中华放射肿瘤学杂志
中華放射腫瘤學雜誌
중화방사종류학잡지
CHINESE JOURNAL OF RADIATION ONCOLOGY
2009年
4期
281-284
,共4页
吴凤%肖建平%张可%姜雪松%宋一昕%张红志%李晔雄
吳鳳%肖建平%張可%薑雪鬆%宋一昕%張紅誌%李曄雄
오봉%초건평%장가%강설송%송일흔%장홍지%리엽웅
肺肿瘤/放射疗法%放射疗法,调强%放射疗法,立体定向%放射疗法,大分割%剂量学
肺腫瘤/放射療法%放射療法,調彊%放射療法,立體定嚮%放射療法,大分割%劑量學
폐종류/방사요법%방사요법,조강%방사요법,입체정향%방사요법,대분할%제량학
Lung neoplasms/radiotherapy%Radiotherapy,intensity modulated%Radiotherapy,stereotactic%Radiotherapy,hypofractioned%Dosimetry
目的 比较肺部肿瘤调强放疗(IMRT)和立体定向放疗(SRT)的大分割治疗计划的剂量分布特点,为临床治疗优选方案提供依据.方法 对近1年内收治的16例采用大分割IMRT的肺部肿瘤(非小细胞肺癌6例和肺转移癌lO例)患者设计处方剂量与治疗间隔相似的SRT计划,采用剂量体积直方图评价IMRT和SRT计划对靶区和正常组织照射剂量等以及适形指数(CI)和不均匀指数(HI).结果 患者采用大分割IMRT和SRT计划时PTV接受的平均剂量分别为6282.1 cGy和6340.6 cGy(t=-0.93,P>0.05),均一化剂量分别为6366.7 cGy和6246.8 cGy(t=-1.18,P>0.05),CI平均值分别为0.78和0.57(t=2.77,P<0.05),HI平均值分别为1.12和1.32(t=-4.38,P<0.01).IMRT和SRT计划的平均全肺组织受照剂量分别为(492.4±368.5)cGy和(310.0±73.1)cGy(t=1.68,P>0.05),全肺V20分别为6.9%±2.1%和4.2%±1.9%(t=3.30,P<0.01).IMRT和SRT计划的心脏和脊髓平均受照剂量无差别.结论 PTV最大径<4.7 cm、靶体积<57 cm3、靶区呈圆形或类圆形时,SRT靶区剂量与大分割IMRT接近并可满足临床要求;SRT计划正常肺组织受照剂量低于大分割IMRT计划.
目的 比較肺部腫瘤調彊放療(IMRT)和立體定嚮放療(SRT)的大分割治療計劃的劑量分佈特點,為臨床治療優選方案提供依據.方法 對近1年內收治的16例採用大分割IMRT的肺部腫瘤(非小細胞肺癌6例和肺轉移癌lO例)患者設計處方劑量與治療間隔相似的SRT計劃,採用劑量體積直方圖評價IMRT和SRT計劃對靶區和正常組織照射劑量等以及適形指數(CI)和不均勻指數(HI).結果 患者採用大分割IMRT和SRT計劃時PTV接受的平均劑量分彆為6282.1 cGy和6340.6 cGy(t=-0.93,P>0.05),均一化劑量分彆為6366.7 cGy和6246.8 cGy(t=-1.18,P>0.05),CI平均值分彆為0.78和0.57(t=2.77,P<0.05),HI平均值分彆為1.12和1.32(t=-4.38,P<0.01).IMRT和SRT計劃的平均全肺組織受照劑量分彆為(492.4±368.5)cGy和(310.0±73.1)cGy(t=1.68,P>0.05),全肺V20分彆為6.9%±2.1%和4.2%±1.9%(t=3.30,P<0.01).IMRT和SRT計劃的心髒和脊髓平均受照劑量無差彆.結論 PTV最大徑<4.7 cm、靶體積<57 cm3、靶區呈圓形或類圓形時,SRT靶區劑量與大分割IMRT接近併可滿足臨床要求;SRT計劃正常肺組織受照劑量低于大分割IMRT計劃.
목적 비교폐부종류조강방료(IMRT)화입체정향방료(SRT)적대분할치료계화적제량분포특점,위림상치료우선방안제공의거.방법 대근1년내수치적16례채용대분할IMRT적폐부종류(비소세포폐암6례화폐전이암lO례)환자설계처방제량여치료간격상사적SRT계화,채용제량체적직방도평개IMRT화SRT계화대파구화정상조직조사제량등이급괄형지수(CI)화불균균지수(HI).결과 환자채용대분할IMRT화SRT계화시PTV접수적평균제량분별위6282.1 cGy화6340.6 cGy(t=-0.93,P>0.05),균일화제량분별위6366.7 cGy화6246.8 cGy(t=-1.18,P>0.05),CI평균치분별위0.78화0.57(t=2.77,P<0.05),HI평균치분별위1.12화1.32(t=-4.38,P<0.01).IMRT화SRT계화적평균전폐조직수조제량분별위(492.4±368.5)cGy화(310.0±73.1)cGy(t=1.68,P>0.05),전폐V20분별위6.9%±2.1%화4.2%±1.9%(t=3.30,P<0.01).IMRT화SRT계화적심장화척수평균수조제량무차별.결론 PTV최대경<4.7 cm、파체적<57 cm3、파구정원형혹류원형시,SRT파구제량여대분할IMRT접근병가만족림상요구;SRT계화정상폐조직수조제량저우대분할IMRT계화.
Objective To compare the characteristics of dose distribution between hypofractionated intensity modulated radiotherapy (IMRT) and hypofractionated stereotactic radiotherapy (SRT) plans in lung tumor and to select an optimal clinical approach. Methods SRT plans were designed for 16 patients with lung tumors who had received IMRT between April 2007 and April 2008. The dose distribution of target volume and normal tissues, conformal index (CI) and heteregenous index (HI) were analyzed using the dose-volume histogram (DVH) for the IMRT and SRT plans. Results The mean dose and equivalent uni-form dose of planning target volume (PTV) in IMRT were similar to those in SRT. SRT had significantly better CI and HI than IMRT (t = 2.77, P < 0.05 and t = - 4.38, P < 0.01 ). The mean lung dose of IMRT and SRT was (492.4 ±368.5) cGy and ( 310.0 ± 73.1 ) cGy, respectively ( t = 1.68, P > 0.05 ). The lung V20 of IMRT and SRT was 6.9% ± 2.1% and 4.2%± 1.9%, respectively ( t = 3.30, P < 0.01 ). No sig-nificant differences were found in the mean dose to the heart or the spinal cord between IMRT and SRT. Conclusions When PTV is less than 57 cm3 or the long diameter of tumor is less than 4.7 cm, hypofrac-tionated SRT has similar dose distribution to hypofractionated IMRT, while the lung dose was lower in the former.
