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  本文選題：食管癌 + 調(diào)強放射治療��； 參考：《昆明醫(yī)科大學(xué)》2015年碩士論文

【摘要】：[目的]：比較胸上段食管癌分別利用靜態(tài)調(diào)強(static intensity modulated radiotherapy,sIMRT)、容積旋轉(zhuǎn)調(diào)強(volumetric modulated arc therapy,VMAT)和螺旋斷層放療(TomoTherapy)制定治療計劃的劑量學(xué)差異。[方法]：選取6例胸上段食管癌病例,分別制定7野sIMRT、單弧VMAT及常規(guī)調(diào)制強度的TomoTherapy放射治療計劃,比較靶區(qū)PTV最大劑量(PTVDmax)、PTV最小劑量(PTVDmin)、PTV平均劑量(PTVDmean)、95%等劑量線所包括的PTV體積百分比(V95)、適型指數(shù)(Conformal index,CI)、劑量不均勻性指數(shù)(Heterogeneous Index, HI);比較危及器官(organs at risk,OARs)的劑量差異；比較計劃治療時間(treatment time,TT)及機器跳數(shù)(monitor units,MU)的差異。[結(jié)果]：1.TomoTherapy計劃在靶區(qū)的V95、CI和HI方面結(jié)果最優(yōu),sIMRT最差。2.對危及器官的保護TomoTherapy治療計劃要好于sIMRT、VMAT,脊髓最大劑量Dmax明顯減小,差異有統(tǒng)計學(xué)意義；TomoTherapy計劃肺V20、V30低于sIMRT、VMAT,但V5、V10劑量要高,差異無統(tǒng)計學(xué)意義。3.出束及治療時間VMAT低于sIMRT、TomoTherapy,差異有統(tǒng)計學(xué)意義。[結(jié)論]：食管癌sIMRT、VMAT和TomoTherapy計劃在靶區(qū)覆蓋和危及器官保護上都可以達到臨床要求,在靶區(qū)的V95、CI和HI上TomoTherapy計劃優(yōu)于VMAT和sIMRT,但在治療時問和加速器的機器跳數(shù)上VMAT較有優(yōu)勢。
[Abstract]:[objective]: to compare the dosimetric differences between static intensity modulated radiotherapymetric (IMRT), volumetric modulated arc (VMATT) and spiral tomography (SCT) for upper thoracic esophageal carcinoma. [methods] six patients with upper thoracic esophageal carcinoma were selected to formulate 7 field sIMRT, single arc VMAT and conventional modulation intensity TomoTherapy radiotherapy plan. The maximum dose of PTV in target area was compared with that in the target area. The mean average dose of PTV was 95% PTV volume percentage, conformal index, Heterogeneous Index, Heterogenous Index, Hip; and the dose difference of organ endangering organs at riskweed OARs was compared. The difference between planned treatment time (TT) and machine hopping monitor (MUU) was compared. [results] 1. Tomotherapy had the worst results for V95 CI and HI in target area. The therapeutic plan of TomoTherapy was better than that of sIMRT. The maximum dose of Dmax in spinal cord was lower than that of sIMRT. The difference was statistically significant, but the dose of V20 V10 was higher than that of sIMRT V30, but the difference was not statistically significant (P < 0. 3). The maximum dose of Dmax in spinal cord was significantly lower than that of sIMRT V30, but the dose of V5 + V10 was higher than that of sIMRT. The VMAT of beam exit and treatment time was lower than that of sIMRT Tomo Therapy.The difference was statistically significant. [conclusion]: both sIMRTT VMAT and TomoTherapy can meet the clinical requirements in target area coverage and organ protection. The TomoTherapy program on V95 CI and HI in the target area is superior to VMAT and sIMRT, but it is superior to VMAT in the number of machine hops of the accelerator during the treatment.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R735.1

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本文編號：1894362