本文選題：局限期中高危前列腺癌 + 旋轉(zhuǎn)調(diào)強放療��； 參考：《中南大學(xué)》2014年碩士論文

【摘要】：目的：分別運用旋轉(zhuǎn)調(diào)強放療技術(shù)(IMAT)與常規(guī)固定野調(diào)強適形放療技術(shù)(IMRT)為局限期中高危前列腺癌患者制定放療計劃,從劑量學(xué)的角度和治療效率的角度比較兩種放療技術(shù)的優(yōu)劣性。 方法：選取2011年4月至2013年12月期間在我院治療的11例局限期中高危前列腺癌患者,在同一計劃系統(tǒng)下,對每例患者分別制定旋轉(zhuǎn)調(diào)強(IMAT)計劃和固定野調(diào)強適形(IMRT)計劃,運用等劑量分布曲線和劑量體積直方圖(DVH圖)評價和比較兩種計劃,劑量學(xué)參數(shù)包括靶區(qū)、危及器官及正常組織的相關(guān)劑量參數(shù),此外,再比較兩種計劃各階段的總機(jī)器跳數(shù)(MU)和總治療時間(T)。 結(jié)果：在本研究中,兩種計劃靶區(qū)劑量參數(shù)的比較：PTV1、PTV2的適形指數(shù)(CI)IMAT計劃均優(yōu)于IMRT計劃,差異均具有統(tǒng)計學(xué)意義(P0.05),均勻性指數(shù)(HI)差異沒有統(tǒng)計學(xué)意義(P0.05)。PTV1、PTV2的Dmax、Dmin、Dmean差異均無統(tǒng)計學(xué)意義(P0.05)。兩種計劃危及器官劑量參數(shù)的比較：直腸Dmax、直腸V70IMRT計劃優(yōu)于IMAT計劃,差異具有統(tǒng)計學(xué)意義(P0.05)。直腸V5o、小腸Dmax、膀胱Dmax、膀胱V50、左側(cè)股骨頭Dmax、左側(cè)股骨頭V50兩種計劃結(jié)果相似,差異無統(tǒng)計學(xué)意義。直腸V40、右側(cè)股骨頭Dmax、右側(cè)股骨頭V50IMAT計劃優(yōu)于IMRT計劃,差異具有統(tǒng)計學(xué)意義(P(0.05)。兩種計劃正常組織劑量參數(shù)的比較：V5、V1o、V15差異沒有統(tǒng)計學(xué)意義(P0.05),V20、V25、V30、V35、V40、 V45、V50IMAT計劃均優(yōu)于IMRT計劃,差異均有統(tǒng)計學(xué)意義(P0.05)。兩種計劃每次治療機(jī)器跳數(shù)的比較,對于一階段計劃(S1)來說,MUIMRT=1706.57±260.97, MUIMat=749.00±154.94, IMAT計劃比IMRT計劃平均少957(56%),差異具有統(tǒng)計學(xué)意義(P0.05)。對于二階段計劃(S2)來說,MUINRT=1105±197.77, MUIMAT=836.29±166.31,IMAT計劃比IMRT計劃平均少269(24%),差異具有統(tǒng)計學(xué)意義(P0.05)。兩種計劃總治療時間的比較：執(zhí)行IMAT計劃一個弧的時間大約需要70-90秒,兩個弧大約3分鐘,IMRT計劃大約需要15分鐘。 結(jié)論：與IMRT計劃比較,IMAT計劃靶區(qū)適形度有所改善,其余靶區(qū)覆蓋情況無明顯差異,危及器官照射劑量相當(dāng),正常器官照射劑量明顯降低,機(jī)器跳數(shù)和治療時間顯著減少。
[Abstract]:Objective: to establish a radiotherapy plan for patients with localized high risk prostate cancer by using rotational intensity modulated radiotherapy (IMATT) and conventional field intensity modulated conformal radiotherapy (IMRTT). The advantages and disadvantages of the two radiotherapy techniques were compared in terms of dosimetry and therapeutic efficiency. Methods: 11 patients with localized high risk prostate cancer treated in our hospital from April 2011 to December 2013 were selected. Under the same planning system, each patient was given a rotating intensity modulated IMATT plan and a fixed field intensity conformal IMRT plan. Using isodose distribution curve and dose volume histogram (DVH) to evaluate and compare the two plans, dosimetric parameters include target area, dose parameters that endanger organs and normal tissues, in addition, Then compare the total machine hops of each stage of the two schemes with the total treatment time. Results: in this study, the comparison of dose parameters of the target area between the two plans was made. The conformal index of 1: PTV1 / PTV2 was better than that of IMRT, and the difference was statistically significant (P 0.05). There was no significant difference in DmaxDmint Dmean of PTV1 / PTV2 (P 0.05). The comparison of dose parameters between the two plans: rectal Dmaxand rectal V70IMRT plan was better than IMAT plan, the difference was statistically significant (P 0.05). The planning results of rectum V5o, small intestine Dmax, bladder Dmax, bladder V50, left femoral head Dmaxand left femoral head V50 were similar, but the difference was not statistically significant. Rectum V40, right femoral head Dmaxand right femoral head V50IMAT plan were superior to IMRT plan, the difference was statistically significant (P 0.05). Comparison of the normal tissue dose parameters of the two plans there was no significant difference in the dose parameters between the two plans. There was no significant difference in the dose parameters between the two plans (P 0.05). The V45 / V50 IMAT plan was better than the IMRT plan, and the difference was statistically significant (P 0.05). Comparing the number of machine hops per treatment between the two plans, for one stage plan (S 1), MUIMRTT was 1706.57 鹵260.97, MUIMat=749.00 鹵154.94, and IMAT plan was 9575656g less than that of IMRT plan, the difference was statistically significant (P 0.05). For the two-stage plan (S2), MUINRTT (1105 鹵197.77), MUIMAT=836.29 鹵166.31 (IMAT) was 269m / 24 (P 0.05) less than that of IMRT (P 0.05). Comparison of total treatment time between two plans: it takes about 70-90 seconds to execute one arc of the IMAT plan, and about 15 minutes for the two arcs to take about 3 minutes for the IMRT program. Conclusion: compared with the IMRT plan, the conformal degree of the target area of the IMRT plan is improved, the coverage of the other target areas is not significantly different, the irradiation dose of the endangering organs is equal, the irradiation dose of the normal organs is obviously reduced, the number of machine jumps and the treatment time are significantly reduced.
【學(xué)位授予單位】：中南大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R737.25

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 ;2005年上海市惡性腫瘤發(fā)病率[J];上海預(yù)防醫(yī)學(xué)雜志;2008年08期

，

本文編號：1927136