| 刘倩倩,陈旭明,胡喆恺,侯灵通,姚升宇.国产直线加速器VenusX在海马保护全脑放疗的临床应用研究[J].中华放射医学与防护杂志,2023,43(5):351-356 |
| 国产直线加速器VenusX在海马保护全脑放疗的临床应用研究 |
| Clinical application of LinaTech linear accelerator VenusX to hippocampal protection in whole-brain radiotherapy |
| 投稿时间：2022-11-03 |
| DOI：10.3760/cma.j.cn112271-20221103-00429 |
| 中文关键词: 全脑放疗 海马体 正交双层多叶光栅 剂量学 |
| 英文关键词:Whole-brain radiotherapy Hippocampus Orthogonal dual-layer MLCs Dosimetry |
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| 中文摘要: |
| 目的 比较VenusX正交双层光栅加速器与瓦里安CLINAC IX和EDGE单层光栅加速器在海马保护全脑放疗中的剂量学差异。方法 选取2021年6月至2023年2月在上海市第一人民医院放疗科收治的40例多发脑转移患者,每例患者分别利用VenusX加速器和Varian EDGE及IX机型的3种加速器设计全脑治疗计划,在给定相同处方剂量、射野及计划限制约束条件下,比较3种计划的靶区、海马体及相邻危及器官的剂量学差异和计划执行效率差异。结果 对于计划靶区(PTV)而言,VenusX计划的近似最大剂量(D2)与IX计划相比,差异有统计学意义(t=4.94,P<0.05);VenusX计划近似最小剂量(D98)与EDGE计划相比,差异有统计学意义(t=5.98,P<0.05);VenusX计划的靶区适形指数(CI)分别与EDGE和IX计划比较,差异均有统计学意义(t=-6.84、-14.30,P<0.05);VenusX计划的剂量均匀性指数(HI)与IX计划相比,差异有统计学意义(t=3.48,P<0.05)。对于危及器官而言,VenusX计划左右海马的最大剂量(Dmax)和平均剂量(Dmean)均低于EDGE和IX计划,差异均有统计学意义(t=8.59~17.11,P<0.05);VenusX计划左右眼晶状体、左右视神经和视交叉的最大剂量(Dmax),较瓦里安两种机型对应的计划剂量有所降低,且差异均有统计学意义(t=2.10~20.80,P<0.05);VenusX计划中脑干的最大剂量(Dmax)与EDGE计划相比差异有统计学意义(t=3.86,P<0.05)。在计划执行效率上,VenusX的机器跳数(MU)明显偏高,治疗时间有所增加,与EDGE和IX计划相比,差异均有统计学意义(t=-56.48、-56.90,P<0.05)。结论 3组治疗计划靶区剂量均达到处方要求,VenusX计划对于危及器官的保护效果优于瓦里安EDGE和IX计划。虽然VenusX执行效率有所下降,但由于其剂量率的提高缩短了实际治疗时间,可以满足临床要求。 |
| 英文摘要: |
| Objective To compare the dosimetric differences between the VenusX accelerator with an orthogonal dual-layer multi-leaf collimator (MLC) and the Varian's CLINAC IX and EDGE accelerators with a single-layer MLC for hippocampus protection in the whole-brain radiotherapy (WBRT). Methods Forty patients with multiple brain metastases admitted to the Radiotherapy Department of the Shanghai General Hospital from June 2021 to February 2023 were selected in this study. Three whole-brain treatment plans were designed based on the above three accelerators for each patient. Under the same prescription dose, radiation field, and plan constraints, the three plans were compared in terms of the dosimetric differences in target volumes, hippocampi, and adjacent organs at risk (OARs), as well as the execution efficiency. Results For the planning target volume (PTV), there were statistically significant differences in approximate maximum dose (D2) between the VenusX and IX plans (t=4.94, P < 0.05), in approximate minimum dose (D98) between the VenusX and EDGE plans (t=5.98, P < 0.05), in the target conformity indices (CIs) between VenusX plan and EDGE plans, and between the VenusX and IX plans (t=-6.84, -14.30; P < 0.05), and dose homogeneity indices (HIs) between the VenusX and IX plans (t=3.48, P < 0.05). For OARs, the maximum doses (Dmax) and average doses (Dmean) to bilateral hippocampi of the VenusX plan were lower than those of the EDGE and IX plans (t=8.59-17.11, P < 0.05); the maximum doses (Dmax) to bilateral lenses, bilateral optic nerves, and optic chiasma of the VenusX plan were lower than those of the other two plans (t=2.10-20.80, P < 0.05); and the differences between the maximum doses (Dmax) to the brain stem of the VenusX and EDGE plans were statistically significant (t=3.86, P < 0.05). In terms of plan execution efficiency, the number of machine jumps (MU) and the treatment time of the VenusX plan were higher than those of the EDGE and IX plans, with statistically significant differences (t=-56.48, -56.90, P < 0.05). Conclusions The doses to target volumes of the three treatment plans all meet the prescription requirements, and the VenusX plan outperforms the EDGE and IX plans in the protection of OARs. Despite the reduced execution efficiency, the VenusX plan shortens the actual treatment time by improving the dosage rate, thus meeting the clinical requirements. |
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