Monaco计划系统中不同调强技术协同射野数变化对宫颈癌放疗剂量分布的影响  

Effect of Changes in the Number of Synergistic Fields of Different Intensity Modulation Techniques in the Monaco Planning System on the Dose Distribution of Radiotherapy for Cervical Cancer

作　　者：朱彤[1] 刘景[1] 谭洪文[1] 刘攀 Zhu Tong;Liu Jing;Tan Hongwen;Liu Pan(Ji'an Central People's Hospital,Ji'an Jiangxi 343000,China)

机构地区：[1]江西吉安市中心人民医院,江西吉安343000

出　　处：《医疗装备》2025年第5期1-4,8,共5页Medical Equipment

基　　金：江西省吉安市科学技术局指导性项目(20233-043564)。

摘　　要：目的探讨固定野静态调强放疗(S-IMRT)技术和固定野动态调强放疗(D-IMRT)技术在5野、7野均分条件下放疗中的剂量学差异。方法选取2022年3月至2024年5月于医院拟行放射治疗的20例宫颈癌术后患者为研究对象,基于Monaco计划系统,在相同优化条件下依次设计5野S-IMRT(S-IMRT-5)、7野S-IMRT(S-IMRT-7)、5野D-IMRT(D-IMRT-5)、7野D-IMRT(D-IMRT-7)计划,比较4种计划的计划靶区(PTV)剂量学指标、危及器官(OARs)剂量学指标及机器参数。结果4组计划的平均剂量(Dmean)比较,差异无统计学意义(P>0.05);D-IMRT-7和S-IMRT-7计划的最大剂量(Dmax)、D98%、适形性指数(CI)、均匀性指数(HI)均小于S-IMRT-5和D-IMRT-5,S-IMRT-7计划的D2%小于S-IMRT-5和D-IMRT-5(P<0.05);小肠、膀胱和直肠的S-IMRT-7和D-IMRT-7计划V_(20)、V30、V_(40)、V_(50)均小于S-IMRT-5,左、右股骨头的S-IMRT-7、D-IMRT-5和D-IMRT-7计划V_(20)均小于S-IMRT-5(P<0.05);D-IMRT-7计划中,小肠的V_(20)和V30、膀胱的V_(40)、直肠的V_(40)和V_(50)以及左、右股骨头的V_(20)均小于D-IMRT-5;D-IMRT-7计划的子野数、MU大于S-IMRT-5和S-IMRT-7,D-IMRT-7计划的ETDT小于S-IMRT-7(P<0.05)。结论在宫颈癌术后放疗中,7野均分条件下的PTV适形性和均匀性更好,D-IMRT-7计划的OARs剂量低于D-IMRT-5,且D-IMRT-7计划的治疗时间更短,推荐于宫颈癌术后放疗中应用。Objective To investigate the dosimetric difference between fixed-field static intensity-modulated radiotherapy(S-IMRT)and fixed-field dynamic intensity-modulated radiotherapy(D-IMRT)in 5-field and 7-field equalization conditions.Methods Twenty postoperative patients with cervical cancer who were to undergo radiotherapy at the hospital from March 2022 to May 2024 were selected for the study,and the 5-field S-IMRT(S-IMRT-5),7-field S-IMRT(S-IMRT-7),5-field D-IMRT-5(D-IMRT),and 7-field D-IMRT(D-IMRT-7)plans,comparing the planning target volume(PTV)dosimetric metrics,organ at risk(OARs)dosimetric metrics,and machine parameters of the 4 plans.Results The mean dose(Dmean)of the 4 plans was not statistically significant when compared(P>0.05);Dmax,D98%,conformity index(CI),and homogeneity index(HI)of the D-IMRT-7 and S-IMRT-7 plans were smaller than those of the S-IMRT-5 and D-IMRT-5,and D2%of the S-IMRT-7 plan was smaller than those of the S-IMRT-5 and D-IMRT-5(P<0.05);V_(20),V30,V_(40),and V_(50)of S-IMRT-7 and D-IMRT-7 plans for small intestine,bladder,and rectum were smaller than those of S-IMRT-5,and V_(20)of S-IMRT-7,D-IMRT-5,and D-IMRT-7 plans for left and right femur were smaller than those of S-IMRT-5(P<0.05);In the D-IMRT-7 program,V_(20)and V30 in the small intestine,V_(40)in the bladder,V_(40)and V_(50)in the rectum,and V_(20)in the left and right femoral heads were smaller than D-IMRT-5;the number of subfields of the D-IMRT-7 plan,MU were larger than those of S-IMRT-5 and S-IMRT-7,and the ETDT of D-IMRT-7 program was shorter than that of S-IMRT-7(P<0.05).Conclusion In postoperative radiotherapy for cervical cancer,the PTV conformability and homogeneity were better in 7-field homogeneous conditions,the dose of OARs was lower in the D-IMRT-7 plan than in the D-IMRT-5,and the treatment time was shorter in the D-IMRT-7 plan,which is recommended for postoperative radiotherapy for cervical cancer.

关 键 词：宫颈癌 固定野调强 Monaco 剂量学 

分 类 号：R814.2[医药卫生—影像医学与核医学]