中华放射医学与防护杂志

李奇欣,岳麒,柏朋刚,等.鼻咽癌三种调强放疗计划剂量学对比研究[J].中华放射医学与防护杂志,2014,34(8):613-616.Li Qixin,Yue Qi,Bai Penggang,et al.Dosimetric comparison of three intensity-modulate radiation therapy treatment modules for nasopharyngeal carcinoma[J].Chin J Radiol Med Prot,2014,34(8):613-616

鼻咽癌三种调强放疗计划剂量学对比研究

Dosimetric comparison of three intensity-modulate radiation therapy treatment modules for nasopharyngeal carcinoma

投稿时间：2013-05-21

DOI：10.3760/cma.j.issn.0254-5098.2014.08.013

中文关键词: 鼻咽癌容积旋转调强断层螺旋调强固定野调强剂量学

英文关键词:Nasopharyngeal carcinoma Volumetric-modulated radiotherapy Helical tomotherapy Fixed field intensity-modulated radiation therapy Dosimetry

基金项目:

作者	单位	E-mail
李奇欣	350014 福州, 福建省肿瘤医院放疗科
岳麒	昆明医科大学第一附属医院放疗科
柏朋刚	350014 福州, 福建省肿瘤医院放疗科
陈开强	350014 福州, 福建省肿瘤医院放疗科
张秀春	350014 福州, 福建省肿瘤医院放疗科	tongzhangxiuchun@126.com
林少俊	350014 福州, 福建省肿瘤医院放疗科
瞿宜艳	350014 福州, 福建省肿瘤医院放疗科

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中文摘要:

目的对比鼻咽癌常规固定野调强（IMRT）、容积旋转调强（VMAT）以及断层调强（HT）3种不同调强放疗计划的剂量学差异。方法选择18例接受VMAT治疗的鼻咽癌患者，以相同处方剂量和目标条件分别重新进行IMRT和HT计划设计。比较3种计划靶区的均匀度（HI）、适形度（CI）、最大剂量以及平均剂量。危及器官的最大量和平均量以及感兴趣区的剂量体积、计划执行时间和机器跳数（MU）。结果 3种计划在靶区的覆盖率满足临床要求。IMRT计划在靶区的HI和CI方面结果最差，HT计划结果最优。危及器官方面，IMRT计划受量最高，HT计划的脊髓、脑干和腮腺受量最低；但对于视神经、晶状体以及视交叉HT计划的受量最高而VMAT计划的受量最低。IMRT的治疗时间（8.0±0.5） min高于VMAT（3.9±0.1）min和HT（7.4±0.9）min。与VMAT相比，IMRT每次治疗为（711.4±78.7）MU，高于VMAT的（596.4±33.7）MU。结论鼻咽癌IMRT、VMAT以及HT计划在靶区覆盖和危及器官保护上都可以达到临床要求，在靶区的适形度和均匀性上HT计划优于VMAT和IMRT，但在治疗时间和加速器的机器跳数上VMAT较有优势。

英文摘要:

Objective To compare the dosimetric differences of fixed field intensity-modulated radiation therapy(IMRT), volumetric modulated arc therapy (VMAT) and helical tomotherapy (HT) for nasopharyngeal carcinoma(NPC) patients. Methods Eighteen NPC patients previously treated with VMAT were retrospectively included and re-planned using HT and IMRT (7 fields) techniques utilizing the same dose prescription and optimization objectives. The following parameters were compared across the three types of plans: homogeneity index (HI), conformity index (CI), maximum dose (D_max) and mean dose (D_mean) of targets; the D_max and D_mean of organs at risk (OARs); the doses and volumes of volume of interest; the treatment delivery time and monitor units (MU). Results Clinically acceptable target coverage could be achieved by IMRT, VMAT and HT plans. The HT plans were the best yet IMRT plans were the worst in HI and CI of targets. IMRT imposed highest doses to OARs while HT deposited least doses to the spinal cord, brainstem and parotid. However, the VMAT plans displayed the lowest doses on optic nerves, chiasma and lens while highest doses were found in IMRT plans. The average delivery time per fraction of IMRT (8.0±0.5) min were more than that of HT (7.4±0.9) min and VMAT (3.9±0.1) min plans. The MUs of IMRT plans (711.4±78.7) were larger than that of VMAT plans (596.4±33.7). Conclusions Three types of plans can all achieve the clinical dosimetric demands, but HT has the best performance on CI and HI. VMAT is most efficient regarding the delivery time and total MUs.

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