CAJ | 학술논문

目的比较质子治疗(PT)与X线调强放疗(IMRT)在颈段食管癌治疗中的剂量分布.方法选取10例颈段食管癌患者CT图像,每例制定1个X线IMRT计划(7个野)与2个PT计划(PT1为前后对穿2个野,PT2为两前斜加后3个野).使用等剂量分布及剂量体积直方图进行计划间比较.结果 IMRT与PT1、PT2计划的计划靶体积(PTV)95%等剂量面适形指数分别为1.43与1.52、1.43(F=3.62,P<0.01),平均剂量分别为64.4 Gy与65.0、63.6 Gy(F=12.06,P<0.01);PTV周围正常组织平均剂量分别为20.7 Gy与10.5、10.6 Gy(F=77.60,P<0.01),全肺的为12.1 Gy与7.3、8.4 Gy(F:15.87,P<0.01),脊髓最大剂量分别为41.4 Gy与34.9、35.0 Gy(F=11.74,P<0.01).结论 3个计划均能满足覆盖靶区要求,但PT可明显降低肿瘤周围正常组织剂量,这为PT剂量提升或合并使用同期化疗提供了可能.PT计划中前后对穿2个野也可满足临床要求.
목적 비교질자치료(PT)여X선조강방료(IMRT)재경단식관암치료중적제량분포.방법 선취10례경단식관암환자CT도상,매례제정1개X선IMRT계화(7개야)여2개PT계화(PT1위전후대천2개야,PT2위량전사가후3개야).사용등제량분포급제량체적직방도진행계화간비교.결과 IMRT여PT1、PT2계화적계화파체적(PTV)95%등제량면괄형지수분별위1.43여1.52、1.43(F=3.62,P<0.01),평균제량분별위64.4 Gy여65.0、63.6 Gy(F=12.06,P<0.01);PTV주위정상조직평균제량분별위20.7 Gy여10.5、10.6 Gy(F=77.60,P<0.01),전폐적위12.1 Gy여7.3、8.4 Gy(F:15.87,P<0.01),척수최대제량분별위41.4 Gy여34.9、35.0 Gy(F=11.74,P<0.01).결론 3개계화균능만족복개파구요구,단PT가명현강저종류주위정상조직제량,저위PT제량제승혹합병사용동기화료제공료가능.PT계화중전후대천2개야야가만족림상요구.
Objective To compare the dosimetric difference of proton therapy(PT)and X-ray intensity-modulated radiotherapy(IMRT)for cervical esophageal cancer.Methods The treatment planning of 10 patients with cervical esophageal cancer were selected for this study.One IMRT plan and 2 PT plans (PT1 plan:two opposed AP-PA beams;PT2 plan:two anterior-oblique beams and one posterior beam)were constructed for each patient.The isodose distribution and statistical data extracted from dose volume histograms were used for dose plan comparison.Results The conformal index(CI95%,defined as the ratio between the volume receiving at least 95%of the prescribed dose and the volume of PTV)of IMRT,PT1 and PT2 was 1.43,1.52 and 1.43(F=3.62,P<0.01),respectively.And the mean dose of PTV was 64.4 Gy,65.0 Gy and 63.6 Gy(F=12.06,P<0.01);the mean dose in normal tissue outside of PTV was 20.7 Gy,10.5 Gy and 10.6 Gy(F=77.60,P<0.01),in whole lung was 12.1 Gy,7.3 Gy and 8.4 Gy (F=15.87,P<0.01);the maximum dose in spinal cord was 41.4 Gy,34.9 Gy and 35.0 Gy(F=11.74,P<0.01),respectively.Conclusions Ail plans full file the requirements for PTV,however.PT plans can reduce radiation dose in surrounding normal significantly.The possibility is provided to escalate PT dose in PTV or to combine more aggressive chemotherapy.The PT1 plan full fills the clinical requirements.