非均整模式与均整模式下儿童肾母细胞瘤容积调强放疗的剂量学研究  

Dosimetric study of volumetric modulated arc therapy for pediatric Wilms'tumor under flattening filter free and flattening filter modes

作　　者：雷占全 LEI Zhan-quan(Department of Radiation Oncology,Fujian Children's Hospital(Fujian Branch of Shanghai Children's Medical Center),Fuzhou 350014,China)

机构地区：[1]福建省儿童医院(上海儿童医学中心福建医院)放疗科,福州350014

出　　处：《医疗卫生装备》2024年第4期70-73,共4页Chinese Medical Equipment Journal

基　　金：福建省自然科学基金项目(2023J011305)。

摘　　要：目的:对比在均整(flattening filter,FF)模式与非均整(flattening filter free,FFF)模式下儿童肾母细胞瘤容积调强放疗(volumetric modulated arc therapy,VMAT)的剂量学差异。方法:回顾性选取2022年8月至2023年10月于某院接受放疗的10例肾母细胞瘤患儿,均设计FF模式和FFF模式下的VMAT计划,比较2种计划的计划靶区(planning target volume,PTV)剂量学参数、危及器官(organ at risk,OAR)受照剂量、机器跳数、γ通过率及治疗时间。结果:FFF计划的D_(2)、D_(98)及均匀性指数均优于FF计划,差异有统计学意义(P<0.05);而2种计划的D50和适形性指数比较,差异无统计学意义(P>0.05)。FFF计划在对侧肾脏D_(mean)、V_(5)、V_(10),肝脏D_(mean)、V_(5)、V_(10)以及脊髓D_(max)方面均优于FF计划,差异有统计学意义(P<0.05)。FF计划在γ通过率、机器跳数方面均优于FFF计划,而FFF计划的治疗时间明显短于FF计划,差异有统计学意义(P<0.05)。2种计划的γ通过率均>95%。结论:FF模式和FFF模式下的VMAT计划均能满足临床治疗要求,FFF模式较FF模式在PTV剂量分布、OAR受照剂量和治疗时间方面更有优势,对提升患儿治疗效果和配合度有积极影响。Objective To compare the dosimetric differences in volumetric modulated arc therapy(VMAT)for pediatric Wilms'tumor under flattening filter(FF)and flattening filter free(FFF)modes.Methods Ten children with Wilms'tumor who received radiotherapy at some hospital from August 2022 to October 2023 were selected retrospectively,for whom the VMAT plans were designed under FF and FFF modes.The two kinds of plans were compared in terms of planning target volume(PTV)dosimetric parameters,exposure dose to organ at risk(OAR),monitor units,gamma pass rate and treatment time.Results The FFF plan behaved significantly better than the FF plan in D_(2),D_(98) and HI(P<0.05);the two kinds of plans had no statistically obvious differences in D_(50) and CI(P>0.05).The FFF plan gained advantages over the FF plan in D_(mean),V_(5) and V_(10) of the contralateral kidney,D_(mean),V_(5) and V_(10) of the liver and D_(max) of the spinal cord,and the differences were statistically significant(P<0.05).The FF plan outperformed the FFF plan in gamma pass rate and monitor units,while the FFF plan had the treatment time shorter than that of the FF plan,and the differences were statistically significant(P<0.05).The two kinds of VMAT plans both had the gamma pass rates higher than 95%.Conclusion The VMAT plans under both FF and FFF modes meet clinical treatment requirements,and the FFF mode has advantages over the FF mode in terms of PTV dose distribution,exposure dose to OAR and treatment time,which contribute to enhancing the treatment outcome and cooperation of the children.

关 键 词：肾母细胞瘤 非均整模式 均整模式 VMAT 剂量学参数 

分 类 号：R318[医药卫生—生物医学工程] R815[医药卫生—基础医学]