临床肿瘤学杂志

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胸中下段食管癌三种放疗技术的剂量学比较

徐朋琴,蔡晶,吴建亭

  

  1. 226361 南通 江苏省南通市肿瘤医院放疗科
  • 收稿日期:2012-07-18 修回日期:2012-10-24 出版日期:2012-11-30 发布日期:2012-11-30
  • 通讯作者: 蔡晶

Dosimetric comparison among three kinds of radiotherapy technologies for middle or low thoracic esophageal carcinoma

XU Peng-qin, CAI Jing,WU Jian-ting   

  1. Department of Radiation Oncology,Nantong Tumor Hospital,Nantong 226361, China
  • Received:2012-07-18 Revised:2012-10-24 Online:2012-11-30 Published:2012-11-30
  • Contact: CAI Jing

摘要: 目的 比较食管癌常规二维照射(2D-RT)、三维适形治疗(3D-CRT)、5野调强放疗(5FsIMRT)和9野调强放疗(9FsIMRT)4种治疗计划的剂量学参数,寻找更优化的放疗技术。方法 应用三维治疗计划系统(3-DTPS)为40例胸中下段食管癌患者设计2D-RT、3D-CRT、5FsIMRT和9FsIMRT 4种治疗计划,应用剂量体积直方图评估各个计划的剂量学参数及正常组织的受照射体积。结果 2D-RT、3D-CRT、5FsIMRT和9FsIMRT 4种治疗计划的适形指数(CI)值分别为0.17±0.08、0.53±0.09、0.78±0.05、0.87±0.05,差异有统计学意义(P<0.05);4种计划的均匀指数(HI)值分别为1.48±0.34、1.14±0.05、1.13±0.03、1.09±0.02, 2D-RT与3D-CRT相比,差异有统计学意义(P<0.05)。IMRT计划在双肺的V20和V30、脊髓最大剂量、心脏的平均剂量及V40方面均低于3D-CRT和2D-RT(P<0.05);9FsIMRT计划在双肺V5上高于5FsIMRT计划(P<0.05),在脊髓最大剂量上低于5FsIMRT(P<0.05)。结论 IMRT计划在靶区剂量的均匀性、靶区适形度以及保护正常组织方面优于2D-RT和3D-CRT;9FsIMRT较5FsIMRT并未带来明显的剂量学改善。

Abstract: Objective To provide a reference for searching more optimal radiatitherapy technology through dosimetric comparison among 2D-RT,3D-CRT and IMRT plan. MethodsForty cases of middle or low thoracic esophageal carcinoma were designed 2D-RT, 3D-CRT, 5 fields and 9 fields IMRT plans for each patient in 3D planning system,and evaluated dosimetric parameters of each treatment plan with dose volume histogram and irradiation volume of normal tissues. ResultsThe CI in 2D-RT, 3D-CRT, 5 fields and 9 fields IMRT plan were 0.17±0.08,0.53±0.09,0.78±0.05,0.87±0.05,respectively(P<0.05);the HI value in four plans were 1.48±0.34,1.14±0.05,1.13±0.03,1.09±0.02, respectively. The HI value in IMRT was lowest,followed by that in 3D-CRT,and that in 2D-RT plan was highest. V20 and V30 of lung,the maximum dose of spinal cord and the mean dose,V40 of heart in IMRT plan were lower than those in 3D-CRT and 2D-RT plans(P<0.05). V5 of lung in 9 fields IMRT plan was higher than that in 5 fields IMRT plan(P<0.05). Conclusion The CI and HI of target area dose in IMRT plan are superior to those in 2D-RT and 3D-CRT plan. Compared to 5 fields IMRT plan, V5 of lung can be increased by 9 fields IMRT plan,and the 9 fields IMRT plan did not bring obvious improvement in dosimetry.

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