RayStation计划系统中不同最大子野数目对宫颈癌术后患者固定野调强放射治疗剂量学差异研究  

Analysis on effect of different max number of segments of RayStation planning system on postoperative fixed-field intensity-modulated radiotherapy for cervical cancer

作　　者：张爱平 龚翠 曹英华 李淑华 ZHANG Aiping;GONG Cui;CAO Yinghua;LI Shuhua(Departmentof Radiation Physics,Tumor Hospital of Jining,Jining,Shandong 272007,China)

机构地区：[1]济宁肿瘤医院物理室,山东济宁272007

出　　处：《社区医学杂志》2025年第3期96-101,共6页Journal Of Community Medicine

基　　金：济宁市重点研发计划项目(2024YXNS230)。

摘　　要：目的探究宫颈癌术后患者在RayStation7.0计划系统中设置不同最大子野数目(MNS)对固定野调强放射治疗(FF-IMRT)计划的剂量学差异的影响。方法随机选取2023-05-01-2024-01-31济宁肿瘤医院完成放射治疗的15例宫颈癌术后患者的影像学资料作为研究对象,采用RayStation7.0计划系统中5种不同的MNS(30、40、50、60和70)设置,在相同约束条件下,为每例患者分别设计5组FF-IMRT计划(即MNS30、MNS40、MNS50、MNS60和MNS70)。评估5组FF-IMRT计划的靶区和危及器官(OAR)的剂量-体积参数及均匀性指数(HI)、适形度指数(CI)、机器跳数(MU)的差异。结果在提高临床靶区(CTV)的靶区覆盖率(TC)方面,MNS50(99.32±0.33)%好于MNS30(98.84±0.49)%、MNS40(99.03±0.55)%,差异有统计学意义,t值分别为-3.899、-2.186,均P<0.05;在降低计划靶区(PTV)内最大体积剂量D2方面,MNS50(54.22±0.25)Gy好于MNS30(55.56±0.55)Gy、MNS40(54.82±0.41)Gy,差异有统计学意义,t值分别为9.983、6.348,均P<0.05;而MNS50与MNS60和MNS70相比,靶区剂量学差异无统计学意义,均P>0.05。随着MNS增加,MU也随之增加,分别为669.9±68.4、703.1±63.2、711.7±45.9、756.5±43.9、765.6±47.1,差异有统计学意义,t值分别为-3.335、-0.636、5.408、6.285,均P<0.05。在OAR保护方面,MNS50与MNS40差异无统计学意义(P>0.05),但随着子野数目的增加,OAR受照射剂量均有不同程度下降,其中MNS60和MNS70的直肠V45[(24.08±7.58)%、(22.43±7.32)%]、Dmean[(33.59±0.26)Gy、(33.07±0.25)Gy]和小肠V40[(111.84±70.86)cm^(3)、(110.36±66.01)cm^(3)]与MNS50[(27.05±8.88)%、(34.75±0.27)Gy、(123.73±72.59)cm^(3)]相比差异有统计学意义,t值分别为-4.197、-5.736、-6.339、-10.01、-5.779、-2.613,均P<0.05。结论在RayStation计划系统中,采用MNS50设计的宫颈癌术后FF-IMRT计划,不但具有较好的靶区适形度和均匀性,也能更有效保护正常组织,同时较少的MU缩短患者治疗时间,在提高治疗效率的同时也增加患者Objective To explore the dosimetric differences of fixed-field intensive-modulated radiotherapy(FF-IMRT)plan designed by different max number of segments(MNS) in RayStation planning system for cervical cancer.Methods The imaging data of fifteen patients with cervical cancer after radiotherapy in Tumor Hospital of Jining were randomly selectedfrom May 1,2023 to January 31,2024 to design FF-IMRT plans(MNS30,MNS40,MNS50,MNS60,and MNS70)by five MNS(30,40,50,60 and 70) under the same optimization function constraints in the RayStation7.0 TPS.The dose-volume parameters of target volume and OARs,conformity index(HI),homogeneity index(CI),and monitor unit(MU) were evaluated.Results In terms of improving the CTV's TC,MNS50(99.32 ± 0.33) % performed better than MNS30(98.84±0.49)% and MNS40(99.03±0.55)%,with statistically significant differences(t-values of-3.899 and-2.186,all P<0.05);In terms of reducing the PTV's D_(2),MNS50(54.22±0.25) Gy outperformed MNS30(55.56±0.55) Gy and MNS40(54.82±0.41) Gy,with statistically significant differences(t-values of 9.983 and 6.348,all P<0.05).However,there were no statistically significant differences between MNS50 and MNS60 or MNS70 in terms of target dose(all P>0.05),As the MNS increased,the MU showed varying degrees of improvement,with values of (669.9±68.4,703.1 ±63.2,711.7±45.9,756.5±43.9,765.6±47.1) showed statistically significant differences(t-values of-3.335,-0.636,5.408,6.285, all P<0.05).In terms of OAR protection,there was no statistically significant difference between MNS50 and MNS40(P>0.05).However,with the increase in subfield number,the radiation dose to OARs decreased to varying degrees.MNS60 and MNS70 compared to MNS50 in the rectum V_(45) [(24.08±7.58)%,(22.43±7.32)%],D_(mean) [(33.59±0.26) Gy,(33.07±0.25) Gy],and small intestine V_(40)[(111.84±70.86)cm^(3),(110.36±66.01) cm^(3)] showed statistically significant differences(t-values of-4.197,-5.736,-6.339,-10.01,-5.779,and-2.613,all P<0.05).Conclusions In the RayStation TPS,the FF-IMRT plan of cervi

关 键 词：宫颈癌 最大子野数目 固定野调强放射治疗 剂量学 

分 类 号：R737.33[医药卫生—肿瘤]