CAJ | 학술논문

目的：比较宫颈癌术后放射治疗常用固定五野静态调强、七野静态调强和容积旋转调强三者之间的剂量学差异。方法随机选取10例宫颈癌术后患者，进行CT扫描后将图像传送至Pinnacle39．6放疗计划系统进行靶区及危及器官勾画。每例患者均采用3种不同射野方式进行计划设计，分别为5野IMRT计划、7野IMRT计划、RapidArc计划。处方剂量为50 Gy／25次。比较分析3种计划的靶区适形指数、均匀性指数、正常组织的照射剂量、机器跳数和照射时间。结果3种调强技术靶区适形度无明显差异，均匀性和靶区的平均剂量RapidArc略高于IMRT（P＜0．05）；小肠和膀胱等危及器官的剂量分布，7野IMRT技术和5野IMRT技术无明显差异；左、右股骨头7野IMRT技术略好于5野IMRT技术，RapidArc技术好于IMRT技术。结论在宫颈癌术后放疗中，3种调强计划肿瘤靶区适形度、均匀性均能较好的满足临床要求，但RapidArc技术对于危及器官的保护要优于IMRT技术，且RapidArc技术同时还具有机器跳数少，治疗时间短的优势，可大幅降低患者在治疗过程中因体位变化导致靶区吸收剂量的误差。
목적：비교궁경암술후방사치료상용고정오야정태조강、칠야정태조강화용적선전조강삼자지간적제량학차이。방법수궤선취10례궁경암술후환자，진행CT소묘후장도상전송지Pinnacle39．6방료계화계통진행파구급위급기관구화。매례환자균채용3충불동사야방식진행계화설계，분별위5야IMRT계화、7야IMRT계화、RapidArc계화。처방제량위50 Gy／25차。비교분석3충계화적파구괄형지수、균균성지수、정상조직적조사제량、궤기도수화조사시간。결과3충조강기술파구괄형도무명현차이，균균성화파구적평균제량RapidArc략고우IMRT（P＜0．05）；소장화방광등위급기관적제량분포，7야IMRT기술화5야IMRT기술무명현차이；좌、우고골두7야IMRT기술략호우5야IMRT기술，RapidArc기술호우IMRT기술。결론재궁경암술후방료중，3충조강계화종류파구괄형도、균균성균능교호적만족림상요구，단RapidArc기술대우위급기관적보호요우우IMRT기술，차RapidArc기술동시환구유궤기도수소，치료시간단적우세，가대폭강저환자재치료과정중인체위변화도치파구흡수제량적오차。
Objective To compare the dose distribution of target volume and normal tissues between the RapidArc plan and fixed-field IMRT plans in cervical cancer.Methods 10 patients with cervical cancer after surgery,the CT images of patients were transmitted to the pinnacle39.6 treatment planning system to contour the tumor target.Treatments planning of RapidArc plan and fixed-field IMRT for every patient were worked out by computer working station,respectively.The Prescribed dose was 50 Gy for 25 times.The dose distributions of plan target volume and normal tissues,conformal index( CI) and heterogeneous index( HI) were evaluated in terms of the dose volume histogram( DVH) .Results There was no significant difference in CI between Rapi-dArc plan and IMRT.However,the HI and PTVmean dose of RapidArc plan were much higher than IMRT.There was no signifi-cant difference of absorbed dose in bladder and small intestine between the 2 IMRT plans.The dose of right and left femoral head was the lowest in RapidArc plan group,and it was lower in 7 fields group than those in 5 fields IMRT group.Conclusion The PTV received dose has no significant difference in the two kinds methods.In protection important crisis organs method RapidArc is obviously much better than fixed-field IMRT plan.Compared with fixed-field IMRT,RapidArc plan has fewer MUs and less treat-ment time which can be used to greatly reduce the absorbed dose of target caused by the setup error.