CAJ | 학술논문

目的研究固定射野动态调强放疗铅门跟随技术与铅门固定技术在直肠癌术前调强放疗中的剂量学差异.方法采用两种治疗技术对10例直肠癌术前患者设计治疗计划.在95％体积的计划靶区(PTV)和计划肿瘤区(PGTV)满足处方剂量的前提下,尽量降低危及器官的剂量.比较两组治疗计划的剂量-体积直方图,评估靶区及危及器官的剂量分布.分别将两组治疗计划用电离室矩阵2D-Array 729和OCTAVIUS(PTW)模体进行剂量验证.结果两组计划的靶区均达到临床处方剂量的要求.PTV和PGTV的最大剂量与平均剂量差异无统计学意义.铅门跟随动态调强计划中全身的V5、V10、V20、V30、V40、Dmean以及双侧股骨头、膀胱、小肠的V10、V20、V30和Dmean均低于铅门固定动态调强计划的相应值,差异有统计学意义(t=-2.32～ 12.24,P＜0.05);双侧股骨头、膀胱、小肠的V40以及Dmax差异无统计学意义.采用γ-2D分析两组计划的通过率,两组计划均通过剂量验证.结论直肠癌术前放疗患者采用固定射野动态调强放疗铅门跟随技术与铅门固定技术两种技术,其靶区和危及器官受量均能满足临床治疗要求,而铅门跟随技术能够更好地降低正常组织和危及器官的低剂量照射.
목적 연구고정사야동태조강방료연문근수기술여연문고정기술재직장암술전조강방료중적제량학차이.방법 채용량충치료기술대10례직장암술전환자설계치료계화.재95％체적적계화파구(PTV)화계화종류구(PGTV)만족처방제량적전제하,진량강저위급기관적제량.비교량조치료계화적제량-체적직방도,평고파구급위급기관적제량분포.분별장량조치료계화용전리실구진2D-Array 729화OCTAVIUS(PTW)모체진행제량험증.결과 량조계화적파구균체도림상처방제량적요구.PTV화PGTV적최대제량여평균제량차이무통계학의의.연문근수동태조강계화중전신적V5、V10、V20、V30、V40、Dmean이급쌍측고골두、방광、소장적V10、V20、V30화Dmean균저우연문고정동태조강계화적상응치,차이유통계학의의(t=-2.32～ 12.24,P＜0.05);쌍측고골두、방광、소장적V40이급Dmax차이무통계학의의.채용γ-2D분석량조계화적통과솔,량조계화균통과제량험증.결론 직장암술전방료환자채용고정사야동태조강방료연문근수기술여연문고정기술량충기술,기파구화위급기관수량균능만족림상치료요구,이연문근수기술능구경호지강저정상조직화위급기관적저제량조사.
Objective To compare the dosimetric difference between jaw tracking technique (JTT) and static jaw technique (SJT) in dynamic intensity-modulated radiotherapy (IMRT) for preoperative radiotherapy of rectal cancer patients.Methods Jaw tracking and static jaw were used to develope the intensity-modulated plans for 10 patients respectively.For all the patients,the dose to surrounding tissues was minimized as low as possible,the 95％ volume of the planning target volume (PTV) and planning gross target volume (PGTV) satisfy the prescribed dose.The doses of the planning target volumes,organs at risk and normal tissue were detected by dose-volume histogram.Two groups of treatment plan dose were verified by ionization chamber array 2D-Array 729 and OCTAVIUS (PTW) phantom.Results The treatment plans of two groups could satisfy the clinical requirements.There was no significant difference between the maximum and the mean dose of target.The volumes of jaw tracking dynamic intensity-modulated radiotherapy were lower,including the V5,V10,V20,V30,V40 (volumes receiving 5,10,20,30 and 40 Gy,respectively),mean dose(D) for body and V10,V20,V30,D for bilateral femoral head,bladder,and small intestine.There was significant difference for the results (t =-2.32-12.24,P ＜0.05).The verification results showed that the treatment plans were all passed the dosimetric verification.Conclusions Jaw tracking intensity-modulated radiotherapy and jaw fixed IMRT plan could achieve equal dose coverage in patients with rectal cancer,while jaw tracking techniques could reduce normal tissue dose and organs at risk dose.