| 陈利,黄晓延,曹午飞,姚杏红,陈阿龙.肺癌调强计划在水与介质中蒙特卡罗计算的剂量差异[J].中华放射医学与防护杂志,2015,35(9):670-673 |
| 肺癌调强计划在水与介质中蒙特卡罗计算的剂量差异 |
| The differences between Monte Carlo calculated dose-to-medium and dose-to-water for lung cancer IMRT |
| 投稿时间：2015-01-28 |
| DOI：10.3760/cma.j.issn.0254-5098.2015.09.007 |
| 中文关键词: 肺癌 调强放疗 蒙特卡罗算法 对介质的剂量 对水的剂量 |
| 英文关键词:Lung cancer Intensity-modulated radiotherapy Monte Carlo algorithm Dose-to-medium Dose-to-water |
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| 摘要点击次数: 2906 |
| 全文下载次数: 2005 |
| 中文摘要: |
| 目的 探讨肺癌调强放疗计划时,蒙特卡罗算法计算对水与介质的剂量差异。方法随机类型抽样法选取10例肺癌患者的5野调强计划,在质量保证模块下以患者自身图像为模体,采用蒙特卡罗算法分别计算两种计划的吸收剂量,计算对实际介质的吸收剂量(Dm)和对水的吸收剂量(Dw);通过剂量体积直方图的剂量体积参数和计划分析,比较两种剂量在患者体内的分布差异。结果 靶区PTV65和PTV50的D50%、D98%和D2%的Dm和Dw差异分别为:-0.3%、-0.2%、0.3%和0.1%、-0.6%、0.4%,其中PTV65的D50%和PTV50的D98%差异有统计学意义(t=-2.536、-3.776,P<0.05)。正常组织的D50%中,脊髓、心脏、肺和食管的Dm与Dw的平均偏差为0.3%、1.1%、-0.2%和-0.1%,脊髓和心脏的Dm比Dw稍低(t=2.535、3.254,P<0.05);正常组织的D2%的平均偏差为0.3%、-0.6%、-0.7%和0.6%,差异有统计学意义(t=2.311、-4.105、-3.878、6.214,P<0.05)。所有剂量的体积偏差均<2%。对于没有勾画出来的一些骨组织区域,Dm和Dw的偏差>5%。结论 在临床使用过程中,在考虑骨性组织的受照剂量限制时,需要注意肺癌患者的Dm与Dw的相对偏差。 |
| 英文摘要: |
| Objective To investigate the differences between Monte Carlo (MC) calculated dose-to-water (Dw) and dose-to-medium (Dm) for lung cancers treated with intensity-modulated radiotherapy (IMRT). Methods A total of 10 lung carcinoma patients with 5-field IMRT treatment plans were stratified sampling randomly selected for this study, which were performed on Monaco treatment planning system (TPS) with MC algorithm. Using the patients' own CT images as quality assurance (QA) phantoms, two kinds of QA plan were calculated, one was the Dm, and another was the Dw plan. Dose volume histogram (DVH) parameters and the subtraction of two plans were used to evaluate the spatial distribution of the difference between the Dm and Dw. Results Differences between dose-volume indices computed with Dm and Dw for the PTV65 and PTV50 doses (D50%, D98% and D2%) were -0.3%,-0.2%,0.3% and 0.1%,-0.6%,0.4%, respectively, of which the D50% of PTV65 and D98% of PTV50 had statistical difference (t=-2.536, -3.776, P<0.05). For normal tissues, spinal cord, heart, lung and esophagus, the D50% differences between Dm and Dw were 0.3%, 1.1%, -0.2% and -0.1%, of which the Dm of spinal cord and heart were slightly lower than the Dw (t=2.535, 3.254, P<0.05). For the D2% of the normal tissues, the differences were 0.3%, -0.6%, -0.7% and 0.6%, the differences were statistically significant (t=2.311, -4.105, -3.878, 6.214, P<0.05). All the differences were within 2%. Meanwhile planned subtraction analysis showed the differences between the Dm and Dw varied very much with the other body parts of the patient, especially for bone tissues, and the two doses were significant difference (>5%). Conclusion In the course of clinical application, the relative differences between Dm and Dw for lung cancers MC calculations should be noted when considering the dose limitations of bone tissue. |
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