the Application of Jaw Tracking in Intensity-modulated Radiotherapy(IMRT)for Esophageal Cancer

作　　者：黄玉玲 袁星星[1] 张云[1] HUANG Yuling;YUAN Xingxing;ZHANG Yun(Jiangxi Cancer Hospital,Nanchang,330029)

机构地区：[1]江西省肿瘤医院,330029

出　　处：《实用癌症杂志》2024年第1期113-117,共5页The Practical Journal of Cancer

基　　金：江西省卫生健康委科技计划课题(编号:202310054)。

摘　　要：目的比较食管癌静态调强和动态调强放疗中两种不同铅门模式的剂量学差异。方法随机选择25例食管癌放疗患者,分别以铅门跟随模式设计静态和动态调强放疗计划,基于相同的通量按固定铅门模式重新计算剂量。剂量体积直方图(DVH)和特定的剂量参数用于评估靶区和正常组织受照剂量,电子射野成像系统(PD)用于测量两种不同铅门模式的计划的二维剂量分布。结果无论是静态调强还是动态调强计划,铅门跟随和固定铅门模式在靶区上无明显的剂量学差异,但铅门跟随技术降低了肺和心脏的受照剂量,尤其是在动态调强计划中,其中肺和心脏的V5 Gy,V10 Gy,V20 Gy,V30 Gy,V40 Gy和平均剂量分别降低了3.22%,1.48%,1.18%,2.12%,0.74%,1.78%,和0.67%,0.90%,2.65%,2.23%,1.43%,1.22%。按3 mm/3%和2 mm/2%标准,固定铅门模式和铅门跟随模式在静态调强计划伽马通过率分别是(98.19±1.17)%、(93.33±3.45)%和(98.56±0.64)%、(94.30±2.44)%;在动态调强计划中分别为(98.36±0.84)%、(91.77±2.83)%和(98.62±0.71)%、(93.31±2.35)%,差异均有统计学意义(P<0.05)。结论铅门跟随模式的调强计划具有临床优势,应推广使用。Objective To compare the dosimetric difference between jaw tracking(JT)and fixed jaw(FJ)techniques in static and dynamic intensity-modulated radiation therapy(IMRT)for esophageal cancer.Methods 25 esophageal cancer patients were randomly selected,and the static and dynamic IMRT with JT treatment planning were created respectively,and the FJ plans were created by re-calculating with the same flounces.The dose-volume histograms and selected dosimetric indexes for the planning target volumes(PTV)and organs at risk were compared,and the 2D dose distribution of JT and FJ were also measured using portal dosimetry,and evaluated by gamma analysis.Results No significant differences between FJ and JT plans were observed in the PTV both on static and dynamic IMRT.However,the JT plan reduced the lung and heart dose,especially in dynamic IMRT.The average reduction for V5,V10,V20,V30,V40 and mean dose of lungs and heart on dynamic IMRT was 3.22%,1.48%,1.18%,2.12%,0.74%,1.78%,and 0.67%,0.90%,2.65%,2.23%,1.43%,1.22%,respectively.The gamma passing rates(3mm/3%,2mm/3%)is 98.19±1.17%(FJ)vs 98.56±0.64%(JT),93.33±3.45%(FJ)vs 94.30±2.44%(JT)for static IMRT,98.36±0.84%(FJ)vs 98.62±0.71%(JT),91.77±2.83%(FJ)vs 93.31±2.35%(JT)for dynamic IMRT,respectively.Conclusion The JT technique in IMRT plans has clinical advantages and should be promoted.

关 键 词：铅门跟随 调强放疗 食管癌 剂量学 伽马通过率 

分 类 号：R735.1[医药卫生—肿瘤]