CAJ | 학술논문

目的研究直肠癌患者应用固定铅门技术(FJT)和分野技术(SFT),分析比较2种不同的调强放疗技术的剂量学差异.方法选择15例直肠癌患者,进行CT模拟定位,勾画靶区及危及器官,对同一CT图像设计FJT计划和SFT计划.评估靶区及危及器官的剂量分布.结果 FJT计划组PTV95覆盖度降低(t=-2.24,P＜0.05)；Dmean升高(=2.54,P＜0.05)；HI较差(=3.09,P＜0.05),CI无差异.小肠V5升高(t=4.76,P＜0.05),骨髓V20和V50优于SFT计划组(t=-2.66、-3.36,P＜0.05),而Dmax高于SFT计划组(t=3.30,P＜0.05)；全身的V20高于SFT计划组(t=2.48,P＜0.05).MU的数量和子野数量明显低于SFT计划组(t=-9.38、-6.46,P＜0.05),计划验证通过率优于SFT计划组(t=10.46,P＜0.05)；治疗时间由原来的平均12 min缩短至6 min,缩短50％.结论与SFT技术比较,直肠癌患者采用FJT技术,其靶区、危及器官受量均能满足临床治疗要求.患者治疗时间缩短,MU数量降低,单位时间内每天每台机器治疗患者的数量增加,减少患者的等待时间,降低加速器质量保证的难度.
목적 연구직장암환자응용고정연문기술(FJT)화분야기술(SFT),분석비교2충불동적조강방료기술적제량학차이.방법 선택15례직장암환자,진행CT모의정위,구화파구급위급기관,대동일CT도상설계FJT계화화SFT계화.평고파구급위급기관적제량분포.결과 FJT계화조PTV95복개도강저(t=-2.24,P＜0.05)；Dmean승고(=2.54,P＜0.05)；HI교차(=3.09,P＜0.05),CI무차이.소장V5승고(t=4.76,P＜0.05),골수V20화V50우우SFT계화조(t=-2.66、-3.36,P＜0.05),이Dmax고우SFT계화조(t=3.30,P＜0.05)；전신적V20고우SFT계화조(t=2.48,P＜0.05).MU적수량화자야수량명현저우SFT계화조(t=-9.38、-6.46,P＜0.05),계화험증통과솔우우SFT계화조(t=10.46,P＜0.05)；치료시간유원래적평균12 min축단지6 min,축단50％.결론 여SFT기술비교,직장암환자채용FJT기술,기파구、위급기관수량균능만족림상치료요구.환자치료시간축단,MU수량강저,단위시간내매천매태궤기치료환자적수량증가,감소환자적등대시간,강저가속기질량보증적난도.
Objective To study the dosimetric comparison of split field and fixed jaw techniques for large IMRT target volumes in the rectum cancer.Methods CT images of fifteen patients with rectum malignancies and regional target volumes were transferred into Eclipse planning system.SFT plan and FJT plan were performed on an Eclipse TPS using beam data generated for linear accelerator.A standard beam arrangement consisting of seven coplanar fields was used in both techniques.Institutional dose-volume constraints used in rectum cancer were kept the same for both techniques.Target and organs at risk were evaluated.Results PTV95 in FJT plan coverage was lower (t =-2.24,P ＜ 0.05).Dmean in FJT plan was increased (t =2.54,P ＜ 0.05),but Dmax was not different.HI in FJT plan became inferior (t =3.09,P ＜0.05),while CI was not different.There was no difference in dose distribution among bladder,femoral head and cauda equina.The value of V5 of small intestine increased in FJT plan (t =4.76,P ＜0.05),and the values of V20 and V50 of bone marrow were better than those in SFT plan (t =-2.66,-3.36,P＜0.05),while Dmax was higher than that in SFT plan (t =3.30,P ＜ 0.05).The value of V20 of body was higher in FJT plan than that in SFT plan (t =2.48,P ＜0.05).The number of MU was significantly lower in FJT plan than that in SFT plan (t =-9.38,P ＜0.05).The average segments in FJT plan decreased by 39.4％ compared with SFT plan (t =-6.46,P ＜ 0.05).Verification rate in FJT plan group was better than that in SFT plan (t =10.46,P＜0.05),and the treatment time was shortened from 12 to 6 min.Conclusions Compared to SFT technique,patients with rectal cancer who were treated with FJT could get better dose of target and organs,which can meet the clinical treatment requirements.The technique could shorten the treatment time and reduce the treatment MU.It also could increase the number of patients to be treated,reduce their waiting time and reduce the difficulty of QA.