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
9期
670-673
,共4页
陈利%黄晓延%曹午飞%姚杏红%陈阿龙
陳利%黃曉延%曹午飛%姚杏紅%陳阿龍
진리%황효연%조오비%요행홍%진아룡
肺癌%调强放疗%蒙特卡罗算法%对介质的剂量%对水的剂量
肺癌%調彊放療%矇特卡囉算法%對介質的劑量%對水的劑量
폐암%조강방료%몽특잡라산법%대개질적제량%대수적제량
Lung cancer%Intensity-modulated radiotherapy%Monte Carlo algorithm%Dose-to-medium%Dose-to-water
目的 探讨肺癌调强放疗计划时,蒙特卡罗算法计算对水与介质的剂量差异.方法 随机类型抽样法选取10例肺癌患者的5野调强计划,在质量保证模块下以患者自身图像为模体,采用蒙特卡罗算法分别计算两种计划的吸收剂量,计算对实际介质的吸收剂量(Dm)和对水的吸收剂量(Dw);通过剂量体积直方图的剂量体积参数和计划分析,比较两种剂量在患者体内的分布差异.结果 靶区PTV65和PTV50的D50％、D98％和D2％的Dm和Dw差异分别为:-0.3％、-0.2％、0.3％和0.1％、-0.6％、0.4％,其中PTV65的D50％和PTV50的D98％差异有统计学意义(t=-2.536、-3.776,P＜0.05).正常组织的D50％中,脊髓、心脏、肺和食管的Dm与Dw的平均偏差为0.3％、1.1％、-0.2％和-0.1％,脊髓和心脏的Dm比Dw稍低(t=2.535、3.254,P＜0.05);正常组织的D2％的平均偏差为0.3％、-0.6％、-0.7％和0.6％,差异有统计学意义(=2.311、-4.105、-3.878、6.214,P＜0.05).所有剂量的体积偏差均＜2％.对于没有勾画出来的一些骨组织区域,Dm和Dw的偏差＞5％.结论 在临床使用过程中,在考虑骨性组织的受照剂量限制时,需要注意肺癌患者的Dm与Dw的相对偏差.
目的 探討肺癌調彊放療計劃時,矇特卡囉算法計算對水與介質的劑量差異.方法 隨機類型抽樣法選取10例肺癌患者的5野調彊計劃,在質量保證模塊下以患者自身圖像為模體,採用矇特卡囉算法分彆計算兩種計劃的吸收劑量,計算對實際介質的吸收劑量(Dm)和對水的吸收劑量(Dw);通過劑量體積直方圖的劑量體積參數和計劃分析,比較兩種劑量在患者體內的分佈差異.結果 靶區PTV65和PTV50的D50％、D98％和D2％的Dm和Dw差異分彆為:-0.3％、-0.2％、0.3％和0.1％、-0.6％、0.4％,其中PTV65的D50％和PTV50的D98％差異有統計學意義(t=-2.536、-3.776,P＜0.05).正常組織的D50％中,脊髓、心髒、肺和食管的Dm與Dw的平均偏差為0.3％、1.1％、-0.2％和-0.1％,脊髓和心髒的Dm比Dw稍低(t=2.535、3.254,P＜0.05);正常組織的D2％的平均偏差為0.3％、-0.6％、-0.7％和0.6％,差異有統計學意義(=2.311、-4.105、-3.878、6.214,P＜0.05).所有劑量的體積偏差均＜2％.對于沒有勾畫齣來的一些骨組織區域,Dm和Dw的偏差＞5％.結論 在臨床使用過程中,在攷慮骨性組織的受照劑量限製時,需要註意肺癌患者的Dm與Dw的相對偏差.
목적 탐토폐암조강방료계화시,몽특잡라산법계산대수여개질적제량차이.방법 수궤류형추양법선취10례폐암환자적5야조강계화,재질량보증모괴하이환자자신도상위모체,채용몽특잡라산법분별계산량충계화적흡수제량,계산대실제개질적흡수제량(Dm)화대수적흡수제량(Dw);통과제량체적직방도적제량체적삼수화계화분석,비교량충제량재환자체내적분포차이.결과 파구PTV65화PTV50적D50％、D98％화D2％적Dm화Dw차이분별위:-0.3％、-0.2％、0.3％화0.1％、-0.6％、0.4％,기중PTV65적D50％화PTV50적D98％차이유통계학의의(t=-2.536、-3.776,P＜0.05).정상조직적D50％중,척수、심장、폐화식관적Dm여Dw적평균편차위0.3％、1.1％、-0.2％화-0.1％,척수화심장적Dm비Dw초저(t=2.535、3.254,P＜0.05);정상조직적D2％적평균편차위0.3％、-0.6％、-0.7％화0.6％,차이유통계학의의(=2.311、-4.105、-3.878、6.214,P＜0.05).소유제량적체적편차균＜2％.대우몰유구화출래적일사골조직구역,Dm화Dw적편차＞5％.결론 재림상사용과정중,재고필골성조직적수조제량한제시,수요주의폐암환자적Dm여Dw적상대편차.
Objective To investigate the differences between Monte Carlo (MC) calculated doseto-water (Dw) and dose-to-medium (Dm) for lung cancers treated with intensity-modulated radiotherapy (IMRT).Methods A total of 10 lung carcinoma patients with 5-field IMRT treatment plans were stratified sampling randomly selected for this study,which were performed on Monaco treatment planning system (TPS) with MC algorithm.Using the patients' own CT images as quality assurance (QA) phantoms,two kinds of QA plan were calculated,one was the Dm,and another was the Dw plan.Dose volume histogram (DVH) parameters and the subtraction of two plans were used to evaluate the spatial distribution of the difference between the Dm and Dw.Results Differences between dose-volume indices computed with Dm and Dw for the PTV65 and PTV50 doses (D50％,D98％ and D2％) were-0.3％,-0.2％,0.3％ and 0.1％,-0.6％,0.4％,respectively,of which the D50％ of PTV65 and D98％ of PTV50 had statistical difference (t =-2.536,-3.776,P ＜ 0.05).For normal tissues,spinal cord,heart,lung and esophagus,the D50％ differences between Dm and Dw were 0.3％,1.1％,-0.2％ and -0.1％,of which the Dm of spinal cord and heart were slightly lower than the Dw (t =2.535,3.254,P ＜ 0.05).For the D2％ of the normal tissues,the differences were 0.3％,-0.6％,-0.7％ and 0.6％,the differences were statistically significant (t =2.311,-4.105,-3.878,6.214,P＜0.05).All the differences were within 2％.Meanwhile planned subtraction analysis showed the differences between the Dm and Dw varied very much with the other body parts of the patient,especially for bone tissues,and the two doses were significant difference (＞ 5％).Conclusion In the course of clinical application,the relative differences between Dm and Dw for lung cancers MC calculations should be noted when considering the dose limitations of bone tissue.
