| 杨岩丽,李宝生,尹勇,陈进琥,孙涛,孙洪福.三维适形、逆向调强和旋转调强放疗技术治疗胸段食管癌的剂量学比较[J].中华放射医学与防护杂志,2012,32(1):65-69 |
| 三维适形、逆向调强和旋转调强放疗技术治疗胸段食管癌的剂量学比较 |
| Dosimetric comparison of three-dimensional conformal radiotherapy, intensity-modulated radiotherapy and RapidArc in treatment of thoracic esophageal cancer |
| 投稿时间：2011-04-06 |
| DOI：10.3760/cma.j.issn.0254-5098.2012.01.016 |
| 中文关键词: 食管癌 剂量学参数 三维适形放疗 调强放射治疗 旋转调强 |
| 英文关键词:Thoracic esophageal cancer Dosimetric parameter Three-dimensional conformal radiotherapy Intensity-modulated radiotherapy Volumetric modulated arc radiotherapy |
| 基金项目:国家自然科学基金(30670617) |
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| 中文摘要: |
| 目的 比较胸段食管癌3种放疗技术(3D-CRT、IMRT、RapidArc)的剂量学特点,并分析3种技术的优劣及应用特点。方法 15例胸段食管癌患者入组,依据CT图像,勾画靶区,针对患者的同一套CT图像的相同靶区分别制定3D-CRT、5野IMRT(IMRT5)、7野IMRT(IMRT7)、9野IMRT(IMRT9)、单弧Arc(Arc1)、双弧Arc(Arc2)共6套计划。PTV处方剂量为40 Gy分20次4周+19.6 Gy分14次7 d。结果 3D-CRT计划各项靶区剂量学参数明显差于IMRT计划及RapidArc计划(t=5.77、3.52,P<0.05),6套计划的PTV V95(%)分别为:3D-CRT (91.55±2.90),IMRT5 (96.66±1.05),IMRT7 (96.87±1.23),IMRT (96.81±1.16),Arc1 (94.98±1.41),Arc2 (95.93±1.32)。RapidArc计划的靶区适形度(CI)最好(t=3.76,10.01,P<0.05),IMRT计划的靶区均匀性(HI)最好(t=3.93、3.37,P<0.05)。危及器官参数RapidArc与IMRT各计划之间差异无统计学意义。3D-CRT和RapidArc计划的机器跳数明显少于IMRT计划,差异高达75%。结论 对于胸段食管癌患者,采用IMRT或RapidArc技术可以在保护正常组织的同时,涵盖临床必需的治疗靶区。3D-CRT计划对降低正常组织低剂量散射区方面优势明显。RapidArc计划靶区剂量学参数与IMRT计划比较未见明显优势。 |
| 英文摘要: |
| Objective To compare the dosimetric characteristics of intensity-modulated arc therapy(IMAT), fixed-gantry intensity-modulated radiotherapy (IMRT) and 3-dimensional conformal radiotherapy (3D-CRT) for the thoracic esophageal cancer. Methods A total of 15 patients with thoracic esophageal cancer were enrolled. 3D-CRT, 5-field IMRT(IMRT5), 7-field IMRT(IMRT7), 9-field IMRT(IMRT9), single arc(Arc1) and double arc(Arc2) RapidArc plans were generated for each patient. All plans were prescribed 40 Gy in 20 fractions and 19.6 Gy in 14 fractions to PTV at 95% isodose line. Results RapidArc and all IMRT treatment plans in dosimetric parameters of target volumes were obviously better compared to 3-dimentional conformal treatments(t=5.77,3.52,P<0.05). The result of V95 of PTV for 3D-CRT, IMRT5, IMRT7, IMRT9, Arc1 and Arc2 plans was 91.55±2.90, 96.66±1.05, 96.87±1.23, 96.81±1.16, 94.98±1.41 and 95.93±1.32, respectively. The best conformation index in PTV was observed in the RapidArc plans(t=3.76,10.01,P<0.05), and the best homogeneity index in PTV was observed in the IMRT plans(t=3.93,3.37,P<0.05). In terms of organ sparing, no statistical difference was observed between IMRT and RapidArc plans(P>0.05), while 3D-CRT provided the lowest number of V1 cGy and V5 cGy for total lung. Compared with the IMRT treatment plans, the number of monitor units was lower in all 3D-CRT and RapidArc cases with differences of 75%. Conclusions All the IMRT and RapidArc plans could offer high quality treatment for patients. 3D-CRT might show advantage in low-dose region to organs at risk. Compared with IMRT,no obvious advantage in PTV dosimetric parameters could be observed in RapidArc plans. |
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