| 王海洋,皮一飞,郭跃信.螺旋断层固定野和旋转调强放疗技术在全身照射中的应用对比研究[J].中华放射医学与防护杂志,2019,39(9):658-662.Wang Haiyang,Pi Yifei,Guo Yuexin.Dosimetric comparison between TomoDirect and Helical Tomotherapy in total body irradiation[J].Chin J Radiol Med Prot,2019,39(9):658-662 |
| 螺旋断层固定野和旋转调强放疗技术在全身照射中的应用对比研究 |
| Dosimetric comparison between TomoDirect and Helical Tomotherapy in total body irradiation |
| 投稿时间：2019-03-05 |
| DOI：10.3760/cma.j.issn.0254-5098.2019.09.004 |
| 中文关键词: 全身照射 螺旋断层固定野放疗 螺旋断层旋转放疗 |
| 英文关键词:Total body irradiation TomoDirect Helical tomotherapy |
| 基金项目:河南省科技计划项目（182102310578） |
|
| 摘要点击次数: 3185 |
| 全文下载次数: 1496 |
| 中文摘要: |
| 目的 探究使用螺旋断层固定野调强（TD）和螺旋断层旋转调强（HT）放射治疗技术在全身照射（TBI）中的应用对比，并评估TD治疗技术下计划的质量和执行效率，指导临床选择最佳的计划设计方案。方法 对郑州大学第一附属医院收治的8例身高在120 cm左右的已行TBI的急性白血病患者进行回顾性研究，分别选择TD和HT治疗技术进行计划设计，其中TD分别设计2~12内奇数个均分射野的计划，且起始角度分别从180°和0°开始，其余计划参数都保持一致。最后对设计好的计划剂量分布进行统计，比较TD与HT治疗技术下的计划在靶区的平均剂量（PTVDmean）、均匀性指数（HI）和危及器官（OARs）受量，以评估计划质量，并比较治疗出束时间以评估治疗效率。结果 9野的TD计划相对于HT计划在PTVDmean和靶区HI能达到一致效果，差异无统计学意义。但TD<9野的计划相对于HT计划在PTVDmean（t=-3.12、-5.41、-20.33、-4.56、-7.22、-11.27，P<0.05）和靶区HI（t=-2.94、-5.18、-15.66、-4.31、-5.51、-9.13，P<0.05）无剂量学优势，差异有统计学意义。同时TD计划中起始角度对PTVDmean和靶区HI没有影响。在危及器官方面，≥ 7野TD计划与HT计划在左肺平均剂量与右肺平均剂量差异无统计学意义；左眼晶状体计划危及体积（PRV）的最大剂量（2.14±0.60）Gy与右眼晶状体PRV最大剂量（3.05±0.10）Gy在3野TD计划与HT计划差异有统计学意义（t=0.77、0.63，P<0.05），眼晶状体PRV在最大剂量方面具有一定优势。治疗出束时间差异无统计学意义。TD计划中起始角度对左右眼晶状体PRV最大剂量、左肺平均剂量及治疗出束时间没有影响。结论 对于≥ 9野的TD调强计划相对于HT计划在靶区、危及器官及治疗出束时间方面能达到一致的结果，但在眼晶状体PRV最大剂量方面具有一定优势。 |
| 英文摘要: |
| Objective To investigate the dosimetric differences between TomoDirect (TD) and Helical Tomotherapy (HT) in total body irradiation (TBI), as well to evaluate the plan quality and delivery efficiency of TD. Methods Eight patients with acute leukemia at an average height of about 120 cm who had undergone TBI in the first affiliated hospital of Zhengzhou university were retrospectively reviewed and replanned with the TD and HT techniques for dosimetric comparison. Identical planning parameters were configured for both techniques except that TD plans were designed with 2-12 equally spaced odd number fields and with an initial angle of 180 or 0 degree. Dosimetric differences in mean dose of plan target volume (PTVDmean), homogeneity index (HI), dose of organs at risk (OARs), as well as delivery time were compared between the TD and HT plans. Results The TD plans with 9 fields or more had similar PTVDmean and HI compared with HT plans, while TD plans with less than 9 fields had a significant different PTVDmean (t=-3.12, -5.41, -20.33, -4.56, -7.22, -11.27, P<0.05) and HI (t=-2.94, -5.18, -15.66, -4.31, -5.51,-9.13, P<0.05) compared with those of HT. In terms of OARs, the TD plans with 7 fields or more had no significant dosimetric differences in the mean dose of left and right lung compared with the HT plans. The TD plans with 3 fields had significant different maximum dose in the left lens plan risk volume(PRV) (2.14±0.60) Gy and the right lens PRV (3.05±0.10) Gy (t=0.77, 0.63, P<0.05) compared with the HT plans. No significant difference in delivery time was observed. The initial angle of the TD plans had no effects on PTVDmean, HI, OAR dosimetry and delivery time. Conclusions The TD plans with 9 fields or more can achieve similar plan quality in terms of target coverage, OAR sparing and delivery time, but have an advantage in the maximum dose to lens PRV compared with the HT plans. |
| HTML 查看全文 查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|