局部晚期头颈鳞癌螺旋断层放射治疗与普通调强放射治疗的剂量学比较  

The Comparison of Dosimetry Between Helical Tomotherapy and Conventional Intensity-Modulated Radiation Therapy for Locally Advanced Head and Neck Squamous Cell Carcinoma

作　　者：黄念 窦钰姣 Huang Nian;Dou Yujiao(Qiyang People's Hospital,Qiyang Hunan 426100,China;Xiangya Hospital of Central South University,Changsha Hunan 410008,China)

机构地区：[1]祁阳市人民医院,湖南祁阳426100 [2]中南大学湘雅医院,湖南长沙410008

出　　处：《医疗装备》2024年第23期34-37,共4页Medical Equipment

摘　　要：目的 分析局部晚期头颈鳞癌螺旋断层放射治疗(TOMO)和普通调强放射治疗(IMRT)的剂量学差异。方法 选取2019年6月至2022年12月在医院行TOMO治疗的30例局部晚期头颈鳞癌患者,将TOMO放射治疗计划命名为TOMO组;另外将患者影像和结构信息导入Varian计划系统进行IMRT计划设计,命名为IMRT组。比较两组靶区相关指标[靶区平均剂量(D_(mean))、均匀性指数(HI)、靶区的适形性指数(CI)]、危及器官剂量[外扩3 mm的计划风险体积(PRV)、PRV中3 cm^(3)体积接受的最大剂量(D_(3cc))、并行器官体积剂量、喉和口腔等器官平均剂量]。结果 两组放射治疗计划靶区D_(mean)比较,差异无统计学意义(P>0.05),TOMO组HI值均高于IMRT组,CI值均低于IMRT组,且TOMO组HI、CI值较IMRT组均更接近于1,差异有统计学意义(P<0.05)。两组危及器官视交叉和视交叉PRV D_(3CC)比较,差异无统计学意义(P>0.05)。IMRT组其他所有器官的最大剂量均大于TOMO组,差异有统计学意义(P<0.05)。结论 TOMO放射治疗可明显改善局部晚期头颈鳞癌靶区的适形性和均匀性,降低大部分危及器官的受照剂量,局部晚期头颈鳞癌患者获益明显。Objective To analyze the dosimetric differences between helical tomotherapy(TOMO)and conventional intensity-modulated radiation therapy(IMRT)for locally advanced head and neck squamous cell carcinoma.Methods With the selection of 30 patients with head and neck squamous cell carcinoma who underwent TOMO treatment in the hospital from June 2019 to December 2022,the original TOMO radiotherapy plan was selected and named the TOMO group;In addition,the patient imaging and structural information were imported into Varian planning system for IMRT plan design,which was named IMRT group.Target-related indicators[the mean dose(D_(mean)),homogeneity index(HI),conformity index(CI)]and the dose of organs at risk[plan risk volume(PRV)with 3 mm margin expansion,the 3 maximum dose received in a 3 cm^(3) volume in the PRV(D_(3cc)),parallel organ volume dose,and mean dose of larynx and oral cavity]were compared between the two groups.Results There was no statistically significant difference in the Dmean of the radiotherapy plan target area between the two groups(P>0.05),all HIs in the TOMO group were higher than those in the IMRT group,and the HI and CI values in the TOMO group were both closer to 1 than in the IMRT group,with statistically significant differences(P<0.05).There was no significant difference in the PRV D_(3CC) of optic chiasma in organs at risk between the two groups(P>0.05),the other CI and HI indexes of the organs at risk in IMRT group were higher than those in TOMO group,and the differences were statistically significant(P<0.05).Conclusion TOMO radiotherapy can significantly improve the conformity and homogeneity of the target area in locally advanced head and neck squamous cell carcinoma,reduce the radiation dose to most organs at risk,and have obvious benefits for patients with locally advanced head and ndck squamous cell carcinoma.

关 键 词：局部晚期头颈鳞癌 TOMO 剂量 危及器官 

分 类 号：R730.55[医药卫生—肿瘤]