本文選題：宮頸癌 + 容積旋轉(zhuǎn)調(diào)強(qiáng)��； 參考：《中國(guó)婦產(chǎn)科臨床雜志》2015年01期

【摘要】：目的宮頸癌術(shù)后放療中,比較三維適形(CRT)、固定野調(diào)強(qiáng)(IMRT)和容積旋轉(zhuǎn)調(diào)強(qiáng)(VMAT)靶區(qū)劑量分布和危及器官受照劑量,為臨床治療技術(shù)的選擇提供依據(jù)。方法順序選取北京大學(xué)第三醫(yī)院2013年10例宮頸癌術(shù)后放療的患者,分別進(jìn)行CRT、IMRT和VMAT計(jì)劃設(shè)計(jì)并比較計(jì)劃靶區(qū)的劑量-體積直方圖(DVH)、適形度指數(shù)(CI)、均勻性指數(shù)(HI)和危及器官的受照劑量。結(jié)果三種技術(shù)CI分別為0.462、0.855和0.875,IMRT和VMAT均優(yōu)于CRT,VMAT較IMRT有較小的優(yōu)勢(shì)(P0.05,t=-2.189);HI分別為1.084、1.063和1.046,VMAT均勻性略低于IMRT(P0.05,t=5.127)。在危及器官的受量上,CRT普遍高于IMRT和VMAT。對(duì)于低劑量區(qū)的受照體積,如小腸、結(jié)直腸、膀胱和骨髓的V10、V20,IMRT比VMAT可以獲得更低的受照劑量(P0.05);對(duì)于高劑量區(qū)的體積V40、V50,直腸和膀胱的受照體積IMRT要小于VMAT(P0.05),其他如小腸、結(jié)腸和股骨頭、骨髓的IMRT和VMAT差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論對(duì)于宮頸癌術(shù)后放療的患者,CRT、IMRT和VMAT均可以達(dá)到靶區(qū)處方劑量覆蓋的要求,但是在靶區(qū)的各項(xiàng)指標(biāo)中,IMRT和VMAT均優(yōu)于CRT。IMRT和VMAT相比,在HI上有優(yōu)勢(shì),但是在CI指數(shù)上略小于VMAT;對(duì)于危及器官而言,低劑量體積和高劑量體積的IMRT和VMAT各自表現(xiàn)了不同的特點(diǎn),在臨床治療中要根據(jù)要求選擇不同的技術(shù)。
[Abstract]:Objective to compare the dose distribution in the target area of CRT, IMRTT and VMATT in postoperative radiotherapy for cervical cancer and to provide evidence for the selection of clinical treatment techniques. Methods Ten patients with cervical cancer received postoperative radiotherapy in the third Hospital of Peking University in 2013 were selected. The dose-volume histogram (DVH), conformability index (CI), homogeneity index (HI) of the planned target area were designed and compared with the radiation dose of the organ in danger by CRT IMRT and VMAT respectively. Results the CI values of the three techniques were 0.462t 0.855 and 0.875U IMRT and VMAT, respectively, which were lower than that of CRTV-VMAT (P 0.05) and IMRT (P < 0.05). The uniformity of VMAT was slightly lower than that of IMRT (0.05t5.127) compared with IMRT (1.084 鹵1.063 and 1.046), respectively. CRT was generally higher than that of IMRT and VMATT in the acceptance of endangered organs. For low-dose areas, such as small intestine, colorectal, bladder and bone marrow, V10 V20IMRT can obtain a lower dose of irradiation than VMAT, and for high dose area of V40V 50, IMRT of rectum and bladder is smaller than that of VMATP0.05, other small intestine, and small intestine. There was no significant difference in IMRT and VMAT between colon and femoral head and bone marrow (P 0.05). Conclusion both CRTIMRT and VMAT can meet the requirement of prescription dose coverage for patients with cervical cancer after postoperative radiotherapy, but in the target area, both IMRT and VMAT are superior to CRT.IMRT and VMAT, and have advantages in HI. However, the CI index is slightly smaller than that of VMATT. For the organs at risk, IMRT and VMAT with low dose volume and high dose volume have different characteristics, so different techniques should be chosen according to the requirements in clinical treatment.
【作者單位】： 北京大學(xué)第三醫(yī)院腫瘤放療科;
【分類號(hào)】：R737.33

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