CAJ | 학술논문

目的研究旋转容积调强技术与常规固定野九野调强技术在宫颈癌放疗中的运用,比较其剂量学分布及周围危及器宫的受照剂量,探讨宫颈癌放疗的最佳方案.方法选择20例宫颈癌患者分为2组,每组10例,一组为宫颈癌未行手术患者(A组),给予根治性放疗,处方剂量GTV 56Gy,CTV 50 Gy;另一组为宫颈癌根治术后患者(B组),给予全盆淋巴结辅助放疗,处方剂量CTV50Gy.对2组患者分别进行容积旋转调强(VMAT)和固定野九野调强(IMRT)计划设计,分别比较2组中两种计划之间的剂量-体积直方图(DVH)、危及器官受照体积、靶区剂量的适形度指数(CI)、均匀度指数(HI)、最大受照剂量(PTV Dmax)、最小受照剂量(PTV Dmin)和平均受照剂量(PTV Dmean).结果两种放疗技术分别在2组中靶区剂量学差异无统计学意义(P＞0.05).在危及器官的保护上,两组中的VMAT计划组在小肠V20和左股骨头V20上有明显的优势,差异有统计学意义(P＜0.05).结论宫颈癌容积旋转调强与固定野九野调强计划两组剂量学相似,两组中的VMAT计划组对危及器官的保护略优于IMRT组,且VMAT计划组治疗时间短,提高了治疗精度和疗效.
목적 연구선전용적조강기술여상규고정야구야조강기술재궁경암방료중적운용,비교기제량학분포급주위위급기궁적수조제량,탐토궁경암방료적최가방안.방법 선택20례궁경암환자분위2조,매조10례,일조위궁경암미행수술환자(A조),급여근치성방료,처방제량GTV 56Gy,CTV 50 Gy;령일조위궁경암근치술후환자(B조),급여전분림파결보조방료,처방제량CTV50Gy.대2조환자분별진행용적선전조강(VMAT)화고정야구야조강(IMRT)계화설계,분별비교2조중량충계화지간적제량-체적직방도(DVH)、위급기관수조체적、파구제량적괄형도지수(CI)、균균도지수(HI)、최대수조제량(PTV Dmax)、최소수조제량(PTV Dmin)화평균수조제량(PTV Dmean).결과 량충방료기술분별재2조중파구제량학차이무통계학의의(P＞0.05).재위급기관적보호상,량조중적VMAT계화조재소장V20화좌고골두V20상유명현적우세,차이유통계학의의(P＜0.05).결론 궁경암용적선전조강여고정야구야조강계화량조제량학상사,량조중적VMAT계화조대위급기관적보호략우우IMRT조,차VMAT계화조치료시간단,제고료치료정도화료효.
Objective To compare the planning quality and volume of organ at risk (OAR) between volumetric-modulated arc therapyv (VMAT) and nine-field dynamic intensity-modulated radiation therapy (IMRT) in radiotherapy for cervical cancer patients,explore the best way to cervical cancer radiotherapy,Methods Selected 20 patients with cervical cancer were divided into 2 groups,10 cases for each group.Cervical cancer patients with no surgery was performed for A group (group A),received the radical radiotherapy,prescription dose gross tumor volume (GTV) 56 Gy,clinical target volume (CTV) 50 Gy.Another group of patients with cervical cancer radical surgery (group B),giving the whole basin lymph node auxiliary radiation therapy,prescription dose CTV 50 Gy.Each cervical cancer patient received VMAT and IMRT program designs,the differences in dose volume histogram (DVH),irradiated volume of organ at risk (OAR),heterogeneity index (HI),conformity index (CI),maximum dose (PTVmax),minimum dose (PTVmin) and mean dose (PTV mean) were compared between two plans in 2 groups.Results Two kinds of radiation technology in target area dosimetry were not statistical difference between two groups (P ＞ 0.05).In endanger organs on the protection of two groups of VMAT planning groups in the small intestine V20 and left femoral head V20 had obvious advantages with statistically significance (P ＜ 0.05).Conclusions Two groups of dosimetry between VMAT and IMRT program design are similar in cervical cancer.Two groups of VMAT planning groups to protect endanger organ slightly better than that of IMRT group,but VMAT planning group shortens treatment time and improves the accuracy and efficacy of treatment.