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
12期
942-945
,共4页
王佳浩%李夏东%邓清华%吴稚冰%夏冰%赖建军%唐荣军
王佳浩%李夏東%鄧清華%吳稚冰%夏冰%賴建軍%唐榮軍
왕가호%리하동%산청화%오치빙%하빙%뢰건군%당영군
容积旋转调强放疗%静态调强放疗%剂量学
容積鏇轉調彊放療%靜態調彊放療%劑量學
용적선전조강방료%정태조강방료%제량학
Volumetric modulated arc therapy(VMAT)%Intensity modulated radiation therapy (IMRT)%Dosimetry
目的 比较乳腺癌根治术后双弧的容积旋转调强放射治疗(VMAT)与5野的静态调强放射治疗(IMRT)2种计划之间的剂量学差异,评估VMAT技术在乳腺癌根治术后的剂量学特点与应用能力.方法 选取28例乳腺癌根治术后患者(左侧10例,右侧18例),分别制定双90度弧段的VMAT与5野的IMRT 2种计划,主要的计划评估参数为靶区的肿瘤控制概率(TCP)、适形指数(CI)、均匀指数(HI)以及接受相应处方剂量水平照射体积百分比K5、V110,危及器官(OAR)评估包括患侧肺的正常组织并发症概率(NTCP)、Dmean、V5、V20、V30,心脏的NTCP值、Dmean、V25,健侧乳腺的Dmean、机器跳数(MU)以及治疗时间.结果 VMAT计划与IMRT计划的TCP值分别为(96±2)％、(90±2)％(t=-6.28,P＜0.01);HI值分别为0.15 ±0.04,0.22±0.02(t=13.29,P＜0.05);肿瘤位于左侧时,心脏NTCP值在VMAT计划与IMRT计划中分别为(1.0±0.12)％,(1.7±0.13)％(t=2.14,P＜0.05);肿瘤位于右侧时,2种计划心脏的NTCP差异无统计学意义,平均剂量分别为(3.27 ±0.26)、(6.0±0.47)Gy(t=9.21,P＜0.01);VMAT计划在MU少于IMRT计划(t=9.58,P＜0.01),治疗时间短于IMRT计划(t=8.40,P＜0.05).结论 乳腺癌根治术后,VMAT计划具有更强的临床应用能力,且表现出更优的剂量学特点.
目的 比較乳腺癌根治術後雙弧的容積鏇轉調彊放射治療(VMAT)與5野的靜態調彊放射治療(IMRT)2種計劃之間的劑量學差異,評估VMAT技術在乳腺癌根治術後的劑量學特點與應用能力.方法 選取28例乳腺癌根治術後患者(左側10例,右側18例),分彆製定雙90度弧段的VMAT與5野的IMRT 2種計劃,主要的計劃評估參數為靶區的腫瘤控製概率(TCP)、適形指數(CI)、均勻指數(HI)以及接受相應處方劑量水平照射體積百分比K5、V110,危及器官(OAR)評估包括患側肺的正常組織併髮癥概率(NTCP)、Dmean、V5、V20、V30,心髒的NTCP值、Dmean、V25,健側乳腺的Dmean、機器跳數(MU)以及治療時間.結果 VMAT計劃與IMRT計劃的TCP值分彆為(96±2)％、(90±2)％(t=-6.28,P＜0.01);HI值分彆為0.15 ±0.04,0.22±0.02(t=13.29,P＜0.05);腫瘤位于左側時,心髒NTCP值在VMAT計劃與IMRT計劃中分彆為(1.0±0.12)％,(1.7±0.13)％(t=2.14,P＜0.05);腫瘤位于右側時,2種計劃心髒的NTCP差異無統計學意義,平均劑量分彆為(3.27 ±0.26)、(6.0±0.47)Gy(t=9.21,P＜0.01);VMAT計劃在MU少于IMRT計劃(t=9.58,P＜0.01),治療時間短于IMRT計劃(t=8.40,P＜0.05).結論 乳腺癌根治術後,VMAT計劃具有更彊的臨床應用能力,且錶現齣更優的劑量學特點.
목적 비교유선암근치술후쌍호적용적선전조강방사치료(VMAT)여5야적정태조강방사치료(IMRT)2충계화지간적제량학차이,평고VMAT기술재유선암근치술후적제량학특점여응용능력.방법 선취28례유선암근치술후환자(좌측10례,우측18례),분별제정쌍90도호단적VMAT여5야적IMRT 2충계화,주요적계화평고삼수위파구적종류공제개솔(TCP)、괄형지수(CI)、균균지수(HI)이급접수상응처방제량수평조사체적백분비K5、V110,위급기관(OAR)평고포괄환측폐적정상조직병발증개솔(NTCP)、Dmean、V5、V20、V30,심장적NTCP치、Dmean、V25,건측유선적Dmean、궤기도수(MU)이급치료시간.결과 VMAT계화여IMRT계화적TCP치분별위(96±2)％、(90±2)％(t=-6.28,P＜0.01);HI치분별위0.15 ±0.04,0.22±0.02(t=13.29,P＜0.05);종류위우좌측시,심장NTCP치재VMAT계화여IMRT계화중분별위(1.0±0.12)％,(1.7±0.13)％(t=2.14,P＜0.05);종류위우우측시,2충계화심장적NTCP차이무통계학의의,평균제량분별위(3.27 ±0.26)、(6.0±0.47)Gy(t=9.21,P＜0.01);VMAT계화재MU소우IMRT계화(t=9.58,P＜0.01),치료시간단우IMRT계화(t=8.40,P＜0.05).결론 유선암근치술후,VMAT계화구유경강적림상응용능력,차표현출경우적제량학특점.
Objective To analyze the biophysical dosimetric characteristics and clinical application ability of VMAT technology for breast cancer post-mastectomy.Methods 28 patients with breast cancer (10 at left side and the other at right side) were planned in different ways respectively.One was two 90 degree arc VMAT plan and the other were 5 beam IMRT plan.The dosimetric parameters of two different plans including tumor control probability (TCP),conformity index(CI),homogeneity index (HI),V95and V110 in target,normal tissue complication probability (NTCP),V5,V20,V30 for ipsilateral lung,NCTP,D V25 for heart,D for the contralateral breast in OARs,MU and times were compared.Results The average tumor control probability (TCP) in VMAT and IMRT group was(96 ±2)％ and (90 ±2)％ (t =-6.28,P ＜ 0.01),respectively.The PTV dose average homogeneity index (HI) of VMAT plans was better than that of IMRT plan (0.15 ±0.04 vs 0.22 ±0.02,t =13.29,P ＜0.01).For cancer position in left side,the mean dose of heart was decreased by 433.24 cGy in the VMAT plan.The NTCP of the hearts in VMAT plans had statistically significant difference compared with IMRT plans [(1.00±0.12)％ vs (1.70±0.13)％,t =2.14,P ＜0.05].For plans of right breast cancer,the average mean dose of hearts in two control group was (3.27 ± 0.26) Gy and (6.00 ± 0.47) Gy (t =9.21,P＜0.01).The total monitor unit (MU) was 530.7 in the VMAT arm and 693.9 in the IMRT arm (t =9.58,P ＜0.01).The treatment time was shorter in VMAT arm (t =8.40,P ＜0.05).Conclusions VMAT plans have better clinical value and more superior biophysical dosimetric characteristics for breast cancer post-mastectomy.
