CAJ | 학술논문

目的比较容积旋转调强(RapidArc)与固定野动态调强(IMRT)两种宫颈癌术后放疗的剂量学参数及急性不良反应发生率,为临床治疗技术的选择提供参考依据.方法选取35例宫颈癌术后盆腔预防放疗患者,其中,17例接受RapidArc,18例接受IMRT,处方剂量50 Gy,共25次.比较两组治疗计划的剂量-体积直方图(DVH)、靶区剂量适形度、均匀性、靶区及危及器官的剂量、机器跳数及治疗时间;对比两组患者治疗期间的急性肠道及膀胱反应发生率.结果与IMRT相比,RapidArc靶区剂量适形度较高(t=3.13,P＜0.05),但均匀性略低(t=-4.25,P＜0.05);RapidArc计划中股骨头V20、V30均低于IMRT(t=2.56、2.34,P＜0.05);RapidArc计划机器跳数减少了52.1％,治疗所需时间缩短了46.8％.两组患者肠道、膀胱急性不良反应发生率相近.结论对于宫颈癌术后盆腔预防放疗患者,采用RapidArc或IMRT技术均可达到靶区的剂量要求及保护危及器官的目的.RapidArc计划靶区剂量学参数、急性不良反应发生率与IMRT计划比较未见明显优势,但机器跳数与出束时间明显优于IMRT计划,实现了治疗效率的大幅提高.
목적 비교용적선전조강(RapidArc)여고정야동태조강(IMRT)량충궁경암술후방료적제량학삼수급급성불량반응발생솔,위림상치료기술적선택제공삼고의거.방법 선취35례궁경암술후분강예방방료환자,기중,17례접수RapidArc,18례접수IMRT,처방제량50 Gy,공25차.비교량조치료계화적제량-체적직방도(DVH)、파구제량괄형도、균균성、파구급위급기관적제량、궤기도수급치료시간;대비량조환자치료기간적급성장도급방광반응발생솔.결과 여IMRT상비,RapidArc파구제량괄형도교고(t=3.13,P＜0.05),단균균성략저(t=-4.25,P＜0.05);RapidArc계화중고골두V20、V30균저우IMRT(t=2.56、2.34,P＜0.05);RapidArc계화궤기도수감소료52.1％,치료소수시간축단료46.8％.량조환자장도、방광급성불량반응발생솔상근.결론 대우궁경암술후분강예방방료환자,채용RapidArc혹IMRT기술균가체도파구적제량요구급보호위급기관적목적.RapidArc계화파구제량학삼수、급성불량반응발생솔여IMRT계화비교미견명현우세,단궤기도수여출속시간명현우우IMRT계화,실현료치료효솔적대폭제고.
Objective To compare the planning quality and acute toxicity between RapidArc and fixed gantry angle dynamic intensity modulated radiotherapy (IMRT) in the postoperative radiotherapy for cervical cancer patients.Methods All 35 patients with cervical cancer who had received postoperative radiotherapy were studied,including 17 patients with RapidArc and 18 patients with IMRT.All plans were prescribed 50 Gy in 25 fractions.The dose-volume histogram data,the conformity index and homogeneity index of the targets,the monitor units (MUs) and delivery time were compared.During the treatment,the incidence of acute intestinal and bladder side effects were also compared.Results Compared to IMRT,the conformity index of RapidArc was better(t =3.13,P ＜ 0.05),but the homogeneity index was slightly worse (t =-4.25,P ＜ 0.05).The V20 and V30 of femoral head planned by RapidArc was significantly lower than that by IMRT (t =2.56,2.34,P ＜ 0.05).The mean MU for RapidArc was reduced by 52.1％ compared with IMRT.The mean treatment time for RapidArc was decreased by 46.8％ compared with IMRT.There was no difference in the incidence of acute intestinal and bladder toxicity between the two groups.Conclusion For patients with cervical cancer who need prophylactic postoperative radiotherapy,both RapidArc and IMRT plan can achieve equal target coverage and organs at risk(OAR) sparing.There is no significant difference in dosimetric parameters and acute toxicity between the two groups.Compared with IMRT,RapidArc plan has fewer MUs and less treatment time and significantly improves the treatment efficiency.