| 毛必静,王文玲,洪卫,董红敏,李媛媛,王鹤然.直肠癌术后盆腔不同放疗技术的剂量学研究[J].中华放射医学与防护杂志,2010,30(1):37-39 |
| 直肠癌术后盆腔不同放疗技术的剂量学研究 |
| Dosimetry of three-dimensional conformal, IMRT and simplified IMRT on rectal cancer post-operative pelvic radiotherapy |
| 投稿时间：2009-03-28 |
| DOI： |
| 中文关键词: 直肠肿瘤 放射治疗 三维适形放疗 适形调强放疗 简化调强放疗 剂量学 |
| 英文关键词:Rectal neoplasms Radiotherapy Three-dimensional conformal radiotherapy Intensity-modulated radiotherapy Simplified intensity-modulated radiotherapy Dosimetry |
| 基金项目:贵州省科学技术基金(E2008-20) |
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| 中文摘要: |
| 目的 比较直肠癌术后盆腔三维适形放疗(3DCRT)、适形调强放疗(IMRT)和简化调强(sIMRT)技术的三维剂量学特点,为直肠癌术后辅助放疗照射方法的优选提供依据。方法 选择Ⅱ～Ⅲ期直肠癌经腹前切除(Dixon手术)术后盆腔放疗的10例患者分别行3DCRT、sIMRT和IMRT3种计划设计,利用剂量体积直方图评价不同照射技术对靶区和正常组织照射剂量和靶区适形指数(CI)及剂量不均匀性指数(HI)。结果 不同放疗技术的剂量学研究:1CI为IMRT＞sIMRT＞3DCRT(t=7.48、9.13,P＜0.05)。23种治疗计划PTV靶区剂量分布的均匀度3DCRT最好,IMRT和sIMRT相似,但两者差异无统计学意义。3对膀胱的保护,IMRT明显优于3DCRT,sIMRT稍低于IMRT;对小肠的保护,sIMRT优于3DCRT,但IMRT并不比sIMRT具有更多优势;对结肠的保护,3种计划差异无统计学意义;对股骨头的保护,IMRT及sIMRT均明显好于3DCRT。IMRT、sIMRT对上述危及器官的保护优势主要体现在高剂量区。43种不同放疗技术的机器子野跳数sIMRT的子野跳数(543.0±69.8)与3DCRT技术(569.7±48.7)相当,但显著低于IMRT计划(770.3±73.1)。结论 在直肠癌术后放疗中sIMRT放疗技术具有最优性价比。 |
| 英文摘要: |
| Objective To compare the dosimetry difference among three-dimensional conformal radiotherapy(3DCRT), simplified intensity-modulated radiotherapy (sIMRT) and intensity-modulated radiotherapy (IMRT) in whole pelvic irradiation in postoperative rectal carcinoma, in order to optimize the protocol for clinical practice. Methods From 2006 to 2008, 10 patients with stage Ⅱand Ⅲ rectal cancer after radical resection (Dixon surgery) participated in this study. 3DCRT, sIMRT and IMRT were performed for each patient. The dose distribution of target volume and normal tissues, conformal index (CI) and HI were analyzed using the dose-volume histogram (DVH). Results The CI for PTV of IMRT and sIMRT was superior to that of 3DCRT. 3DCRT had the best HI in PTV target area dose distribution, while IMRT was similar with sIMRT, however, there were no significant difference among them. As regarded as the protection on organs at risk, for bladder, IMRT was superior to 3DCRT and slightly better than sIMRT; for small intestine, sIMRT showed better performance than 3DCRT while IMRT was better than sIMRT but with no significant difference; for colon, no dosimetry difference was found among three plans; for caput femoris, IMRT and sIMRT were better than 3DCRT. Additionally, sIMRT was similar to 3DCRT in MU of segments, but significantly lower than IMRT. The mean values of total MU for 3DCRT, sIMRT and IMRT were 569.73±48.69, 542.97±69.78, and 770.25±73.12, respectively. Conclusions All of 3DCRT, sIMRT and IMRT could provide target area with sufficient and accurate dose, meanwhile they could also protect organs at risk well on rectal cancer after radical resection. Compared with 3DCRT plan and IMRT plan, sIMRT plan might be the optimal plan for clinical practice. |
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