肝细胞癌立体定向放射治疗计划的质量评估  

Quality evaluation in small hepatocellular carcinoma SBRT

作　　者：吴泇俣 张建英 陈芷涵 嵇卫星 高宇楠 李婷婷 陈一兴 WU Jiayu;ZHANG Jianying;CHEN Zhihan;JI Weixing;GAO Yu'nan;LI Tingting;CHEN Yixing(Department of Radiation Oncology,Zhongshan Hospital,Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学附属中山医院放疗科,上海200032

出　　处：《现代肿瘤医学》2024年第23期4477-4481,共5页Journal of Modern Oncology

摘　　要：目的:提出可参考的肝细胞癌SBRT计划质量评估指标标准,指导放射治疗计划的设计以获得更优方案。方法:回顾性分析了本中心内84例肝细胞癌患者的SBRT计划,计算并统计分析RTOG、ICRU建议的均匀性指标(HI)、适形性指标(CI)和剂量梯度指标(GI、D 2 cm)。结果:CI在0.97~1.31小范围内波动,与PTV整体无显著相关性;GI和D 2 cm与PTV有显著相关性(P=0.001/P=0.001)。文中给出了对应不同靶区体积时上述评估指标的可接受范围。结论:与现有文献及RTOG 0915、0813指南中SBRT计划质量指标数据相比偏差较小。建议在PTV处方剂量覆盖率和危及器官剂量限值达标的基础上考虑剂量梯度、适形性评估指标,这对计划质量的提升、临床流程的规范有重要意义。Objective:To formulate an achievable recommendations of plan quality indices for different range of target volume which could be applied as a guideline to better radiotherapy plan designing in our clinic.Methods:The SBRT plan of 84 patients with HCC in our center was retrospectively analyzed.The dose estimation indices from guidelines of the American Radiotherapy Collaboration Group(RTOG)and the International Commission on Radiological Units and Measurements(ICRU)including conformity index(CI),homogeneity index(HI),gradient index(GI)and D 2 cm were calculated and statistically analyzed.Results:CI fluctuated within a small range of 0.97 to 1.31 which presented no significant correlation with PTV volume globally.GI and D 2 cm were significantly correlated with the target volume(P=0.001/P=0.001).As a conclusion,the acceptable ranges of the above evaluation indices for different target volumes are given.Conclusion:The results have small deviation compared with the reference in existing literature and RTOG 0915 guideline.The main benefit of this study is to provide acceptable range of plan quality metrics for liver SBRT apart from prescription dose coverage of PTV and dose limitation of OARs.Therefore,the new guidance formulated for the plan quality indices in liver SBRT paves the way for future clinical trials.

关 键 词：肝细胞癌 立体定向放射治疗 计划质量评估 适形性 剂量梯度 

分 类 号：R735.7[医药卫生—肿瘤]