| 卢洁,尹勇,范廷勇,孙涛,刘波,张桂芳.鼻咽癌调强放疗中实施同一计划对剂量的影响[J].中华放射医学与防护杂志,2008,28(5):456-458 |
| 鼻咽癌调强放疗中实施同一计划对剂量的影响 |
| Effect of the same plan on doses to patients during radiotherapy with nasopharyngeal carcinoma |
| 投稿时间：2008-05-08 |
| DOI： |
| 中文关键词: 鼻咽癌 调强放疗 同一计划 剂量 |
| 英文关键词:Nasopharyngeal carcinoma Intensity modulated radiotherapy The same plan The influence of dose |
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| 中文摘要: |
| 目的 探讨鼻咽癌调强放疗过程中实施同一治疗计划的可行性。方法 选10例采用调强放射治疗的鼻咽癌患者,用Pinnacle3制定IMRT计划。在患者放疗中期重新行CT定位扫描,把基于初次定位CT图像所做的IMRT计划复制到重新定位CT图像上,使得照射野参数保持一致,测得基于两套图像计划中的肿瘤靶区、脊髓、脑干和腮腺的受量。统计在整个放疗过程中如果实施同一计划,患者靶区及各器官的剂量变化率。结果 两组计划相比,等中心层面外轮廓左右和前后长度平均缩小8%、3%。靶区PTV1(D95)减少0.6%~5.3%;放疗中期和放疗前相比右侧和左侧腮腺体积分别缩小13.1%~41.4%、12.0%~49.0%;右侧和左侧腮腺平均剂量增加5.6%~45.1%、3.3%~32.2%;脊髓最大剂量变化为-4.1%~13.9%;脑干剂量变化为-3.9%~9.3%。结论 对于采用鼻咽癌调强放射治疗的患者,在不考虑摆位误差的影响因素下,由于靶区及正常组织显著变化等因素影响有重新定位修改计划的必要性。 |
| 英文摘要: |
| Objective To evaluate the feasibility of primitive IMRT plan was used throughout the treatment course in the nasopharyngeal carcinoma. Methods Ten patients with nasopharyngeal carcinoma who had undergone radiotherapy by IMRT were selected. IMRT plan was designed by Pinnacle3 planning system. During the middle period of the irradiation, the secondary scans were made with the same CT parameters of the first, and then to copy the primitive plan to secondary CT image,the same energy, beam angles, control points, and optimization parameters were used for dose calculations for each paired plans using a treatment optimization system. The two plans were compared using a set of parameters derived from DVHs and dose-volume statistics. Detailed analysis of the dose distribution of the treatment volume. Results The secondary plan was compared with the first plan. At the isocenter layer,the mean length was decreased to 8% in the anterior-posterior direction and 3% in the left-right direction. PTV1(D95)was decreased to 0.6%-5.3%;the extent of the averaged volume to the right/left parotids was decreased to13.1%-41.4%and 12.0%-49.0%,respectively;The averaged dose to the right/left parotids was increase to 5.6%-45.1%and 3.3%-32.2%respectively;the waving extent of Dmax to the spine cord and brain stem are -4.1%-13.9%,-3.9%-9.3%,respectively. Conclusions Our planning study showed that there were the essentiality to modify the plan to correcting the target and normal tissue variation in treatment courses in the nasopharyngeal carcinoma. |
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