【摘要】：目的:比較容積旋轉(zhuǎn)調(diào)強(VMAT)、固定野調(diào)強(IMRT)和三維適形(3D-CRT)放療技術(shù)在局部復發(fā)鼻咽癌患者治療中的劑量學參數(shù),分析3種治療計劃的劑量學特性。方法:選擇12例局部復發(fā)的鼻咽癌患者,采用Pinnacle 9.2和Preciseplan 2.03治療計劃系統(tǒng),每例患者均設計VMATIMRT和3D-CRT,比較3組計劃的劑量分布及危及器官受量等。結(jié)果:VMAT及IMRT組適形度指數(shù)(CI)相似,但均優(yōu)于3D-CRT組,組間比較差異有統(tǒng)計學意義(P0.05)。3組計劃的靶區(qū)不均勻指數(shù)(HI)相近,組間比較差異無統(tǒng)計學意義(P0.05)。3D-CRT組機器跳數(shù)(MU)及出束時間優(yōu)于其他2組,VMAT組優(yōu)于IMRT組,組間比較差異均有統(tǒng)計學意義(P0.05)。危及器官受量,3組計劃腦干及晶體受量比較差異無統(tǒng)計學意義(P0.05);VMAT組和IMRT組脊髓、視神經(jīng)、視交叉和大腦顳葉的受量明顯優(yōu)于3D-CRT組,組間比較差異有統(tǒng)計學意義(P0.05),但VMAT組與IMRT組比較差異無統(tǒng)計學意義(P0.05)。結(jié)論:3種放療技術(shù)的治療計劃劑量分布有差異,VMAT與IMRT計劃均能較好覆蓋靶區(qū),并減少周圍正常組織受量,滿足臨床需求。VMAT計劃的靶區(qū)適形度、MU和出束時間優(yōu)于IMRT計劃。3D-CRT僅在MU和治療時間上有優(yōu)勢。
[Abstract]:Objective: to compare the dosimetric parameters of volume rotation intensity modulated (VMAT),) fixed field intensity modulated (IMRT) and three dimensional conformal (3D-CRT) radiotherapy in patients with locally recurrent nasopharyngeal carcinoma (NPC) and to analyze the dosimetric characteristics of the three treatment plans. Methods: twelve patients with locally recurrent nasopharyngeal carcinoma were selected and treated with Pinnacle 9.2 and Preciseplan 2.03. VMAT?IMRT and 3D-CRT were designed for each patient. Results the conformability index (CI) of the two groups was similar to that of the IMRT group, but it was better than that of the 3D-CRT group. The difference between the two groups was statistically significant (P0.05). The target heterogeneity index (HI) of group 3 was similar to that of the control group. There was no significant difference between the two groups (P0.05). 3D-CRT group machine jump number (MU) and beam out time were better than the other two groups VMAT group was better than IMRT group, the difference between groups were statistically significant (P0.05). There was no significant difference in the intake of planned brainstem and lens between the three groups (P0.05). The amount of spinal cord, optic nerve, optic chiasma and temporal lobe of cerebrum in VMAT group and IMRT group was significantly higher than that in 3D-CRT group. There was significant difference between groups (P0.05), but there was no significant difference between VMAT group and IMRT group (P0.05). Conclusion there are differences in dose distribution between the three kinds of radiotherapy techniques. Both VMAT and IMRT can cover the target area and reduce the normal tissue intake. The conformal degree of target MU and the time of beam exit were better than that of IMRT plan. 3D-CRT only had advantages in MU and treatment time.
【作者單位】： 吉林省腫瘤醫(yī)院放療三科;
【基金】：吉林省科技廳自然科學基金資助課題(201015235)
【分類號】：R739.63

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