中华放射医学与防护杂志
中華放射醫學與防護雜誌
중화방사의학여방호잡지
Chinese Journal of Radiological Medicine and Protection
2014年
2期
116-119
,共4页
胡江%孙文钊%王彬%黄虹%祁振宇
鬍江%孫文釗%王彬%黃虹%祁振宇
호강%손문쇠%왕빈%황홍%기진우
鼻腔NK/T淋巴瘤%调强放疗%非共面%旋转调强
鼻腔NK/T淋巴瘤%調彊放療%非共麵%鏇轉調彊
비강NK/T림파류%조강방료%비공면%선전조강
Nasal NK/T-cell lymphoma%Intensity modulated radiotherapy%Non-coplanar%RapidArc therapy
目的 探讨早期结外鼻腔NK/T细胞淋巴瘤固定野调强和旋转调强放疗的剂量学和执行效率差异.方法 选取10例ⅠE～ⅡE期鼻腔NK/T细胞淋巴瘤患者,分别设计共面5野(5F)、共面9野(9F)、非共面5野(5F-N)和旋转调强(RapidArc)方案,以5F计划为参照,9F、5F-N和RapidArc计划分别与其就靶区适形度指数(CI)、均匀性指数(HI)和危及器官的受照剂量进行比较,同时比较各计划剂量验证通过率、出束跳数和治疗时间.结果 CI值9F(0.478 ±0.181)、5F-N(0.465 ±0.121)、RapidArc(0.518 ±0.111)与5F(0.419 ±0.159)计划相比,差异无统计学意义；HI值9F(0.111 ±0.027)、RapidArc(0.112±0.031)显著低于5F计划的(0.136±0.038)(t=3.11、3.04,P＜0.05).9F计划晶状体Dmax显著高于5F计划(健侧=2.82,P＜0.05;患侧t=3.25,P＜0.05).5F-N计划视神经Dmax显著低于5F计划(健侧t=4.27,P＜0.05；患侧=2.82,P＜0.05).RapidArc计划健侧晶状体(=3.25,P＜0.05)、眼球(t=3.25,P＜0.05)和视神经(t=2.57,P＜0.05)Dmax显著低于5F计划.此外,RapidArc计划视交叉Dmax显著低于5F计划(t=7.62,P＜0.05).各计划执行效率为RapidArc＞5F＞5F-N＞9F.结论 在剂量学和计划执行效率方面,RapidArc较共面固定野5野调强更具优势,推荐作为早期结外鼻腔NK/T细胞淋巴瘤调强放疗布野模式首选.
目的 探討早期結外鼻腔NK/T細胞淋巴瘤固定野調彊和鏇轉調彊放療的劑量學和執行效率差異.方法 選取10例ⅠE～ⅡE期鼻腔NK/T細胞淋巴瘤患者,分彆設計共麵5野(5F)、共麵9野(9F)、非共麵5野(5F-N)和鏇轉調彊(RapidArc)方案,以5F計劃為參照,9F、5F-N和RapidArc計劃分彆與其就靶區適形度指數(CI)、均勻性指數(HI)和危及器官的受照劑量進行比較,同時比較各計劃劑量驗證通過率、齣束跳數和治療時間.結果 CI值9F(0.478 ±0.181)、5F-N(0.465 ±0.121)、RapidArc(0.518 ±0.111)與5F(0.419 ±0.159)計劃相比,差異無統計學意義；HI值9F(0.111 ±0.027)、RapidArc(0.112±0.031)顯著低于5F計劃的(0.136±0.038)(t=3.11、3.04,P＜0.05).9F計劃晶狀體Dmax顯著高于5F計劃(健側=2.82,P＜0.05;患側t=3.25,P＜0.05).5F-N計劃視神經Dmax顯著低于5F計劃(健側t=4.27,P＜0.05；患側=2.82,P＜0.05).RapidArc計劃健側晶狀體(=3.25,P＜0.05)、眼毬(t=3.25,P＜0.05)和視神經(t=2.57,P＜0.05)Dmax顯著低于5F計劃.此外,RapidArc計劃視交扠Dmax顯著低于5F計劃(t=7.62,P＜0.05).各計劃執行效率為RapidArc＞5F＞5F-N＞9F.結論 在劑量學和計劃執行效率方麵,RapidArc較共麵固定野5野調彊更具優勢,推薦作為早期結外鼻腔NK/T細胞淋巴瘤調彊放療佈野模式首選.
목적 탐토조기결외비강NK/T세포림파류고정야조강화선전조강방료적제량학화집행효솔차이.방법 선취10례ⅠE～ⅡE기비강NK/T세포림파류환자,분별설계공면5야(5F)、공면9야(9F)、비공면5야(5F-N)화선전조강(RapidArc)방안,이5F계화위삼조,9F、5F-N화RapidArc계화분별여기취파구괄형도지수(CI)、균균성지수(HI)화위급기관적수조제량진행비교,동시비교각계화제량험증통과솔、출속도수화치료시간.결과 CI치9F(0.478 ±0.181)、5F-N(0.465 ±0.121)、RapidArc(0.518 ±0.111)여5F(0.419 ±0.159)계화상비,차이무통계학의의；HI치9F(0.111 ±0.027)、RapidArc(0.112±0.031)현저저우5F계화적(0.136±0.038)(t=3.11、3.04,P＜0.05).9F계화정상체Dmax현저고우5F계화(건측=2.82,P＜0.05;환측t=3.25,P＜0.05).5F-N계화시신경Dmax현저저우5F계화(건측t=4.27,P＜0.05；환측=2.82,P＜0.05).RapidArc계화건측정상체(=3.25,P＜0.05)、안구(t=3.25,P＜0.05)화시신경(t=2.57,P＜0.05)Dmax현저저우5F계화.차외,RapidArc계화시교차Dmax현저저우5F계화(t=7.62,P＜0.05).각계화집행효솔위RapidArc＞5F＞5F-N＞9F.결론 재제량학화계화집행효솔방면,RapidArc교공면고정야5야조강경구우세,추천작위조기결외비강NK/T세포림파류조강방료포야모식수선.
Objective To investigate the dosimetric characteristics and their clinical applications of volumetric modulated Arc therapy (RapidArc) with fixed-fields intensity modulated radiotherapy for early stage nasal NK/T-cell lymphoma.Methods Ten patients with stage Ⅰ E and Ⅱ E nasal NK/T-cell lymphoma were enrolled in the study.Five field coplanar plan (5F),nine field coplanar plan (9F),five field non-coplanar plan (5F-N) and RapidArc plans were designed for each patient,in which 5F plan was set as the control group.Conformity index (CI) and homogeneity index (HI) as well as the maximum dose of organs at risks were compared.Results The target CI of 5F,9F,5F-N and RapidArc plan was 0.419±0.159,0.478 ±0.181,0.465 ±0.121 and 0.518 ±0.111,respectively.Compared with 5F (0.136±0.038),the target HI of 9F and RapidArc plan was 0.111 ±0.027 and 0.112 ±0.031 (t =3.11,3.04,P ＜ 0.05).9F plan significantly increased the Dmax of lens in the contralateral side(t =2.82,P ＜ 0.05) and in ipsilateral side (t =3.25,P ＜ 0.05),while 5F-N plan decreased the Dmax of optical nerves by up to 9％.RapidArc plan effectively reduced the radiation to organs at risk in lens (t =3.25,P ＜0.05),eyes (t =3.25,P ＜0.05),optical nerve (t =2.57,P ＜0.05) and optical chaism(t =7.62,P ＜0.05).The delivery efficiency of four plans ranked as RapidArc ＞ 5F ＞ 5F-N ＞ 9F.Conclusions RapidArc produced statistically significant improvement in the dose distributions of targets,and also reduced the Dmax of organs at risk,which would be the better choice of radiotherapy for nasal NK/T-cell lymphoma.
