中华放射医学与防护杂志

戴相昆,蔡博宁,葛瑞刚,等.胸上段食管癌螺旋断层放疗和容积旋转调强放疗的剂量学比较[J].中华放射医学与防护杂志,2016,36(1):58-62.Dai Xiangkun,Cai Boning,Ge Ruigang,et al.Dosimetric comparison of helical tomotherapy and volume-modulated arc therapy for upper thoracic esophageal carcinoma[J].Chin J Radiol Med Prot,2016,36(1):58-62

胸上段食管癌螺旋断层放疗和容积旋转调强放疗的剂量学比较

Dosimetric comparison of helical tomotherapy and volume-modulated arc therapy for upper thoracic esophageal carcinoma

投稿时间：2015-08-18

DOI：10.3760/cma.j.issn.0254-5098.2016.01.011

中文关键词: 食管癌螺旋断层调强放疗容积旋转调强放疗剂量学

英文关键词:Esophageal neoplasms Helical tomotherapy Volume-modulated arc therapy Dosimetry

基金项目:

作者	单位
戴相昆	100853 北京, 解放军总医院放射治疗科
蔡博宁	100853 北京, 解放军总医院放射治疗科
葛瑞刚	100853 北京, 解放军总医院放射治疗科
王小深	100853 北京, 解放军总医院放射治疗科
王运来	100853 北京, 解放军总医院放射治疗科

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中文摘要:

目的比较胸上段食管癌螺旋断层(HT)与容积旋转调强放疗(VMAT)计划的剂量学差异。方法随机抽样法选取10例胸上段食管癌患者,分别设计HT和VMAT双弧照射调强放疗计划,肿瘤靶区体积(GTV)给予66 Gy/30次,计划靶区体积(PTV)给予50 Gy/30次。根据剂量体积直方图(DVH)评价靶区的D_1%、D_5%、D_95%、D_99%、适形指数(CI)、均匀性指数(HI)和危及器官(OAR)受量,比较治疗时间和机器跳数(MU)的差异。结果 HT组GTV和PTV的D_99%高于VMAT组(t=4.476、3.756,P<0.05);GTV与PTV的D_1%、D_5%、D_95%、HI和CI差异均无统计学意义(P>0.05)。HT组全肺V₁₀、V₁₅、V₂₀和全肺平均剂量(MLD)均显著低于VMAT组(t=-3.369、-4.824、-4.869、-3.657,P<0.05);全肺V₅、V₃₀和脊髓D_max差异均无统计学意义(P >0.05)。HT组治疗时间和MU数均远大于VMAT组(t=13.970、7.982,P<0.05)。结论 HT与VMAT技术均能满足胸上段食管癌放疗剂量要求。HT技术能显著减小双肺受量,而VMAT技术具备明显的效率优势。

英文摘要:

Objective To compare the dosimetric differences between helical tomotherapy (HT) and volume-modulated arc therapy (VMAT) in the treatment of upper thoracic esophageal carcinoma (UTEC). Methods A total of 10 patients with UTEC were randomly selected. HT plan and double-arc VMAT plan were designed and optimized for each patient. The prescription dose was 50 Gy/30 fractions for gross target volume (GTV), 66 Gy/30 fractions for planned target volume (PTV). The dose distribution and conformal index (CI), homogeneity index (HI) of target volume, the D_1%, D_5%, D_95%, D_99%, and dose of organ at risk (OAR) were analyzed by using the dose volume histogram (DVH). The monitor units and delivery time were also evaluated. Results For GTV and PTV, the D_99%of HT plans were slightly higher than those of VMAT plans (t=4.476, 3.756, P<0.05), but no significant differences in D_1%, D_5%, D_95%, HI and CI (P>0.05) were found. The V₁₀, V₁₅, V₂₀ and mean lung dose (MLD) to the total-lung of HT plans were all significantly lower than those of VMAT plans (t=-3.369, -4.824, -4.869, -3.657, P<0.05). There were no significant differences for V₅, V₃₀and D_maxof cord (P>0.05). The monitor units and delivery time of VMAT plans were significantly lower than those of HT plans (t=13.970, 7.982, P<0.05). Conclusions Both HT and VMAT are appropriate for esophageal cancer radiotherapy. HT significantly reduces the radiation dose of the total-lung, while VMAT has obvious advantages in efficiency.

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