CAJ | 학술논문

目的通过比较颈段食管癌固定野调强放疗(IMRT)与旋转调强放疗(IMAT)计划,分析IMRT与IMAT在剂量学与实际应用方面特点和可行性.方法选取10例在本院进行IMRT的颈段食管癌患者,针对相同CT图像与靶区制定单弧(IMAT1)、双弧(IMAT2)IMAT计划.使用Eclipse(R) ver 8.6计划系统,6 MV X线.模拟处方剂量为60 Gy分30次,计划要求97%计划靶体积(PTV)(V98)达98%处方剂量,超过110%处方剂量PTV(V110)<15%.脊髓最大剂量≤45 Gy.通过剂量体积直方图统计PTV相关剂量参数、适形指数(CI)、均匀指数(HI)、肺及心脏剂量体积参数,以及加速器总机器跳数、总治疗时间.用SPSS 13.0软件对3个组计划行单因素方差分析,LSD算法进行组内分析.结果 3个组PTV的D98、V98及CI,肺的V5、V10、V30、V40、V50及平均肺剂量差异均无统计学意义(P值均>0.05);PTV的D2、V110及HI,肺V20差异均有统计学意义(P值均<0.05).总机器跳数比较,IMRT组(1174.8 MU)比IMAT1(709.7 MU)、IMAT2(803.8 MU)组分别减少了39.6%、31.6%(F=39.25,P=0.000).总治疗时间比较,IMRT组(14.9 min)比IMAT1(1.9 min)、IMAT2(2.66 min)组分别减少了87.2%、82.1%(F=45.14,P=0.000).结论 IMAT可以达到与IMRT相似的剂量学要求,IMAT2计划优于IMAT1.IMAT具有较少总MU、总治疗时间优势,并减少了治疗中不确定性因素影响及患者不适感.
목적 통과비교경단식관암고정야조강방료(IMRT)여선전조강방료(IMAT)계화,분석IMRT여IMAT재제량학여실제응용방면특점화가행성.방법 선취10례재본원진행IMRT적경단식관암환자,침대상동CT도상여파구제정단호(IMAT1)、쌍호(IMAT2)IMAT계화.사용Eclipse(R) ver 8.6계화계통,6 MV X선.모의처방제량위60 Gy분30차,계화요구97%계화파체적(PTV)(V98)체98%처방제량,초과110%처방제량PTV(V110)<15%.척수최대제량≤45 Gy.통과제량체적직방도통계PTV상관제량삼수、괄형지수(CI)、균균지수(HI)、폐급심장제량체적삼수,이급가속기총궤기도수、총치료시간.용SPSS 13.0연건대3개조계화행단인소방차분석,LSD산법진행조내분석.결과 3개조PTV적D98、V98급CI,폐적V5、V10、V30、V40、V50급평균폐제량차이균무통계학의의(P치균>0.05);PTV적D2、V110급HI,폐V20차이균유통계학의의(P치균<0.05).총궤기도수비교,IMRT조(1174.8 MU)비IMAT1(709.7 MU)、IMAT2(803.8 MU)조분별감소료39.6%、31.6%(F=39.25,P=0.000).총치료시간비교,IMRT조(14.9 min)비IMAT1(1.9 min)、IMAT2(2.66 min)조분별감소료87.2%、82.1%(F=45.14,P=0.000).결론 IMAT가이체도여IMRT상사적제량학요구,IMAT2계화우우IMAT1.IMAT구유교소총MU、총치료시간우세,병감소료치료중불학정성인소영향급환자불괄감.
Objective To compare and analyze the characteristics of intensity-modulated arc therapy (IMAT) versus fixed-gantry intensity-modulated radiotherapy (IMRT) in the treatment of cervical esophageal cancer.Methods Ten patients treated in our radiotherapy center were selected for this study.Based on the identical CT and planning target volume (PTV), two IMAT plans were generated with Eclipse ver8.6 planning system.IMAT1 consisting of a single 359.8° rotation, and IMAT2 consisting of two coplanar 359.8° rotations.PTV were prescribed to 60 Gy in 30 fractions.Planning objectives for PTV,corresponding with the IMRT plans, were V98 larger than 97% and V110 no more than 15%.The maximum dose of spinal-cord was constrained below 45 Gy.One-way ANOVA were applied to dose-volume values for PTV and OAR from DVH.Results There were no significant differences between IMRT and IMAT in PTV D98, V98, CI or total-lung V5, V10, V30, V40, V50 and mean lung dose (all P > 0.05).However, the differences were significant in terms of D2, V110 and HI of PTV, V20 of the total-lung (all P<0.05).On the MU,IMRT = 1174.8 MU,IMAT1 =709.7 MU,and IMAT2 =803.8 MU (F =39.25,P =0.000).On the treatment time,IMRT= 14.9 min,IMAT1 = 1.9 min, and IMAT2 =2.66 min (F=45.14,P=0.000).Conclusions IMAT is equal to IMRT in dosimetric evaluation.Due to much less MU and delivery time,IMAT is an ideal technique in treating patients by reducing the uncomfortable influences which could effect the treatment.However, IMAT1 is slightly inferior to IMAT2.