铅门自动跟随技术在多发性脑转移瘤容积调强计划中的剂量学研究  

Jaw automated tracking techniques in volumetric modulated arc therapy plans for multiple brain metastases

作　　者：金建华 李明[1] 袁波 李中亚 JIN Jianhua;LI Ming;YUAN Bo;LI Zhongya(Department of Radiation Oncology,Tumor Hospital Affiliated to Nantong University,Nantong 226361,China;Department of Radiation Oncology,Yunyang County People’s Hospital,Chongqing 404500,China)

机构地区：[1]南通大学附属肿瘤医院放疗科,南通226361 [2]云阳县人民医院肿瘤科,重庆404500

出　　处：《辐射研究与辐射工艺学报》2025年第1期49-55,共7页Journal of Radiation Research and Radiation Processing

基　　金：南通市科技局项目(MSZ20209)资助。

摘　　要：探讨铅门自动跟随(Jaw automated tracking,JAT)技术对多发性脑转移瘤容积调强(Volumetric modulated arc therapy,VMAT)计划质量的影响。选取云阳县人民医院2017年8月至2020年3月治疗的15例多发性脑转移瘤患者进行回顾性分析,分别采用JAT技术和铅门手动固定(Jaw manual fixed,JMF)技术设计两组VMAT计划。比较JAT和JMF两组计划在靶区的适形度指数CI、均匀性指数HI以及危及器官全脑、脑干的受照剂量。结果显示,JAT组较JMF组HI(0.060 vs.0.080,p<0.05)更优,全脑平均剂量(853.8 c Gy vs.893.4 c Gy,p<0.05)更低,低剂量体积V_(10) (56.1%vs.60.2%,p<0.05),V_(20)(28.5%vs.29.5%,p<0.05)更小,CI和脑干最大剂量无显著性差异。结果提示,使用JAT技术较JMF技术能得到更好的HI,降低全脑的低剂量体积,能更好地保护正常脑组织。This study investigated the dosimetric results and gamma passing rates of jaw-automated tracking(JAT)techniques in volumetric modulated arc therapy(VMAT)plans for patients with multiple brain metastases.From August 2017 to March 2020,15 patients with multiple brain metastases were enrolled in this study at Yunyang People's Hospital.For each patient,a VMAT plan was created using both the JAT and jaw manual fixed(JMF)techniques.Plan quality was evaluated by comparing the conformity index(CI),homogeneity index(HI),and dose to organs at risk,including the whole brain and brainstem.Evaluation indicators and dose distributions were compared between the JAT and JMF groups.The results indicated that the JAT plans demonstrated better HI(0.060 vs.0.080,p<0.05)and a lower mean dose for the whole brain(853.8 cGy vs.893.4 cGy,p<0.05).Additionally,the JAT plans exhibited reduced dose exposure in V_(10)(56.1%vs.60.2%,p<0.05)and V_(20)(28.5%vs.29.5%,p<0.05)compared to the JMF plans.No significant differences were observed between the two groups in terms of CI and maximum dose to the brainstem.In conclusion,VMAT plans utilizing JAT techniques can enhance HI and decrease dose exposure to the entire brain.

关 键 词：多发脑转移瘤 容积调强计划 铅门自动跟随 铅门手动固定 

分 类 号：R739.91[医药卫生—肿瘤] R815[医药卫生—临床医学]