不同X射线能量在宫颈癌VMAT放疗中剂量学比较  

Dosimetric comparison of volumetric modulated arc therapy plans with different X-ray energies in patients with cervical cancer

作　　者：杨超 韩济华[1] 朱志坚[1] 何栋成[1] YANG Chao;HAN Jihua;ZHU Zhijian;HE Dongcheng(The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University,Huai'an 223300 China)

机构地区：[1]南京医科大学附属淮安第一医院,江苏淮安223300

出　　处：《中国辐射卫生》2024年第5期573-577,583,共6页Chinese Journal of Radiological Health

摘　　要：目的比较6 MV和10 MV X射线光子能量在宫颈癌患者容积旋转调强(VMAT)放疗中的剂量。方法选取2019年3月—2020年5月在本院肿瘤放射治疗科行放射治疗的宫颈癌患者24例,重新为每位患者分别设计6MV和10 MV光子能量的VMAT计划。比较两组计划的靶区参数(D_(98%)、D_(2%)、D_(mean))、适形指数(CI)、均匀性指数(HI),还比较了膀胱、直肠、小肠、左侧股骨头、右侧股骨头、除PTV之外的正常组织(Body-PTV)接受到的照射剂量、以及机器跳数(MU)和预估出束时间(t)。结果10 MV组计划的靶区PTV的参数D_(2%),D_(mean),HI和MU均小于6 MV组计划[(50.78±0.33)Gy vs(50.35±0.29)Gy;(49.05±0.2)Gy vs(48.93±0.17)Gy;(0.08±0.01)vs(0.07±0.01);(1179.26±110.55)vs(1099.3±80.9)],且差异具有统计学意义。危及器官受量比较结果:与10 MV组计划相比,6MV组计划的膀胱V_(40Gy)、右侧股骨头D5%、PTV以外的正常组织D_(2%),V_(5Gy)均较低[(60.37±13.66)vs(60.84±13.88);(37.09±5.43)Gy vs(38.03±5.68)Gy;(41.71±1.39)Gy vs(42.16±1.31)Gy;(47.88±9.75)vs(48.23±9.74)],且差异有统计学意义。其余参数无统计学意义。结论6 MV和10MV两种X射线光子能量的容积旋转调强放疗计划均能满足宫颈癌放射治疗的临床需求,6 MV光子能量的宫颈癌VMAT计划能更好的保护危及器官,建议选择6 MV光子能量。Objective To investigate the effects of volumetric modulated arc therapy(VMAT)with 6 MV and 10 MV X-ray photon energies in patients with cervical cancer.Methods From March 2019 to May 2020,24 patients with cervical cancer who underwent radiation therapy in the Oncology Radiotherapy Department of our hospital were selected.VMAT plans with 6 MV and 10 MV photon energies were re-designed for each patient.The target parameters(D_(98%),D_(2%),D_(mean)),conformal index,and homogeneity index of the two groups were compared.The radiation doses received by the bladder,rectum,small intestine,left femoral head,right femoral head,and normal tissue other than planning target volume(Body-PTV),as well as monitor units and estimated total delivery time,were also compared.Results D_(2%),D_(mean),homogeneity index,and monitor units were significantly lower in the 10 MV group than in the 6 MV group(50.78±0.33 Gy vs.50.35±0.29 Gy;49.05±0.2 Gy vs.48.93±0.17 Gy;0.08±0.01 vs.0.07±0.01;1179.26±110.55 vs.1099.3±80.9).Comparison of organs at risk showed that compared with the 10 MV group,the 6 MV group demonstrated significantly lower V_(40Gy) of the bladder,D5%of the right femoral head,and D_(2%)and V_(5Gy) of Body-PTV(60.37±13.66 vs.60.84±13.88;37.09±5.43 Gy vs.38.03±5.68 Gy;41.71±1.39 Gy vs.42.16±1.31 Gy;47.88±9.75 vs.48.23±9.74).There were no significant differ-ences in other parameters between the two groups.Conclusion The VMAT plans with 6 MV and 10 MV X-ray photon en-ergies both meet the clinical needs of cervical cancer radiotherapy.The cervical cancer VMAT plan with 6 MV photon en-ergy is recommended due to better protection of the organs at risk.

关 键 词：宫颈癌 容积旋转调强 剂量 放疗 

分 类 号：R816[医药卫生—放射医学]