中央型肺癌容积旋转调强放疗计划中减少肺低剂量体积的研究  

Method of Reducing Low-Dose Lung Volume in VMAT on Central Lung Cancer Planning

作　　者：张皓嘉 张毅 金海洁 游士虎 甘家应 胡银祥 ZHANG Haojia;ZHANG Yi;JIN Haijie;YOU Shihu;GAN Jiaying;HU Yinxiang(The Affiliated Hospital of Guizhou Medical University,Guiyang,551400;The Affiliated Cancer Hospital of Guizhou Medical University,Guiyang,551400)

机构地区：[1]贵州医科大学附属医院,贵阳市551400 [2]贵州医科大学附属肿瘤医院,贵阳市551400

出　　处：《中国医疗器械杂志》2025年第2期181-185,共5页Chinese Journal of Medical Instrumentation

基　　金：贵州省抗癌协会2023年科研项目(抗协科技〔2023〕015)。

摘　　要：目的研究中央型肺癌容积旋转调强放疗计划设计中,采用不同弧段以及不同形状剂量限制区,探讨有效降低肺V_(5)、V_(10)和肺平均剂量(mean lung dose,MLD)的方法。方法对入组病例分别设计5组计划:A组为全弧射野,B组为部分弧射野,C、D、E组为全弧射野,分别增加竖长条状、半环状和三角状剂量限制区,比较各组靶区的剂量学相似性及全肺V_(5)、V_(10)、V_(20)和MLD的剂量学差异。结果B、C、D、E组与A组相比,靶区均匀性指数和适形度指数均降低,全肺V_(5)和V_(10)明显降低。C、D、E组与A组相比,MLD降低。结论采用全弧射野同时增加剂量限制区,可有效降低肺V_(5)、V_(10)和MLD。Objective To study effective methods for reducing lung V_(5),V_(10),and mean lung dose(MLD)in the design of volumetric modulated arc therapy for central lung cancer by using different arc configurations and dose-limiting blocks designs.Methods Five groups of plans were designed for the enrolled patients.Group A used a full-arc field.Group B used a partial-arc field.Groups C,D,and E used full-arc fields with vertical-length,semi-ring,and triangular dose-limiting blocks added respectively.The dosimetric similarities of target areas and the dosimetric differences in lung V_(5),V_(10),V_(20),and MLD among the groups were compared.Results Compared with group A,groups B,C,D,and E had decreased homogeneity and conformity of the target area,but significantly lower V_(5) and V_(10) of the whole lung.The MLD of groups C,D,and E was lower than that of group A.Conclusion Using a full-arc field combined with dose-limiting blocks can effectively reduce lung V_(5),V_(10),MLD,and monitor units(MU).

关 键 词：肺癌 容积旋转调强 剂量限制区域 低剂量体积 

分 类 号：R815[医药卫生—放射医学] TH774[医药卫生—临床医学]