中华放射医学与防护杂志
中華放射醫學與防護雜誌
중화방사의학여방호잡지
Chinese Journal of Radiological Medicine and Protection
2011年
3期
322-325
,共4页
蒋皤%吴昊%弓健%韩树奎
蔣皤%吳昊%弓健%韓樹奎
장파%오호%궁건%한수규
快速旋转调强%固定射野动态调强%直肠癌%剂量学
快速鏇轉調彊%固定射野動態調彊%直腸癌%劑量學
쾌속선전조강%고정사야동태조강%직장암%제량학
RapidArc%Dynamic intensity modulated radiation therapy%Rectal cancer%Dosimetry
目的 比较快速旋转调强(RapidArc)与固定射野动态调强(dIMRT)两种放射治疗技术在直肠癌术前放疗中的剂量学差异.方法 采用两种治疗技术对10例Ⅱ、Ⅲ期直肠癌术前患者设计同步加量治疗计划.处方剂量为GTV 50.6 Gy,分22次;PTV41.8 Gy,分22次,危及器官限量参考临床常规要求.在95%体积的PTV达到处方剂量前提下,比较两种计划的剂量体积直方(DVH)图、靶区和危及器官剂量、靶区剂量适形度、剂量分布均匀性、机器跳数以及治疗时间.结果 RapidArc计划中,GTV和PTV的靶区剂量适形度较高(t=7.643、8.226,P＜0.05);而靶区剂量均匀性略低于dIMRT(t=-10.065、-4.235,P＜0.05).RapidArc计划中大、小肠的平均受量显著低于dIMRT计划(t=2.781,P＜0.05).膀胱平均受照剂量略低于dIMRT,股骨头的平均受量略高于dIMRT,但差异无统计学意义.RapidArc计划机器跳数减少48.5%,平均治疗时间节省79.5%.结论 RapidArc与dIMRT计划在直肠癌术前放射治疗的剂量学上无明显差异.RapidArc每次治疗时间明显缩短,减少了治疗期间患者非主观运动引起的误差,总的机器跳数降低,减少了正常组织照射.
目的 比較快速鏇轉調彊(RapidArc)與固定射野動態調彊(dIMRT)兩種放射治療技術在直腸癌術前放療中的劑量學差異.方法 採用兩種治療技術對10例Ⅱ、Ⅲ期直腸癌術前患者設計同步加量治療計劃.處方劑量為GTV 50.6 Gy,分22次;PTV41.8 Gy,分22次,危及器官限量參攷臨床常規要求.在95%體積的PTV達到處方劑量前提下,比較兩種計劃的劑量體積直方(DVH)圖、靶區和危及器官劑量、靶區劑量適形度、劑量分佈均勻性、機器跳數以及治療時間.結果 RapidArc計劃中,GTV和PTV的靶區劑量適形度較高(t=7.643、8.226,P＜0.05);而靶區劑量均勻性略低于dIMRT(t=-10.065、-4.235,P＜0.05).RapidArc計劃中大、小腸的平均受量顯著低于dIMRT計劃(t=2.781,P＜0.05).膀胱平均受照劑量略低于dIMRT,股骨頭的平均受量略高于dIMRT,但差異無統計學意義.RapidArc計劃機器跳數減少48.5%,平均治療時間節省79.5%.結論 RapidArc與dIMRT計劃在直腸癌術前放射治療的劑量學上無明顯差異.RapidArc每次治療時間明顯縮短,減少瞭治療期間患者非主觀運動引起的誤差,總的機器跳數降低,減少瞭正常組織照射.
목적 비교쾌속선전조강(RapidArc)여고정사야동태조강(dIMRT)량충방사치료기술재직장암술전방료중적제량학차이.방법 채용량충치료기술대10례Ⅱ、Ⅲ기직장암술전환자설계동보가량치료계화.처방제량위GTV 50.6 Gy,분22차;PTV41.8 Gy,분22차,위급기관한량삼고림상상규요구.재95%체적적PTV체도처방제량전제하,비교량충계화적제량체적직방(DVH)도、파구화위급기관제량、파구제량괄형도、제량분포균균성、궤기도수이급치료시간.결과 RapidArc계화중,GTV화PTV적파구제량괄형도교고(t=7.643、8.226,P＜0.05);이파구제량균균성략저우dIMRT(t=-10.065、-4.235,P＜0.05).RapidArc계화중대、소장적평균수량현저저우dIMRT계화(t=2.781,P＜0.05).방광평균수조제량략저우dIMRT,고골두적평균수량략고우dIMRT,단차이무통계학의의.RapidArc계화궤기도수감소48.5%,평균치료시간절성79.5%.결론 RapidArc여dIMRT계화재직장암술전방사치료적제량학상무명현차이.RapidArc매차치료시간명현축단,감소료치료기간환자비주관운동인기적오차,총적궤기도수강저,감소료정상조직조사.
Objective To compare the dosimetric difference between RapidArc and fixed gantry angle dynamic intensity modulated radiotherapy (dIMRT) in developing the pre-operative radiotherapy for rectal cancer patients.Methods Two techniques,RapidArc and dIMRT,were used respectively to develop the synchronous intensity modulated plans for 10 stage Ⅱ and Ⅲ rectal cancer patients at the dose of gross tumor volume (GTV) of 50.6 Gy divided into 22 fractions and planning target volume (PTV) of 41.8 Gy divided into 22 fractions.Both plans satisfied the condition of 95% of PTV covered by 41.8 Gy.The dose-volume histogram data,isodose distribution,monitor units,and treatment time were compared.Results The two kinds of dose volume histogram (DVH) developed by these two techniques were almost the same.The conformal indexes of GTV and PTV by RapidArc were better than those by dIMRT (t =7.643,8.226 ,P < 0.05),while the homogeneity of target volume by dIMRT was better (t =-10.065,-4.235 ,P <0.05).The dose of rectum and small bowel planned by RapidArc was significantly lower than that by dIMRT (t =2.781 ,P <0.05).There were no significant differences in the mean doses of bladder and femoral head between these two techniques.The mean monitor units of RapidArc was 475.5,fewer by 48.5% in comparison with that by the dIMRT (924.6).The treatment mean time by RapidArc was 1.2min,shorter by 79.5% in comparison with that by dIMRT (5.58 min).Conclusions There is no significant dosimetric difference between the two plans of RapidArc and dIMRT.Compared with dIMRT,RapidArc achieves equal target coverage and organs at risk(OAR) sparing while using fewer monitor units and less time during radiotherapy for patient with rectal cancer.
