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
10期
756-760
,共5页
廖雄飞%李厨荣%黎杰%陈亚正%王培
廖雄飛%李廚榮%黎傑%陳亞正%王培
료웅비%리주영%려걸%진아정%왕배
多等中心计划设计%全中枢神经系统%调强放疗%螺旋断层放射治疗
多等中心計劃設計%全中樞神經繫統%調彊放療%螺鏇斷層放射治療
다등중심계화설계%전중추신경계통%조강방료%라선단층방사치료
Multi-ISO center planning method%Craniospinal system%IMRT%Helical tomotherapy
目的 探讨多中心计划设计方法(M-ISO)在全中枢神经系统放疗(CSI)中的应用价值.方法 选取在本院已接受螺旋断层放射治疗(HT)的10例CSI患者的治疗计划,将此10例患者带有靶区及危及器官的CT图像通过网络传输至Eclipse 11.0计划系统,重新用M-ISO进行计划优化,比较两种计划中靶区、危及器官的受照剂量、治疗时间和机器跳数的差异.结果 两种计划设计方案得到的靶区剂量均能满足临床要求.D98％、D2％和HI参数HT组优于M-ISO组(t=2.822、2.333、4.743,P＜0.05),D50％、Dmean和CI参数M-ISO组优于HT组(t=5.259、3.685、8.835,P＜0.05);HT组计划对左右中耳、左右腮腺、颌下腺、甲状腺和肾脏的保护优于M-ISO组(t=4.365、5.416、2.674、3.077、2.782、2.607、4.659,P＜0.05),而M-ISO组胰腺和小肠的受照剂量优于HT组(t=5.265、5.935,P＜0.05);正常组织受照剂量M-ISO组V10、V20和V36均低于HT组(t=3.57、3.701、2.602,P＜0.05),而两组V5差异无统计学意义;M-ISO组计划在治疗时间、机器跳数两项参数明显优于HT组(t=8.477、19.313,P＜0.05),均值分别减少41.0％和94.1％.结论 多中心计划设计方法应用在全中枢调强放疗中能够满足剂量学临床要求,缩短治疗时间,减少机器损耗,可以作为一种新的计划设计方案推广.
目的 探討多中心計劃設計方法(M-ISO)在全中樞神經繫統放療(CSI)中的應用價值.方法 選取在本院已接受螺鏇斷層放射治療(HT)的10例CSI患者的治療計劃,將此10例患者帶有靶區及危及器官的CT圖像通過網絡傳輸至Eclipse 11.0計劃繫統,重新用M-ISO進行計劃優化,比較兩種計劃中靶區、危及器官的受照劑量、治療時間和機器跳數的差異.結果 兩種計劃設計方案得到的靶區劑量均能滿足臨床要求.D98％、D2％和HI參數HT組優于M-ISO組(t=2.822、2.333、4.743,P＜0.05),D50％、Dmean和CI參數M-ISO組優于HT組(t=5.259、3.685、8.835,P＜0.05);HT組計劃對左右中耳、左右腮腺、頜下腺、甲狀腺和腎髒的保護優于M-ISO組(t=4.365、5.416、2.674、3.077、2.782、2.607、4.659,P＜0.05),而M-ISO組胰腺和小腸的受照劑量優于HT組(t=5.265、5.935,P＜0.05);正常組織受照劑量M-ISO組V10、V20和V36均低于HT組(t=3.57、3.701、2.602,P＜0.05),而兩組V5差異無統計學意義;M-ISO組計劃在治療時間、機器跳數兩項參數明顯優于HT組(t=8.477、19.313,P＜0.05),均值分彆減少41.0％和94.1％.結論 多中心計劃設計方法應用在全中樞調彊放療中能夠滿足劑量學臨床要求,縮短治療時間,減少機器損耗,可以作為一種新的計劃設計方案推廣.
목적 탐토다중심계화설계방법(M-ISO)재전중추신경계통방료(CSI)중적응용개치.방법 선취재본원이접수라선단층방사치료(HT)적10례CSI환자적치료계화,장차10례환자대유파구급위급기관적CT도상통과망락전수지Eclipse 11.0계화계통,중신용M-ISO진행계화우화,비교량충계화중파구、위급기관적수조제량、치료시간화궤기도수적차이.결과 량충계화설계방안득도적파구제량균능만족림상요구.D98％、D2％화HI삼수HT조우우M-ISO조(t=2.822、2.333、4.743,P＜0.05),D50％、Dmean화CI삼수M-ISO조우우HT조(t=5.259、3.685、8.835,P＜0.05);HT조계화대좌우중이、좌우시선、합하선、갑상선화신장적보호우우M-ISO조(t=4.365、5.416、2.674、3.077、2.782、2.607、4.659,P＜0.05),이M-ISO조이선화소장적수조제량우우HT조(t=5.265、5.935,P＜0.05);정상조직수조제량M-ISO조V10、V20화V36균저우HT조(t=3.57、3.701、2.602,P＜0.05),이량조V5차이무통계학의의;M-ISO조계화재치료시간、궤기도수량항삼수명현우우HT조(t=8.477、19.313,P＜0.05),균치분별감소41.0％화94.1％.결론 다중심계화설계방법응용재전중추조강방료중능구만족제량학림상요구,축단치료시간,감소궤기손모,가이작위일충신적계화설계방안추엄.
Objective To explore the application value of multi-ISO center planning method in intensity-modulated radiotherapy for carniospinal irradiation.Methods Ten patients treated with craniospinal irradiation with helical tomotherapy were selected.For these patients, new plans were designed with multi-ISO centers planning method on the treatment planning system (TPS) named Eclipse 11.0.Dose distribution to the tumor, OARs and normal tissue, the treatment time and the monitor units (MUs) of the two plans were compared.Results The plans designed in two groups satisfied all clinical requirements.For the tumor target (PTV) , the difference of D95％ between two groups was not statistical significant, while D9s ％ , D2 ％ and HI in HT group were superior to M-ISO group (t =2.822,2.333,4.743, P ＜0.05) , D50％ , D and CI in M-ISO group were superior to HT group (t =5.259,3.685,8.835 ,P ＜ 0.05).The dose of OARs such as cochlea, parotid, submandibular gland, thyroid gland and kidney in HT group was lower than M-ISO group (t =4.365,5.416,2.674,3.077,2.782,2.607,4.659,P ＜0.05) , and the dose of pancreas and small bowel was higher than M-ISO group (t =5.265,5.935, P ＜ 0.05).Differences were not significant for V5 of normal tissue between two groups;while V10, V20 and V36 of normal tissue in M-ISO group were lower than HT group (t =3.57,3.701,2.602, P ＜ 0.05).M-ISO group reduced 41.0％ of the treatment time by average and reduced 94.1％ MUs by average.Conclusions Intensity-modulated radiotherapy for carniospinal irradiation with multi-ISO centers planning method not only met the requirements of clinical dosimetry, but also shorten the treatment time, reduced the damage to the machine.Multi-ISO centers planning method might be promoted as a new design scheme.
