CAJ | 학술논문

目的比较宫颈癌术后患者应用HT、固定野IMRT、VMAT的剂量学差异.方法选择10例宫颈癌术后放疗患者的CT图像进行靶区及OAR勾画,并对同一CT图像设计固定野IMRT、VMAT、HT计划.评估靶区及OAR的剂量分布.采用单因素方差分析3个计划参数差异,用LSD法进行两两比较.结果 IMRT、VMAT、HT计划的靶区覆盖度均满足临床处方剂量要求,但HT计划靶区覆盖度最优(P=0.000),且HT计划的105％ PTV降低约46％ (47.12％、45.83％、0.05％,P=0.000)、Dmax降低约2Gy(54.53、53.65、52.69 Gy,P=0.000),膀胱V40和Dmax最低(50.01％、46.84％、42.98％,P=0.001和54.49、52.96、52.78 Gy,P=0.000),直肠V40最低(54.61％、48.34％、46.78％,P=0.006),小肠Dmax最低(54.53、53.65、52.66 Gy,P=0.000),骨髓Dmax最低(54.51、54.44、52.13 Gy,P=0.000),但机器跳数最高(1429.20、617.80、7 002.04 MU,P=0.000).结论宫颈术后癌患者HT临床应用具有可行性,可以作为一种新的照射方式推广.
목적 비교궁경암술후환자응용HT、고정야IMRT、VMAT적제량학차이.방법 선택10례궁경암술후방료환자적CT도상진행파구급OAR구화,병대동일CT도상설계고정야IMRT、VMAT、HT계화.평고파구급OAR적제량분포.채용단인소방차분석3개계화삼수차이,용LSD법진행량량비교.결과 IMRT、VMAT、HT계화적파구복개도균만족림상처방제량요구,단HT계화파구복개도최우(P=0.000),차HT계화적105％ PTV강저약46％ (47.12％、45.83％、0.05％,P=0.000)、Dmax강저약2Gy(54.53、53.65、52.69 Gy,P=0.000),방광V40화Dmax최저(50.01％、46.84％、42.98％,P=0.001화54.49、52.96、52.78 Gy,P=0.000),직장V40최저(54.61％、48.34％、46.78％,P=0.006),소장Dmax최저(54.53、53.65、52.66 Gy,P=0.000),골수Dmax최저(54.51、54.44、52.13 Gy,P=0.000),단궤기도수최고(1429.20、617.80、7 002.04 MU,P=0.000).결론 궁경술후암환자HT림상응용구유가행성,가이작위일충신적조사방식추엄.
Objective To investigate dosimetric advantage of fixed field intensity-modulated radiotherapy (FF-IMRT),volumetric modulated arc therapy (VMAT) and helical tomotherapy (HT) for cervix uteri cancer.Methods CT datasets of ten patients with cervix uteri cancer were enrolled in the study.FF-IMRT,VMAT and HT plans were designed on Eclipse and HT treatment planning system.Plans were optimized with the aim to assess OAR while enforcing highly conformal target coverage.Institutional dose-volume constraints used in cervix uteri cancer were kept the same for three techniques.The different of three plan was play by single factor analysis of variance and compared to two groups by LSD method.Results All FF-IMRT,VMAT and HT resulted in equivalent target coverage but HT had an improved homogeneity index (P =0.000) and conformity index (P =0.000),or PTV of 105％ prescription dose (47.12％,45.83％ and 0.05％,P=0.000) and lowest Dmax dose (54.53 Gy,53.65 Gy,52.69 Gy,P=0.000).Compared with FF-IMRT and VMAT,the bladder V40 and Dmax of HT were lowest (50.01％,46.84％,42.98％,P=0.001 and 54.49 Gy,52.96 Gy,52.78 Gy,P=0.000),with the rectum V40 lowest (54.61％,48.34％,46.78％,P =0.006),the intestine Dmax lowest (54.53 Gy,53.65 Gy,52.66 Gy,P =0.000) and marrow Dmax lowest (54.51 Gy,54.44 Gy,52.13 Gy,P=0.000).But the delivery MU per fraction were highest (1429.20 MU,617.80 MU,7002.04 MU,P =0.000).Conclusions HT technology is feasible for clinical applications in cervical uteri cancer and can be used as a new method to promote.