本文選題：復(fù)發(fā)鼻咽癌　切入點(diǎn)：容積弧形調(diào)強(qiáng)放療　出處：《上海交通大學(xué)學(xué)報(bào)(醫(yī)學(xué)版)》2014年03期 　論文類(lèi)型：期刊論文

【摘要】：目的探討在局部復(fù)發(fā)鼻咽癌治療中容積弧形調(diào)強(qiáng)放療(VMAT)與適形調(diào)強(qiáng)放療(IMRT)的劑量學(xué)特點(diǎn)。方法選擇30例確診的局部復(fù)發(fā)鼻咽癌患者納入本研究。所有患者均采用同步加量技術(shù)給予處方劑量,計(jì)劃大體腫瘤靶區(qū)(PGTV):2.26 Gy/F×30 F,計(jì)劃臨床病灶區(qū)(PCTV):2 Gy/F×30 F,每例患者采用相同的劑量學(xué)限制條件,分別進(jìn)行雙弧容積弧形調(diào)強(qiáng)計(jì)劃與適形調(diào)強(qiáng)計(jì)劃設(shè)計(jì)。通過(guò)其劑量學(xué)分析評(píng)估:①靶區(qū)覆蓋,均勻性及適形性。②危及器官(OAR)劑量分布。③機(jī)器跳數(shù)。結(jié)果 VMAT總體的計(jì)劃臨床靶區(qū)平均劑量、2%靶體積受到的劑量(D2)和98%靶體積受到的劑量(D98)高于IMRT(P0.05);計(jì)劃臨床靶區(qū)適形性指數(shù)(CI)高于IMRT(P0.05);均勻性指數(shù)(HI)低于IMRT(P0.05)。VMAT右側(cè)顳葉的D1低于IMRT(P0.05);VMAT腦干的Dmax、D1高于IMRT(P0.05)。VMAT左側(cè)顳頜關(guān)節(jié)的Dmax、左側(cè)顳葉的Dmax高于IMRT(P0.05);脊髓Dmax、視神經(jīng)Dmax、晶體Dmax和腮腺D50等OAR的劑量學(xué)指標(biāo)兩者比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。VMAT比IMRT的總機(jī)器跳數(shù)平均減少了33.2%(P0.05)。結(jié)論對(duì)于復(fù)發(fā)鼻咽癌患者,VMAT的計(jì)劃臨床靶區(qū)平均劑量、適形性和均勻性優(yōu)于IMRT,可以縮短機(jī)器跳數(shù)。但在正常組織保護(hù)方面,VMAT的優(yōu)勢(shì)不是特別明顯。
[Abstract]:Objective to investigate the dosimetric characteristics of VMATT and IMRTT in the treatment of locally recurrent nasopharyngeal carcinoma. Methods 30 patients with locally recurrent nasopharyngeal carcinoma were included in this study. Simultaneous dosing technique for prescription dose, The gross tumor target was planned to be 2.26 Gy/F 脳 30F, and the clinical focus area was planned to be PCTVV: 2 Gy/F 脳 30F. Each patient was given the same dosimetric restriction. The double arc volume intensity adjustment plan and the conformal intensity adjustment plan were designed, respectively. The dosimetric analysis was used to evaluate the coverage of the target area of 1: 1. Results the average dose of 2% target volume in the planned clinical target area of VMAT was higher than that of the target volume of 98% (D98), and the planned clinical target area was planned to be a clinical target area with a dose of 0. 05% (P 0. 05%). The conformal index (CI) is higher than IMRT P0.05; the homogeneity index (HI) is lower than that of IMRT(P0.05).VMAT in the right temporal lobe (DmaxD1) is lower than that in IMRT P0.05VMAT brain stem is higher than that in left temporomandibular joint of IMRT(P0.05).VMAT, and the Dmax in left temporal lobe is higher than that of IMRT P0.05; the dose of OAR in spinal cord, optic nerve, crystal Dmax and parotid gland D50 is higher than that in left temporal lobe. There was no statistically significant difference between the two indexes. Compared with the total machine jump of IMRT, the average number of VMAT decreased by 33.2 and P0.050.Conclusion the planned average dose of VMAT in patients with recurrent nasopharyngeal carcinoma (NPC) is estimated to be higher than that of the patients with recurrent nasopharyngeal carcinoma (NPC). The conformability and uniformity are superior to IMRTs and can shorten the number of machine hops, but the advantages of VMAT in normal tissue protection are not particularly obvious.
【作者單位】： 廣西醫(yī)科大學(xué)研究生院;重慶市腫瘤醫(yī)院放療科;
【分類(lèi)號(hào)】：R739.63

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