CAJ | 학술논문

目的研究简单调强放射治疗(sIMRT)技术在胃癌术后放射治疗中的剂量学特点,为临床提供参考.方法选取2012年2-6月间在南京医科大学附属淮安第一医院接受治疗的12例胃癌术后患者,分别设计三维适形放疗(3D-CRT)、5野调强放射治疗(IMRT)计划和5野简单调强放射治疗(sIMRT)计划,其中3D-CRT采用上下分野照射,调强放疗均选取20°、80°、180°、280°和340°5个照射野.应用剂量体积直方图(DVH)比较3种计划的适形度指数、不均匀性指数、正常组织受照剂量特点、机器治疗总跳数及治疗总时间.结果 sIMRT和IMRT计划适形度优于3D-CRT计划,但不均匀性亦甚于3D-CRT计划,差异有统计学意义(均P＜0.05).在不同的放疗剂量下, sIMRT计划受照射的肝脏和双肾体积百分比均低于3D-CRT计划(均P＜0.05),与IMRT计划相近(均P＞0.05).sIMRT计划的机器总跳数和总治疗时间均少于IMRT计划和3D-CRT计划.结论 sIMRT技术和IMRT技术用于胃癌术后放疗,其剂量分布明显优于3D-CRT技术;但sIMRT技术治疗时间最短,在临床应用具有更便捷的优势.
목적 연구간단조강방사치료(sIMRT)기술재위암술후방사치료중적제량학특점,위림상제공삼고.방법 선취2012년2-6월간재남경의과대학부속회안제일의원접수치료적12례위암술후환자,분별설계삼유괄형방료(3D-CRT)、5야조강방사치료(IMRT)계화화5야간단조강방사치료(sIMRT)계화,기중3D-CRT채용상하분야조사,조강방료균선취20°、80°、180°、280°화340°5개조사야.응용제량체적직방도(DVH)비교3충계화적괄형도지수、불균균성지수、정상조직수조제량특점、궤기치료총도수급치료총시간.결과 sIMRT화IMRT계화괄형도우우3D-CRT계화,단불균균성역심우3D-CRT계화,차이유통계학의의(균P＜0.05).재불동적방료제량하, sIMRT계화수조사적간장화쌍신체적백분비균저우3D-CRT계화(균P＜0.05),여IMRT계화상근(균P＞0.05).sIMRT계화적궤기총도수화총치료시간균소우IMRT계화화3D-CRT계화.결론 sIMRT기술화IMRT기술용우위암술후방료,기제량분포명현우우3D-CRT기술;단sIMRT기술치료시간최단,재림상응용구유경편첩적우세.
Objective To elucidate the application and the dosimetry characteristic of the simplified intensity modulated radiation therapy (sIMRT) for gastric cancer after operation,and to compare the dose distribution with intensity modulated radiation therapy (IMRT) and three-dimension conformal radiation therapy (3D-CRT).Methods Twelve patients with gastric cancer after operation were enrolled in this study.3D-CRT plan,5-field IMRT plans(20°,80°,180°,280°,340°) and 5-field sIMRT plans(20°,80°,180°,280°,340°) were performed for each patient.The conformal index (CI),heterogeneity index (HI) of the planning target volume (PTV) and the dose of normal organs were analyzed with the dose volume histogram (DVH).The total MU and treatment time were also compared.Results The sIMRT and IMRT plans had comparable CI (sIMRT＞IMRT＞3D-CRT),and showed better dose comformity but worse homogeneity than 3D-CRT.The percentage of volume receiving 20 Gy,25 Gy,30 Gy and 40 Gy by liver were significantly lower in sIMRT than that in 3D-CRT,and comparable to IMRT.All the dose volumes to kidneys with sIMRT were still significantly lower as compared to 3D-CRT,and comparable to IMRT.The sIMRT plan was better than IMRT plan in total MU and treatment time.Conclusions sIMRT has comparable dose distribution in patients with gastric cancer to IMRT,but is significantly better than 3D-CRT.Treatment time of sIMRT is the shortest.So sIMRT technique can be applied more simply.