本文關(guān)鍵詞：宮頸癌術(shù)后IMRT和VMAT放療技術(shù)劑量學研究　出處：《中華腫瘤防治雜志》2017年10期 　論文類型：期刊論文

  更多相關(guān)文章： 宮頸癌 放射治療 IMRT VMAT 劑量學

【摘要】：目的我國是宮頸癌的高發(fā)地區(qū),放療是治療宮頸癌的主要治療方式之一。本研究旨在分析宮頸癌術(shù)后患者,采用逆向調(diào)強放療技術(shù)(intensity modulated radiotherapy,IMRT)和旋轉(zhuǎn)容積調(diào)強技術(shù)(volumetric modulated arc therapy,VMAT)放療的劑量學分布特征。方法分析四川省腫瘤醫(yī)院2014-05-01-2015-10-31接受宮頸癌術(shù)后輔助放療的43例患者臨床資料,在同一套CT圖像上設(shè)計共面七野均分IMRT和共面二弧VMAT計劃,處方劑量均為45Gy/25次,危及器官限量參考臨床要求,并基于MATLAB平臺編程獲取計劃統(tǒng)計結(jié)果,在靶區(qū)95%的體積達到處方劑量的條件下,分析比較兩種計劃的靶區(qū)相關(guān)參數(shù)、危及器官劑量分布、機器跳數(shù)和治療時間等。結(jié)果 VMAT技術(shù)對危及器官的保護差異較大,小腸V_(30)和V_(20)、膀胱V_(40)、股骨頭V_(20)和V_(30)、骨盆V_(20)和V_(30)、馬尾D_(max)均優(yōu)于IMRT計劃(P0.05),所有器官的D_(max)和D_(mean)(除直腸偏高外)也均有不同程度的降低,P0.05;VMAT計劃體內(nèi)15Gy左右劑量覆蓋的體積較小,15Gy左右劑量覆蓋的體積較大,P0.05。兩種治療計劃對整個骨盆受照射劑量分布影響最大的是髂骨和髖骨,骶骨的平均劑量D_(mean)均高于髂骨和髖骨,P0.05。VMAT技術(shù)放療的機器平均跳數(shù)(558±8)MU和平均治療時間(2.6±0.3)min明顯偏少,平均分別減小了71%和73%,P0.05。結(jié)論宮頸癌術(shù)后患者采用IMRT和VMAT兩種治療計劃,靶區(qū)均能獲得較滿意的劑量分布,但VMAT計劃對特定危及器官的保護更好,靶區(qū)適形度和均勻度更佳,且放療機器跳數(shù)和治療時間明顯降低。從劑量學角度分析,VMAT技術(shù)更具優(yōu)勢。
[Abstract]:Objective China is a high incidence area of cervical cancer, radiotherapy is one of the main treatment methods of cervical cancer. Intensity modulated radiotherapy was used in inverse intensity modulated radiotherapy (IMRT). Volume metric modulated arc therapy. Methods the clinical data of 43 patients receiving adjuvant radiotherapy for cervical cancer from 2014-05-01-2015-10-31 in Sichuan Cancer Hospital were analyzed. The coplanar seven-field mean IMRT and coplanar two-arc VMAT were designed on the same set of CT images. The prescribed dose was 45 Gy / 25 times, which endangered the organ limited reference clinical requirements. And based on the MATLAB platform programming to obtain the statistical results of the plan, under the condition that the volume of target area 95% reaches the prescribed dose, the related parameters of the two plans are analyzed and compared, which endangers the dose distribution of organs. Results there was a great difference in the protection of the endangered organs by VMAT technique, and there was a significant difference between the two groups: Vap30 (small intestine) and 20 cases (Vaps), and Vaps (40) in the bladder (P < 0.05). Both the femoral head and the IMRT are better than the IMRT plan (P0.05) and the Vaphe (V20) and the Vaphe (20) and the Vashi-30 (DX) are better than the IMRT plan (P0.05). In all organs, there was also a decrease of P0.05 in all organs (with the exception of the high rectum). The volume of VMAT plan to cover about 15 Gy dose is larger than that of small dose about 15 Gy. P0.05. the dose distribution of the whole pelvis was most affected by the two treatment plans, the average dose of the sacrum was higher than that of the iliac bone and the hip bone, and the mean dose of the sacrum was higher than that of the iliac bone and the hip bone. P0.05. VMAT technique showed a significant decrease in the mean number of jumps (558 鹵8MU) and the average treatment time (2.6 鹵0.3min) by 71% and 73%, respectively. P0.05.Conclusion both IMRT and VMAT can obtain satisfactory dose distribution in the target area of patients with cervical cancer after operation, but the VMAT program is better for the protection of specific organs. The conformability and uniformity of the target area are better, and the number of machine hops and the treatment time of radiotherapy are obviously reduced, so it is more advantageous to analyze the technique of VMAT from the dosimetric point of view.
【作者單位】： 四川綿陽四0四醫(yī)院腫瘤科;四川省腫瘤醫(yī)院放療中心;甘肅省腫瘤醫(yī)院放療科;
【分類號】：R730.55;R737.33
【正文快照】： 中華腫瘤防治雜志,2017,24(10):708-713Chin J Cancer Prev Treat,2017,24(10):708-713我國宮頸癌發(fā)病率居女性惡性腫瘤的首位,早期宮頸癌患者多選擇術(shù)后輔助放療,以達到消滅盆腔隱匿病灶,控制局部復(fù)發(fā)[1-2]。隨著放療技術(shù)的發(fā)展,逆向調(diào)強放療技術(shù)(intensity modulated radiot，

本文編號：1438168