發(fā)布時(shí)間：2018-05-01 16:12

  本文選題：多葉準(zhǔn)直器 + 容積旋轉(zhuǎn)調(diào)強(qiáng)放療�。� 參考：《中國醫(yī)學(xué)物理學(xué)雜志》2016年11期

【摘要】：目的:研究多葉準(zhǔn)直器(MLC)葉片寬度在容積旋轉(zhuǎn)調(diào)強(qiáng)放療(VMAT)中對(duì)劑量分布的影響。方法:選取頭部腫瘤患者12例,劃分成大靶區(qū)體積(腦膠質(zhì)瘤)組和小靶區(qū)體積(垂體瘤)組。在Eclipse治療計(jì)劃系統(tǒng)中,對(duì)每例患者使用相同的劑量學(xué)限制條件,并將腫瘤靶區(qū)置于窄MLC葉片(5mm)區(qū)和寬MLC葉片(10mm)區(qū),分別制定兩個(gè)VMAT治療計(jì)劃。通過計(jì)算對(duì)比劑量分布圖和劑量學(xué)指標(biāo),分析MLC葉片寬度對(duì)不同靶區(qū)體積腫瘤劑量分布的影響。結(jié)果:無論是大體積靶區(qū)腫瘤還是小體積靶區(qū)腫瘤,使用較窄的MLC葉片都可以改善劑量學(xué)指標(biāo),但是這種改進(jìn)不具有統(tǒng)計(jì)學(xué)差異(P0.05)。而對(duì)于給定寬度(5mm或10mm)的MLC葉片,大體積靶區(qū)腫瘤組的VMAT治療計(jì)劃劑量學(xué)指標(biāo)優(yōu)于小體積靶區(qū)腫瘤組,并且具有統(tǒng)計(jì)學(xué)差異(P0.05);另一方面,隨著腫瘤體積的減小,劑量學(xué)指標(biāo)的改進(jìn)率明顯提高。結(jié)論:VMAT放療技術(shù)可以改善劑量學(xué)指標(biāo),并且能夠有效減小MLC葉片寬度對(duì)劑量分布的影響;靶區(qū)體積的大小是影響VMAT治療計(jì)劃劑量學(xué)指標(biāo)改進(jìn)率的重要因素。在VMAT臨床應(yīng)用中,應(yīng)根據(jù)腫瘤靶區(qū)體積大小及其與危及器官的位置關(guān)系,合理選擇MLC葉片厚度以達(dá)到最佳療效。
[Abstract]:Aim: to study the effect of blade width of multileaf collimator MLC on dose distribution in VMATT. Methods: 12 patients with head tumor were divided into two groups: large target volume (glioma) and small target volume (pituitary adenoma). In the Eclipse treatment planning system, each patient was given the same dosimetric restriction, and the tumor target was placed in the narrow MLC leaf area (5 mm) and the wide MLC leaf area (10 mm). Two VMAT treatment plans were made respectively. The effects of leaf width of MLC on the dose distribution of tumor in different target areas were analyzed by comparing the dose distribution map and dosimetry index. Results: both large and small target tumors could improve dosimetric indices by using narrow MLC leaves, but there was no statistical difference in this improvement. For the MLC leaves with a given width of 5 mm or 10 mm, the dose indices of the VMAT treatment plan in the mass target tumor group were better than those in the small volume target tumor group, and the difference was statistically significant (P 0.05); on the other hand, with the decrease of tumor volume, The improvement rate of dosimetric index was improved obviously. Conclusion the dose index can be improved and the effect of leaf width of MLC on dose distribution can be effectively reduced by using the technique of: VMAT, and the volume of target area is an important factor affecting the improvement rate of dosimetric index in VMAT treatment plan. In clinical application of VMAT, we should choose the thickness of MLC leaf reasonably according to the volume of tumor target and the relationship between the volume of tumor target and the location of the organ at risk to achieve the best curative effect.
【作者單位】： 武漢大學(xué)物理科學(xué)與技術(shù)學(xué)院;武漢大學(xué)中南醫(yī)院放療科;克拉瑪依市中心醫(yī)院血液腫瘤科;
【基金】：國家自然科學(xué)基金(10875092) 湖北省自然科學(xué)基金(2012FKB04449)
【分類號(hào)】：R730.55

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1 謝耩;徐志勇;李龍根;;采用不同葉片寬度MLC調(diào)強(qiáng)計(jì)劃的比較[A];中華醫(yī)學(xué)會(huì)放射腫瘤治療學(xué)分會(huì)六屆二次暨中國抗癌協(xié)會(huì)腫瘤放療專業(yè)委員會(huì)二屆二次學(xué)術(shù)會(huì)議論文集[C];2009年

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