發(fā)布時間：2018-05-26 16:31

  本文選題：鼻咽腫瘤 + 口腔粘膜炎�。� 參考：《汕頭大學》2010年碩士論文

【摘要】： 目的:比較鼻咽癌常規(guī)設野方式以及3種不同機架角布置方式的IMRT計劃之間口腔劑量的差異,試圖找出能降低口腔劑量的治療計劃設計方案。 資料和方法:2009年4月至2009年6月在汕頭大學醫(yī)學院腫瘤醫(yī)院10例初治鼻咽癌患者接受7野全周等分布野IMRT治療,機架角為0°,50°,100°,150°,210°,250°,310°(Applied組)。在同樣的優(yōu)化參數(shù)下,改變機架角成包括180°射野的全周等分方式治療(30°,80°,130°,180°,230°,280°,330°)的計劃(Opposed組),以及一個射線經由后方射入的南半球方式(80°,110°,140°,180°,210°,240°,280°)治療計劃(South組),并以相同的靶區(qū)設計出相應的常規(guī)設野計劃(Routine組),行方差單變量分析組間配對檢驗(LSD)。 結果:常規(guī)設野組(Routine組)與其余3個IMRT組(Applied組,Opposed組,South組)之間,在PTVnx的各組劑量參數(shù)上均有顯著差異(P0.05);3個IMRT組(Applied組,Opposed組,South組)之間,在各組劑量參數(shù)上無任何顯著性差異。常規(guī)設野組與3個IMRT組之間在CI均存在顯著性差異(P0.001);3個IMRT組計劃之間CI差異無顯著性(P值為0.408,0.625及0.732)。常規(guī)設野組(Routine組)與其余3個IMRT組(Applied組,Opposed組, South組)在口腔Min Dose及Mean Dose上有顯著差異,常規(guī)設野組更低;劑量體積百分比的比較中,常規(guī)設野組在V30、V35、V40上與IMRT中的各組均有顯著差異;在V45上常規(guī)設野組與Opposed組及Applied組有顯著差異(P0.05),在V55上常規(guī)設野組與South組有顯著差異;V60上常規(guī)設野組與3個IMRT組之間均存在顯著性差異;3個IMRT設計之間,Applied組與Opposed組在Min Dose、V30上存在顯著性差;Applied組與South組在V35上存在顯著性差異;其余各組數(shù)據的相互比較中并未出現(xiàn)顯著性差異。 結論:常規(guī)設野計劃與IMRT計劃之間在PTVnx及口腔劑量上均存在差異,3種IMRT設計方案腫瘤靶區(qū)的劑量基本一致。在口腔的劑量分布上常規(guī)設野方案較IMRT計劃接受高于25Gy的低劑量照射體積更低,接受高于55Gy的高劑量照射體積更高,結合其他文獻報道,提示放射性口腔粘膜炎的發(fā)生可能與局部高劑量相關。3種IMRT設野方案之間無明顯差異。
[Abstract]:Objective: to compare the difference of oral dose between IMRT plan with conventional field setting and three different rack angle arrangement, and try to find out the treatment plan design which can reduce the oral dose. Materials and methods: from April 2009 to June 2009, 10 patients with nasopharyngeal carcinoma were treated with 7 field isobaric IMRT in the tumor Hospital of Shantou University. With the same optimization parameters, To change the angle of the rack to include a full cycle equipartition of 180 擄field for 30 擄/ 80 擄/ 130 擄/ 180 擄/ 180 擄/ 180 擄/ 180 擄/ 230 擄/ 280 擄/ 330 擄) / unplanned group, and a method of 80 擄/ 110 擄/ 140 擄/ 180 擄/ 210 擄/ 210 擄/ 240 擄280 擄/ 2 / 2 for the southern hemisphere from which a ray is fired through the rear, and to design the corresponding conventional field with the same target area The Routine group was tested by paired test of variance univariate analysis (ANOVA). Results: there were significant differences in the dose parameters of PTVnx between the conventional field group (Routine group) and the other three IMRT groups (applied group exposed group South group), but there was no significant difference in the dose parameters of each group between the three IMRT groups and the applied group (South group). There was significant difference in CI between routine field group and three IMRT groups (P 0.001), but no significant difference in CI between three IMRT groups (P = 0.408 0. 625 and 0. 732g / L). There were significant differences in oral Min Dose and Mean Dose between the conventional field group (Routine group) and the other three IMRT groups (South group). There were significant differences between the routine field group and the IMRT group on V30 V35 and V40. There was significant difference between routine field setting group and Opposed group and Applied group on V45, there was significant difference between routine field setting group and South group on V55, and there was significant difference between routine field setting group and three IMRT group on V60, and between applied group and Opposed group among three IMRT designs. There was a significant difference in V35 between the applied group and the South group on the V30 of Min. There was no significant difference between the other groups. Conclusion: there are differences in PTVnx and oral dose between conventional field planning and IMRT plan. The dose of tumor target area in three IMRT design schemes is basically the same. The dose distribution of oral cavity by conventional field setting scheme was lower than that of IMRT plan, which was higher than that of 25Gy, and higher than that of 55Gy. The results suggest that there may be no significant difference between the occurrence of radioactive oral mucositis and local high dose related IMRT wild-setting regimen.
【學位授予單位】：汕頭大學
【學位級別】：碩士
【學位授予年份】：2010
【分類號】：R739.63

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