基于AAA算法的三种调强方式在宫颈癌放射治疗中的剂量学比较  

Dosimetry Comparison of Three Intensity Modulation Methods in Cervical Cancer Radiotherapy Based on AAA Algorithm

作　　者：韩超[1] 陈晶晶[2] 陈宏林[1] 苗慧[1] Han Chao;Chen Jingjing;Chen Honglin;Miao Hui(Xuzhou Cancer Hospital,Xuzhou Jiangsu 221005,China;Pizhou People's Hospital,Pizhou Jiangsu 221300,China)

机构地区：[1]徐州市肿瘤医院,江苏徐州221005 [2]邳州市人民医院,江苏邳州221300

出　　处：《医疗装备》2024年第1期14-17,共4页Medical Equipment

基　　金：江苏省妇幼健康科研项目(F201950);徐州市卫生健康委科技面上项目(XWKYHT20220124)。

摘　　要：目的比较宫颈癌术后放射治疗中容积旋转调强(RA)、动态调强(SW)、动态调强固定钨门(FJ)技术3种调强方式的剂量学差异。方法选取2023年1-5月于徐州市肿瘤医院接受宫颈癌术后放射治疗的30例患者,使用Eclipse 13.5治疗计划系统(调用AAA算法),对所有患者分别设计RA、SW、FJ 3种调强方式的放射治疗计划。根据剂量体积直方图(DVH)比较计划靶区(PTV)平均剂量(Dmean)、靶区适形指数(CI)、均匀指数(HI)及危及器官(OARs)脊髓、直肠、股骨头等的受照射剂量,并比较加速器跳数(MU)及低剂量区指数(LDAI)。结果3种调强方式PTV的Dmean比较,差异无统计学意义(P>0.05);靶区CI、HI、直肠V40、膀胱V40、加速器MU方面RA技术优势明显。小肠V40、双侧股骨头的最大剂量(Dmax)、低剂量区指数(LDAI),RA表现不如SW和FJ,差异有统计学意义(P<0.05)。结论RA可以明显缩短治疗时间,提高治疗效率,且靶区适形度和均匀性更好,但对膀胱、直肠和小肠的高剂量控制不如SW和FJ,因此推荐在宫颈癌放射治疗计划设计中优先考虑使用RA调强方式。Objective To compare the dosimetry differences of RapidArc(RA),Sliding Window(SW)and Fixed Jaw(FJ)technique in postoperative radiotherapy for cervical cancer,so as to provide reference for physicists to make radiotherapy plans.Methods A total of 30 patients who received postoperative radiotherapy for cervical cancer in xuzhou cancer hospital from January to May 2023 were selected.Eclipse 13.5 version treatment planning system was used(AAA algorithm was called).Three intensity-modulated radiotherapy plans of RA,SW and FJ were designed for each patient,so that the prescribed dose(45Gy)covered 95%of the planned target area(PTV),and the isodose line of 42.75Gy covered at least 99%of PTV.According to the dose volume histogram(DVH),the mean dose of PTV(Dmean),target conformation index(CI),homogeneity index(HI)and the dose of the spinal cord,rectum and femoral head were compared,and the accelerator monitor unit(MU)and low dose area index(LDAI)were compared.Results There was no significant difference in the mean dose of PTV(Dmean)among the three intensity modulation methods(P>0.05).RA technology has obvious advantages in target CI,HI,rectal V40,bladder V40 and accelerator MU.Small intestine V40,bilateral femoral head maximum dose(Dmax),low dose area index(LDAI)and other indicators,RA intensity modulation mode was worse than SW and FJ intensity modulation mode,the difference was statistically significant(P<0.05).Conclusions RA modulated intensity can significantly shorten the treatment time,improve the treatment efficiency,and better conformal and uniform target area,but the high dose control of bladder,rectum and small intestine is not as good as SW and FJ.Therefore,it is recommended to prioritize the use of RA intensification in cervical cancer program design.

关 键 词：宫颈癌 调强放射治疗 剂量学 低剂量区指数 

分 类 号：R737.33[医药卫生—肿瘤]