| 翟德胤,尹勇,陈进琥,等.RapidArc联合主动呼吸控制技术应用于胸段食管癌调强放疗的剂量学研究[J].中华放射医学与防护杂志,2012,32(4):364-368.ZHAI De-yin,YIN Yong,CHEN Jin-hu,et al.Dosimetric study of thoracic esophageal carcinoma radiotherapy using RapidArc combined with active breathing coordinator[J].Chin J Radiol Med Prot,2012,32(4):364-368 |
| RapidArc联合主动呼吸控制技术应用于胸段食管癌调强放疗的剂量学研究 |
| Dosimetric study of thoracic esophageal carcinoma radiotherapy using RapidArc combined with active breathing coordinator |
| 投稿时间：2011-12-13 |
| DOI：10.3760/cma.j.issn.0254-5098.2012.04.008 |
| 中文关键词: 食管肿瘤 调强放射治疗 旋转调强 剂量学 主动呼吸控制技术 |
| 英文关键词:Esophageal carcinoma Intensity modulated radiotherapy RapidArc Dosimetry Active breathing coordinator |
| 基金项目:山东省自然科学基金(ZR2010HM071); 山东省科技攻关项目(2011GGX10119) |
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| 中文摘要: |
| 目的 探讨RapidArc联合主动呼吸控制(ABC)技术在胸段食管癌调强放疗的剂量学特点。方法 选取10例接受放疗的胸段食管癌患者,在ABC辅助下选择吸气末屏气触发方式(mDIBH),触发阈值设定为呼吸曲线峰值的80%,和自由呼吸(FB)状态下分别行定位CT扫描,应用三维治疗计划系统为每例患者设计FB下的IMRT(IMRT-FB)和双弧RapidArc(Arc-FB)、mDIBH下的3个小弧RapidArc(Arc-ABC)3种调强放疗计划。评价靶区的D2%、D98%、V95,均匀指数(HI)和适形指数(CI),正常组织的相关剂量体积参数Vx,以及总机器跳数(MU)、总控制点数(control points)和治疗时间。结果 PTV的平均体积由FB下的376 cm3 减少到了mDIBH下的260 cm3。mDIBH下的双肺平均体积为5964.6 cm3, 而FB 则为3838.8 cm3,增加了35%;mDIBH和FB状态下平均心脏体积分别为524.4和642.7 cm3。Arc-ABC计划靶区的CI、HI及D2%、D98%、V95与 IMRT-FB和Arc-FB计划差异无统计学意义,双肺的V10、V20、V30、V40及平均剂量(Dmean)明显低于IMRT-FB 和Arc-FB (F=4.38、5.34、4.07、3.89、4.28,P<0.05),心脏的V20、V30、V40、Dmean及脊髓Dmax有不同程度的下降,但差异无统计学意义。Arc-ABC计划的总机器跳数和子野数也明显少于IMRT-FB计划(F=26.86、12.56,P<0.05)。结论 RapidArc联合ABC在胸段食管癌精确放疗中具有提高靶区剂量和降低肺组织受照剂量的作用。 |
| 英文摘要: |
| Objective To compare and analyze the dosimetric characteristics of the intensity-modulated arc therapy (RapidArc) combined with active breathing coordinator (ABC) in the thoracic esophageal carcinoma radiation therapy.Methods Ten thoracic esophageal carcinoma patients undergoing radiotherapy were selected for this study. The CT simulations were performed under three breath patterns respectively: moderate deep inspiration breath-hold (mDIBH) with ABC aid; Set the trigger threshold to 80% of the peak of the respiration curve; and free breathing (FB). Based on the corresponding CT image sets, three treatment plans were generated for each patient respectively: Arc-ABC(three small arcs), Arc-FB (consisted of two coplanar full arcs) and IMRT-FB plan. The following dosimetric parameters were compared among different plans: D2%, D98%, V95,homogeneity index(HI), conformal index(CI)the percentage of volume receiving dose of over x Gy (Vx), monitor unit (MU), control points and treatment time. Results The planning target volume (PTV) of FB was 376 cm3 which decreased to 260 cm3 after using ABC. For mDIBH and FB patients, the total lung volumes were 5964.6 cm3 (35% more than FB) and 3838.8 cm3 respectively; the heart volumes were 524.4 cm3 and 642.7 cm3 respectively. No significant difference was observed among Arc-ABC, IMRT-FB and Arc-FB in terms of D2, D98,V95, CI and HI. For Arc-ABC plans, there were significant decreases of radiation dose in total-lung’s V10, V20, V30, V40 and mean lung dose (F=4.38,5.34,4.07,3.89,4.28,P<0.05). Various dose decreases of heart V20, V3,V40, Dmean and spinal cord Dmax were observed, yet no statistically significant difference existed. The MUs and total control points of Arc-ABC plans were significantly lower than other plans (F=26.86,12.56,P<0.05).Conclusions When thoracic esophageal carcinoma patients were treated with radiotherapy, the combined utilization of RapidArc and ABC can potentially decrease the volume of irradiated lung yet escalate the dose in target. |
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