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
2015年
5期
353-355,359
,共4页
杨金磊%卜明伟%黄巍%刘博宇
楊金磊%蔔明偉%黃巍%劉博宇
양금뢰%복명위%황외%류박우
水平方向射野%调强放疗%肺癌
水平方嚮射野%調彊放療%肺癌
수평방향사야%조강방료%폐암
Horizontal beam%Intensity modulated radiation therapy%Lung cancer
目的 探讨水平方向射野对肺癌调强计划结果的影响.方法 收集肺癌患者18例,其中左肺癌患者10例,右肺癌患者8例,设计普通调强(IMRT计划)和在普通调强基础上添加一个水平方向射野(H-IMRT计划)的计划,比较机器跳数、子野数及靶区和危及器官(OARs)的剂量分布.结果 两种计划PTV的Dmax、Dmin及Dmean,患侧肺的V30和Dmean,健侧肺的V200和V30,全肺的V30差异均无统计学意义.与IMRT计划相比,添加水平射野后,PTV的均匀性(HI)及适形度(CI)都有显著提高(t=-9.33、10.88,P＜0.05);肺的其他剂量指标均变差(t=-1.55～-7.58,P＜0.05);心脏的保护更优(t=1.84 ～3.99,P＜0.05);MUs及子野数量降低(t=12.57、3.19,P＜0.05).结论 在肺癌的IMRT治疗中,添加水平射野可以改善靶区的剂量分布,但会使肺的低剂量照射体积增加,无益于肺的保护.
目的 探討水平方嚮射野對肺癌調彊計劃結果的影響.方法 收集肺癌患者18例,其中左肺癌患者10例,右肺癌患者8例,設計普通調彊(IMRT計劃)和在普通調彊基礎上添加一箇水平方嚮射野(H-IMRT計劃)的計劃,比較機器跳數、子野數及靶區和危及器官(OARs)的劑量分佈.結果 兩種計劃PTV的Dmax、Dmin及Dmean,患側肺的V30和Dmean,健側肺的V200和V30,全肺的V30差異均無統計學意義.與IMRT計劃相比,添加水平射野後,PTV的均勻性(HI)及適形度(CI)都有顯著提高(t=-9.33、10.88,P＜0.05);肺的其他劑量指標均變差(t=-1.55～-7.58,P＜0.05);心髒的保護更優(t=1.84 ～3.99,P＜0.05);MUs及子野數量降低(t=12.57、3.19,P＜0.05).結論 在肺癌的IMRT治療中,添加水平射野可以改善靶區的劑量分佈,但會使肺的低劑量照射體積增加,無益于肺的保護.
목적 탐토수평방향사야대폐암조강계화결과적영향.방법 수집폐암환자18례,기중좌폐암환자10례,우폐암환자8례,설계보통조강(IMRT계화)화재보통조강기출상첨가일개수평방향사야(H-IMRT계화)적계화,비교궤기도수、자야수급파구화위급기관(OARs)적제량분포.결과 량충계화PTV적Dmax、Dmin급Dmean,환측폐적V30화Dmean,건측폐적V200화V30,전폐적V30차이균무통계학의의.여IMRT계화상비,첨가수평사야후,PTV적균균성(HI)급괄형도(CI)도유현저제고(t=-9.33、10.88,P＜0.05);폐적기타제량지표균변차(t=-1.55～-7.58,P＜0.05);심장적보호경우(t=1.84 ～3.99,P＜0.05);MUs급자야수량강저(t=12.57、3.19,P＜0.05).결론 재폐암적IMRT치료중,첨가수평사야가이개선파구적제량분포,단회사폐적저제량조사체적증가,무익우폐적보호.
Objective To explore the effect of horizontal beam on IMRT plan for lung cancer.Methods Totally 18 patients were enrolled,including 10 cases of left lung cancer and 8 cases of right lung cancer.Two intensity modulated radiation therapy (IMRT) plans were generated:one was the normal IMRT plan and another was the IMRT plan including a horizontal beam (H-IMRT).MUs,sub-field and the dose distribution of target and organs at risk (OARs) were compared.Results There were no statistically significant differences between two plans in D Dminand D of PTV,the V30 and D of the ipsilateral lung,V20 and V30 of the contralateral lung,and V30 of the total lung.When the horizontal beam was added,the PTV heterogeneity index (HI) and conformity index (CI) were significantly increased (t=-9.33,10.88,P＜0.05),the other dose index in lung was inferior (t =-1.55--7.58,P＜ 0.05),whleheart sparing were clearly better (t =1.84-3.99,P＜0.05),the number of MUs and segments were less(t =12.57,3.19,P ＜ 0.05).Conclusions IMRT in the treatment of lung cancer can further improve the PTV coverage when the horizontal beam is added.However,the increasing lung volume of low dose irradiation is not conducive to lung protection.
