胸中上段食管癌患者调强放疗照射野数的剂量学研究  

Dosimetry study of intensity-modulated radiation therapy field number in patients with middle-upper esophageal carcinoma

作　　者：张青[1] 臧豹[2] 宋亚颀[1] 黄婧 骆红蕾[1] 王加阳 ZHANG Qing;ZANG Bao;SONG Ya-qi;HUANG Jing;LUO Hong-lei;WANG Jia-yang(Department of Oncology and Radiotherapy,the Affiliated Huai an NO.1 Hospital of Nanjing Medical University,Huai an 223300,Jiangsu,China;Department of Thoracic Surgery,the Affiliated Huai an NO.1 Hospital of Nanjing Medical University,Huai an 223300,Jiangsu,China)

机构地区：[1]南京医科大学附属淮安第一医院肿瘤放疗科,江苏淮安223300 [2]南京医科大学附属淮安第一医院胸外科,江苏淮安223300

出　　处：《川北医学院学报》2024年第11期1468-1471,共4页Journal of North Sichuan Medical College

基　　金：南京医科大学附属淮安第一医院“高层次人才”科研项目(GQ202207)。

摘　　要：目的:比较5野、7野IMRT用于胸中上段食管癌患者调强放射治疗(IMRT)的剂量学差异。方法:纳入接受IMRT的150例胸中上段食管癌患者为研究对象,根据IMRT照射野数不同分为7野组(n=71)及5野组(n=79)。全部患者总治疗剂量为50 Gy,每周期治疗5次,共计治疗25次。比较两组治疗期间靶区及相关危及器官剂量学参数,比较两组治疗前后血清学指标及对治疗的满意度。结果:两组患者靶区平均受照剂量比较,差异无统计学意义(P>0.05);7野组患者均匀指数低于5野组(P<0.05),适形指数高于5野组(P<0.05)。两组患者心脏、脊髓、左肺、右肺平均受照剂量比较,差异均无统计学意义(P>0.05);7野组患者左肺及右肺V5均高于5野组(P<0.05),左肺及右肺V20、V30均低于5野组(P<0.05)。治疗后,两组患者血清血管内皮生长因子(VEGF)、基质金属蛋白酶-2(MMP-2)、MMP-9水平均低于治疗前(P<0.05),且7野组均低于5野组(P<0.05)。两组患者满意度比较,组间差异无统计学意义(P>0.05)。结论:5野IMRT并未增加胸中上段食管癌患者相关危及器官的受照剂量,且有利于降低双肺的V5,但7野IMRT用于在靶区适形度及临床疗效方面更具优势。Objective:To compare the dosimetry difference between 5-field IMRT and 7-field IMRT for intensity-modulated radiation therapy(IMRT)in patients with middle-upper esophageal carcinoma.Methods:A total of 150 patients with middle-upper esophageal carcinoma who received IMRT were selected as the study objects.According to the number of IMRT irradiation fields,150 patients were divided into 7 field groups(n=71)and 5 field groups(n=79).The total therapeutic dose of all patients was 50 Gy,5 times each cycle,a total of 25 treatments.The dosimetric parameters of target area and related organs at risk during treatment,serological indexes before and after treatment and satisfaction with treatment were compared between the two groups.Results:There was no significant difference in the average radiation dose in the target area between the two groups(P>0.05).The homogeneity index of patients in the 7 field group was lower than that in the 5 field group,and the conformal index was higher than that in the 5 field group(P<0.05).There was no significant difference in the mean radiation dose of heart,spinal cord,left lung and right lung between the two groups(P>0.05).The V5 of left lung and right lung in the 7 field group were higher than those in the 5 field group,and the V20 and V30 of left lung and right lung were lower than those in the 5 field group(P<0.05).After treatment,the serum levels of vascular endothelial growth factor(VEGF),matrix metalloproteinase-2(MMP-2)and MMP-9 in the two groups were lower than before treatment,and the levels in 7 field group were lower than those in 5 field group(P<0.05).There was no significant difference in patient satisfaction between the two groups(P>0.05).Conclusion:5-field IMRT do not increase the dose of exposure to relevant organs at risk in patients with middle-upper esophageal carcinoma,and is conducive to reducing V5 in both lungs,but 7-field IMRT is more advantageous in terms of target conformation and clinical efficacy.

关 键 词：胸中上段食管癌 调强放射治疗 布野方案 剂量学 

分 类 号：R735.1[医药卫生—肿瘤]