CAJ | 학술논문

目的：比较分析肝癌旋转容积调强放疗（ VMAT）计划与固定野调强放疗（ IMRT）计划靶区及其周围危机器官的剂量学差异。方法选择36例肝癌患者的CT图像数据，分别设计VMAT计划、IMRT计划，比较两者的靶区剂量分布、危及器官受量、正常组织受量、机器跳数及治疗时间等。结果 VMAT计划的靶区剂量最大值比IMRT计划低（ Z=2.090，P<0.05）；VMAT计划的90%的处方剂量的适形指数比IMRT计划小（Z=2.809，P<0.05）；VMAT计划的正常肝组织的V30低于IMRT计划（Z=2.395，P<0.05）；VMAT计划的正常肾脏组织的V20低于 IMRT计划（Z=2.201，P<0.05）；VMAT计划机器跳数是 IMRT计划的<40%，治疗时间低于IMRT计划的50%。结论2种治疗计划在剂量学上均能满足临床要求，并且剂量分布基本一致，VMAT计划的适形指数比IMRT好，危及器官剂量比IMRT计划略有降低，正常组织的低剂量区VMAT计划与IMRT相比有先高后低的趋势，并且机器跳数少，治疗时间短，更值得临床推广应用。
목적：비교분석간암선전용적조강방료（ VMAT）계화여고정야조강방료（ IMRT）계화파구급기주위위궤기관적제량학차이。방법선택36례간암환자적CT도상수거，분별설계VMAT계화、IMRT계화，비교량자적파구제량분포、위급기관수량、정상조직수량、궤기도수급치료시간등。결과 VMAT계화적파구제량최대치비IMRT계화저（ Z=2.090，P<0.05）；VMAT계화적90%적처방제량적괄형지수비IMRT계화소（Z=2.809，P<0.05）；VMAT계화적정상간조직적V30저우IMRT계화（Z=2.395，P<0.05）；VMAT계화적정상신장조직적V20저우 IMRT계화（Z=2.201，P<0.05）；VMAT계화궤기도수시 IMRT계화적<40%，치료시간저우IMRT계화적50%。결론2충치료계화재제량학상균능만족림상요구，병차제량분포기본일치，VMAT계화적괄형지수비IMRT호，위급기관제량비IMRT계화략유강저，정상조직적저제량구VMAT계화여IMRT상비유선고후저적추세，병차궤기도수소，치료시간단，경치득림상추엄응용。
Objective To compare the dosimetric differences of the target volume and the surrounding organ at risk between volumetric modulated arc radiotherapy( VMAT)and fixed field intensity-modulated radiation therapy ( IMRT)plans for liver cancer. Methods The CT image data of 36 patients with liver cancer were observed,the VMAT plan and the IMRT plan were designed,the target dose distribution of the two plans,organs at risk affected by quantity ,normal tissue by volume ,the number of machine unit and treatment time of the two plans were compared .Results The maximum value in the target region of the VMAT plan was lower than that of the IMRT plan( Z=2. 090,P<0. 05);the conformal index of 90% of prescription dose in the VMAT plan was smaller than that in the IMRT plan(Z=2. 809,P<0. 05);the V30 of liver in the VMAT plan was lower than that in the IMRT plan(Z=2. 395,P<0. 05);the V20 of kidney in the VMAT plan was lower than that in the IMRT plan( Z=2. 201,P<0. 05);the machine unit in the VMAT plan was 40% of that in the IMRT plan,the treatment time in the VMAT plan was lower than 50% in the IMRT plan. Conclusion Two kinds of treatment plan can satisfy the clinical re-quirements on dosimetry and dose distribution;conformal index of the VMAT plan is better than IMRT plan;dose of organs at risk in the VMAT plan is lower than that in the IMRT plan;compared with the IMRT plan,low dose area of normal tissues in the VMAT plan has the tendency of high after the first low,and the less machine units,the short treatment time.