国际肿瘤学杂志
國際腫瘤學雜誌
국제종류학잡지
JOURNAL OF INTERNATIONAL ONCOLOGY
2012年
5期
391-395
,共5页
巩贯忠%尹勇%翟德胤%刘同海%宋金龙%卢洁%陈进琥%王若峥
鞏貫忠%尹勇%翟德胤%劉同海%宋金龍%盧潔%陳進琥%王若崢
공관충%윤용%적덕윤%류동해%송금룡%로길%진진호%왕약쟁
肝肿瘤%辐射剂量%放射疗法
肝腫瘤%輻射劑量%放射療法
간종류%복사제량%방사요법
Liver neoplasms%Radiation dosage%Radiotherapy
目的 探讨应用6 MV和15 MV X射线容积调强放疗(RapidArc)进行肝脏多发性恶性肿瘤放射治疗的剂量学差异.方法 选取12例多发的肝脏恶性肿瘤(原发5例.继发7例)患者进行自由呼吸下的三维计算机断层成像(3D-CT)模拟定位.针对同一患者分别应用6 MV和15 MV X射线设计单个和两个358°全弧的RapidArc计划,处方量为2 Gy/次×25次.比较不同RapidArc计划间剂量学差异.结果 4种RapidArc计划均能满足临床要求.4种RapidArc计划的适形指数(CI)、均匀性指数(HI)、靶区最大剂量和最小剂量间的差异均无统计学意义(P＞0.05),CI均可达0.91,HI均达0.88.双弧RapidArc计划中正常肝脏V5、V10、V15略高于单弧计划,V20、V25、V30、V35、V40低于单弧计划.正常肝脏的V5至V40、胃、十二指肠、脊髓受量在不同RapidArc计划之间的差异均无统计学意义(P＞0 05),6MVX射线RapidArc计划的机器跳数较15 MV的平均增加12％.结论 应用全弧RapidArc技术进行肝脏多发恶性肿瘤放疗时,6MVX射线可作为首选.
目的 探討應用6 MV和15 MV X射線容積調彊放療(RapidArc)進行肝髒多髮性噁性腫瘤放射治療的劑量學差異.方法 選取12例多髮的肝髒噁性腫瘤(原髮5例.繼髮7例)患者進行自由呼吸下的三維計算機斷層成像(3D-CT)模擬定位.針對同一患者分彆應用6 MV和15 MV X射線設計單箇和兩箇358°全弧的RapidArc計劃,處方量為2 Gy/次×25次.比較不同RapidArc計劃間劑量學差異.結果 4種RapidArc計劃均能滿足臨床要求.4種RapidArc計劃的適形指數(CI)、均勻性指數(HI)、靶區最大劑量和最小劑量間的差異均無統計學意義(P＞0.05),CI均可達0.91,HI均達0.88.雙弧RapidArc計劃中正常肝髒V5、V10、V15略高于單弧計劃,V20、V25、V30、V35、V40低于單弧計劃.正常肝髒的V5至V40、胃、十二指腸、脊髓受量在不同RapidArc計劃之間的差異均無統計學意義(P＞0 05),6MVX射線RapidArc計劃的機器跳數較15 MV的平均增加12％.結論 應用全弧RapidArc技術進行肝髒多髮噁性腫瘤放療時,6MVX射線可作為首選.
목적 탐토응용6 MV화15 MV X사선용적조강방료(RapidArc)진행간장다발성악성종류방사치료적제량학차이.방법 선취12례다발적간장악성종류(원발5례.계발7례)환자진행자유호흡하적삼유계산궤단층성상(3D-CT)모의정위.침대동일환자분별응용6 MV화15 MV X사선설계단개화량개358°전호적RapidArc계화,처방량위2 Gy/차×25차.비교불동RapidArc계화간제량학차이.결과 4충RapidArc계화균능만족림상요구.4충RapidArc계화적괄형지수(CI)、균균성지수(HI)、파구최대제량화최소제량간적차이균무통계학의의(P＞0.05),CI균가체0.91,HI균체0.88.쌍호RapidArc계화중정상간장V5、V10、V15략고우단호계화,V20、V25、V30、V35、V40저우단호계화.정상간장적V5지V40、위、십이지장、척수수량재불동RapidArc계화지간적차이균무통계학의의(P＞0 05),6MVX사선RapidArc계화적궤기도수교15 MV적평균증가12％.결론 응용전호RapidArc기술진행간장다발악성종류방료시,6MVX사선가작위수선.
Objective To investigate the dosimetric difference in the application of RapidArc using 6 and 15 MV X-rays for radiotherapy of multiple hepatic malignancy.Methods A total of 12 cases with multiple hepatic tumors ( primary 5 cases and secondary 7 cases) were selected.All patients underwent the three dimensional CT simulation in free breathing.For each patient,RapidArc plans with single or two 358° arcs using 6 or 15 MV X-rays were designed respectively,the prescription dose was 2Gy per fraction × 25 fractions.The dosimetric differences were compared among RapidArc plans.Results All of RapidArc plans could meet the clinicalrequirement.There were no significant differences in the conformity index ( CI ),homogeneity index ( HI),the maximum dose and the minimum dose of PTV among RapidArc plans ( P ＞ 0.05).All the CI could get to 0.91 and HI could get to 0.88.In the RapidArc plans with two 358° arcs,the Vs,V10,V15 of normal liver were higher than with single arc,while V20,V25,V30,V35,V40 were lower than with single arc.There were no significant differences in the different radiation dose of normal liver,stomach,duodenum and spinal cord among different plans ( P ＞0.05 ).The monitor units of RapidArc plans using 6 MV X-rays increased 12％ compared to 15 MV averagely.Condusion The 6 MV X-ray would be selected chiefly in the radiotherapy of multiple haptic tumor using RapidArc with whole arc(s).
