中华放射医学与防护杂志

冯仲苏,吴昊,蒋璠,刘卓伦,程金生,苏旭.铅门跟随技术与铅门固定技术在直肠癌术前调强放疗中的剂量学比较[J].中华放射医学与防护杂志,2014,34(12):938-941

铅门跟随技术与铅门固定技术在直肠癌术前调强放疗中的剂量学比较

Dosimetric comparison of jaw tracking technique with static jaw technique in intensity-modulated radiotherapy for preoperative radiotherapy of rectal cancer

投稿时间：2014-06-25

DOI：10.3760/cma.j.issn.0254-5098.2014.12.018

中文关键词: 铅门跟随铅门固定直肠癌调强放疗剂量学

英文关键词:Jaw tracking Static jaw Rectal cancer Intensity-modulated radiation therapy Dosimetry

基金项目:卫生行业科研专项(201002009)

作者	单位	E-mail
冯仲苏	中国疾病预防控制中心辐射防护与核安全医学所辐射防护与核应急中国疾病预防控制中心重点实验室, 北京 100088
吴昊	北京大学肿瘤医院暨北京市肿瘤防治研究所放射治疗科恶性肿瘤发病机制及转化研究教育部重点实验室, 北京 100088
蒋璠	北京大学肿瘤医院暨北京市肿瘤防治研究所放射治疗科恶性肿瘤发病机制及转化研究教育部重点实验室, 北京 100088
刘卓伦	北京大学肿瘤医院暨北京市肿瘤防治研究所放射治疗科恶性肿瘤发病机制及转化研究教育部重点实验室, 北京 100088
程金生	中国疾病预防控制中心辐射防护与核安全医学所辐射防护与核应急中国疾病预防控制中心重点实验室, 北京 100088
苏旭	中国疾病预防控制中心辐射防护与核安全医学所辐射防护与核应急中国疾病预防控制中心重点实验室, 北京 100088	suxu@nirp.cn

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中文摘要:

目的研究固定射野动态调强放疗铅门跟随技术与铅门固定技术在直肠癌术前调强放疗中的剂量学差异.方法采用两种治疗技术对10例直肠癌术前患者设计治疗计划.在95%体积的计划靶区(PTV)和计划肿瘤区(PGTV)满足处方剂量的前提下,尽量降低危及器官的剂量.比较两组治疗计划的剂量-体积直方图,评估靶区及危及器官的剂量分布.分别将两组治疗计划用电离室矩阵2D-Array 729和OCTAVIUS(PTW)模体进行剂量验证.结果两组计划的靶区均达到临床处方剂量的要求.PTV和PGTV的最大剂量与平均剂量差异无统计学意义.铅门跟随动态调强计划中全身的V₅、V₁₀、V₂₀、V₃₀、V₄₀、D_mean以及双侧股骨头、膀胱、小肠的V₁₀、V₂₀、V₃₀和D_mean均低于铅门固定动态调强计划的相应值,差异有统计学意义(t=-2.32~12.24,P<0.05);双侧股骨头、膀胱、小肠的V₄₀以及D_max差异无统计学意义.采用γ-2D分析两组计划的通过率,两组计划均通过剂量验证.结论直肠癌术前放疗患者采用固定射野动态调强放疗铅门跟随技术与铅门固定技术两种技术,其靶区和危及器官受量均能满足临床治疗要求,而铅门跟随技术能够更好地降低正常组织和危及器官的低剂量照射.

英文摘要:

Objective To compare the dosimetric difference between jaw tracking technique (JTT) and static jaw technique (SJT) in dynamic intensity-modulated radiotherapy(IMRT) for preoperative radiotherapy of rectal cancer patients. Methods Jaw tracking and static jaw were used to develope the intensity-modulated plans for 10 patients respectively. For all the patients, the dose to surrounding tissues was minimized as low as possible, the 95% volume of the planning target volume (PTV) and planning gross target volume (PGTV) satisfy the prescribed dose. The doses of the planning target volumes, organs at risk and normal tissue were detected by dose-volume histogram. Two groups of treatment plan dose were verified by ionization chamber array 2D-Array 729 and OCTAVIUS(PTW) phantom. Results The treatment plans of two groups could satisfy the clinical requirements. There was no significant difference between the maximum and the mean dose of target. The volumes of jaw tracking dynamic intensity-modulated radiotherapy were lower, including the V₅, V₁₀, V₂₀, V₃₀, V₄₀ (volumes receiving 5, 10, 20, 30 and 40 Gy, respectively), mean dose(D_mean) for body and V₁₀, V₂₀, V₃₀, D_mean for bilateral femoral head, bladder, and small intestine. There was significant difference for the results (t=-2.32-12.24, P<0.05). The verification results showed that the treatment plans were all passed the dosimetric verification. Conclusions Jaw tracking intensity-modulated radiotherapy and jaw fixed IMRT plan could achieve equal dose coverage in patients with rectal cancer, while jaw tracking techniques could reduce normal tissue dose and organs at risk dose.

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