MatrixX两种剂量验证方法在乳腺癌动静态调强放疗计划剂量验证中的对比研究  

Comparison of two dosimetric verification methods of MatrixX in plan verification of dynamic and static intensity modulated radiotherapy for breast tumor

作　　者：范亚明 郁家文 年峰[1] 沈少艳 Fan Yaming;Yu Jiawen;Nian Feng;Shen Shaoyan(Department of Radiotherapy,The Third People’s Hospital of Bengbu,Bengbu 233000,China)

机构地区：[1]蚌埠市第三人民医院放射治疗科,蚌埠233000

出　　处：《现代仪器与医疗》2025年第1期63-69,共7页Modern Instruments & Medical Treatment

基　　金：蚌埠医科大学科技项目(自然科学重点):乳腺癌保乳术后切线调强放疗的剂量学与验证方法研究。

摘　　要：目的 比较IBAMatrixX两种剂量验证方法在乳腺癌动静态调强计划剂量验证中的差异。方法 选取2023年11月—2024年10月蚌埠市第三人民医院收治的20例需要放疗的乳腺癌女性患者,包括保乳术后(Breast Conserving Surgery,BCS)患者10例,根治术后(Radical Mastectomy,RM)患者10例,利用IBA MatrixX分别对每位患者的静态调强(Static Intensity Modulated Radiation Therapy,s IMRT)和动态调强(dynamic Intensity Modulated Radiotherapy,dIMRT)治疗计划进行机架角度归零和实际机架角度多野合成的两种方法的剂量验证,根据不同评判标准比较剂量验证γ通过率。结果 八组放疗计划在3mm/3%标准下γ通过率均大于95%满足临床要求,随着标准的提高逐渐变差。同种调强模式下,机架角度归零组明显优于实际机架组,差异有统计学意义(P <0.05);同种验证方法,不同调强模式,在2mm/2%、2mm/3%、3mm/3%标准条件下,sIMRT与dIMRT比较差异均无统计学意义(P>0.05),在1mm/1%标准下,BCS_sIMRT_0组优于BCS_dIMRT_0组、RM_sIMRT组优于RM_dIMRT组,差异有统计学意义(P <0.05)。在BEV方向BCS患者PTV边缘到射野中心X、Y轴方向平均最大垂直距离分别为(9.80±1.72)cm、(7.18±1.48)cm,RM患者分别为(12.89±2.13)cm、(9.48±0.98)cm,实际机架角度多野合成验证方法 γ通过率不受PTV边缘到X轴距离的影响(P>0.05),但RM患者的γ通过率与PTV边缘到Y轴距离呈负相关性(r <0),且具有统计学意义(P <0.05)。结论 对于乳腺癌偏中心切线野IMRT放疗计划进行验证时,选择3mm/3%标准时,可采用更符合真实照射情况的实际机架角度多野合成的验证方法,选择2mm/2%、2mm/3%标准时,在保证严格质量控制的前提下,可以选择机架角度归零多野合成的验证方法,从而更快速获取剂量误差,提高工作效率。Objective To explore the difference between two dosimetric verification methods by using the IBA MatrixX in the verification of dynamic and static intensity modulated plan for breast tumor.Methods A total of 20 breast tumor patients treated with postoperative radiotherapy in our hospital form November 2023 to October 2024 were selected.The integrated dosimetric measurement of static intensity modulation(sIMRT)and dynamic intensity modulation(dIMRT)treatment plans for each patient were measured with the gantry fixed at 0 degree for all beams and actual gantry.According to different 1mm/1%,2mm/2%,2 mm/3%and 3mm/3%standards,theγpassing rate of each measurement result was analyzed.Results Under the 3mm/3%standard,theγpassing rate of each measurement result was greater than 95%,which meets clinical requirements.Theγpassing rate with the continuous improvement of the standard,the differences in dose distribution gradually become more prominent,and theγpassing rate gradually deteriorates.Under the same intensity modulation mode,the gantry Angle zeroing group was significantly better than the actual gantry group,and the difference was statistically significant(P<0.05).There was no significant difference between sIMRT and dIMRT under 2mm/2%,2mm/3%,3mm/3%standard conditions with the same verification method and different intensity modulation modes(P<0.05).At the 1mm/1%standard,the BCS_sIMRT_0 was better than the BCS_dIMRT_0,and the RM_sIMRT was better than RM_dIMRT,and the difference was statistically significant(P<0.05).In the BEV direction,the average maximum vertical distances from the PTV edge to the center of the shooting field in X and Y axis directions were(9.80±1.72)cm and(7.18±1.48)cm in BCS group,and(12.89±2.13)cm and(9.48±0.98)cm in RM group,respectively.Actual gantry Angle multi-field combination verification methodγpass rate is not affected by PTV edge to X wheelbase separation(P<0.05),but theγpass rate of RM group was negatively correlated with PTV edge to Y wheelbase departure(r<0)and were statisti

关 键 词：MatrixX 乳腺癌 动态调强 静态调强 γ通过率 剂量验证 

分 类 号：R737.9[医药卫生—肿瘤] TH77[医药卫生—临床医学]