共面与非共面调强放射治疗在局限期小细胞肺癌患者预防性海马保护性全脑放射治疗中的剂量学比较  

Dosimetric Comparison of Coplanar and Non-coplanar Intensity-Modulated Radiotherapy in Hippocampal Avoidance Radiotherapy Prophylactic Cranial Irradiation for Patients with Limited-Stage Small Cell Lung Cancer

作　　者：汤幸妮 庞笑珍 侯利桥 周超[1,2,3] 于长辉 贾海健[1,2,3] Tang Xingni;Pang Xiaozhen;Hou Liqiao;Zhou Chao;Yu Changhui;Jia Haijian(Taizhou Hospital of Zhejiang Province,Taizhou Zhejiang 317000,China;Taizhou Hospital Affiliated to Wenzhou Medical University,Taizhou Zhejiang 317000,China;Radiation Oncology Institute of Enze Medical Health Academy,Taizhou Zhejiang 317000,China)

机构地区：[1]浙江省台州医院,浙江台州317000 [2]温州医科大学附属台州医院,浙江台州317000 [3]恩泽医学健康研究院肿瘤放疗研究所,浙江台州317000

出　　处：《医疗装备》2025年第5期29-35,共7页Medical Equipment

摘　　要：目的探讨共面调强放射治疗(CO-IMRT)和非共面调强放射治疗(NC-IMRT)在小细胞肺癌(SCLC)患者预防性海马保护性全脑放射治疗(WBRT)中的剂量学差异。方法回顾性分析2019-2020年于医院放疗科接受固定野调强(FF-IMRT)技术进行预防性WBRT的20例患者的临床资料。对所有患者进行CO-IMRT和NC-IMRT计划,两种计划均满足美国肿瘤放射治疗协作组织(RTOG)0614和RTOG 0933的剂量限制标准且三维剂量验证均合格后,比较两种计划的计划靶区(PTV)剂量参数、典型病例的剂量分布图、危及器官(OARs)剂量参数、计划执行指标[包括机器跳数(MU)、治疗时间及三维验证通过率]。结果两种计划的PTV D98%、D2%、均匀性指数(HI)比较,差异无统计学意义(P>0.05);NC-IMRT的Dmedian、适形性指数(CI)大于CO-IMRT,差异有统计学意义(P<0.05)。两种计划的剂量覆盖体积相同,但是NC-IMRT比CO-IMRT的剂量覆盖更均匀,NC-IMRT的左侧和右侧海马区、左侧眼球、左侧和右侧晶体及脑干的Dmax均低于CO-IMRT,左侧海马区的Dmean低于CO-IMRT,差异有统计学意义(P<0.05)。NC-IMRT的MU少于CO-IMRT,治疗时间长于CO-IMRT,差异有统计学意义(P<0.05),但两种计划的三维验证通过率比较,差异无统计学意义(P>0.05)。结论两种计划均能实现预防性WBRT,同时保护海马区。但NC-IMRT比CO-IMRT的靶区剂量均匀性及对OARs保护性更好。Objective To explore the dosimetric differences between coplanar intensity-modulated radiation therapy(CO-IMRT)and non-coplanar intensity-modulated radiation therapy(NC-IMRT)in prophylactic hippocampal-sparing whole-brain radiation therapy(WBRT)for patients with small cell lung cancer(SCLC).Methods A retrospective analysis was conducted on the clinical data of 20 patients who received fixed-field intensity-modulated radiation therapy(FF-IMRT)technology for prophylactic WBRT in the Department of Radiotherapy of the hospital from 2019 to 2020.CO-IMRT and NC-IMRT plans were made for all patients.After both plans met the dose limitation criteria of the Radiation Therapy Oncology Group(RTOG)0614 and RTOG 0933 and passed the three-dimensional dose verification,the dose parameters of the planning target volume(PTV),the dose distribution diagrams of typical cases,the dose parameters of the organs at risk(OARs),and the plan execution indicators[including the machine monitor units(MU),treatment time,and the passing rate of three-dimensional verification]of the two plans were compared.Results There were no statistically significant differences in PTV D98%,D2%,and homogeneity index(HI)between the two plans(P>0.05);the Dmedian and conformity index(CI)of NC-IMRT were greater than those of CO-IMRT,and the differences were statistically significant(P<0.05).The dose coverage volumes of the two plans were the same,but the dose coverage of NC-IMRT was more uniform than that of CO-IMRT.The Dmax values of the left and right hippocampi,the left eye,the left and right lenses,and the brainstem in NC-IMRT were all lower than those in CO-IMRT,and the Dmean value of the left hippocampus in NC-IMRT was lower than that in CO-IMRT,with statistically significant differences(P<0.05).The MU of NC-IMRT was less than that of CO-IMRT,and the treatment time of NC-IMRT was longer than that of CO-IMRT,with statistically significant differences(P<0.05).There was no statistically significant difference in the passing rate of three-dimensional verificati

关 键 词：全脑放射治疗 海马保护 非共面调强放射治疗 小细胞肺癌 调强放射治疗 

分 类 号：R814.2[医药卫生—影像医学与核医学]