[1]左宇浩,杨振,周剑良,等. 基于广义等效均匀剂量优化的直肠癌计划在固定野和容积旋转调强放疗中的比较[J].中国医学物理学杂志,2018,35(2):171-175.[doi:DOI:10.3969/j.issn.1005-202X.2018.02.010]
　ZUO Yuhao,YANG Zhen,ZHOU Jianliang,et al. Comparison of different plans based on generalized equivalent uniform dose optimization for rectal cancer: fixed-field intensity-modulated radiotherapy vs volumetric modulated arc therapy[J].Chinese Journal of Medical Physics,2018,35(2):171-175.[doi:DOI:10.3969/j.issn.1005-202X.2018.02.010]
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 基于广义等效均匀剂量优化的直肠癌计划在固定野和容积旋转调强放疗中的比较
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《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
35卷
期数:
2018年第2期
页码:
171-175
栏目:
医学放射物理
出版日期:
2018-02-08

文章信息/Info

Title:
 Comparison of different plans based on generalized equivalent uniform dose optimization for rectal cancer: fixed-field intensity-modulated radiotherapy vs volumetric modulated arc therapy
文章编号:
1005-202X（2018）02-0171-05
作者:
 左宇浩1; 杨振2; 周剑良1; 雷明军2; 曹瑛2; 杨晓喻2; 唐杜2; 刘礼东1
 1.南华大学核科学技术学院， 湖南 衡阳 421000； 2.中南大学湘雅医院肿瘤科， 湖南 长沙 410008
Author(s):
 ZUO Yuhao1;  YANG Zhen2;  ZHOU Jianliang1;  LEI Mingjun2;  CAO Ying2;  YANG Xiaoyu2;  TANG Du2;  LIU Lidong1
 1. School of Nuclear Science and Technology, University of South China, Hengyang 421000, China; 2. Department of Oncology,
Xiangya Hospital, Central South University, Changsha 410008, China
关键词:
 ; 广义等效均匀剂量; 容积旋转调强放疗; 固定野调强放疗; 直肠癌
Keywords:
 ; Keywords: generalized equivalent uniform dose;  volumetric modulated arc therapy;  fixed-field intensity-modulated radiotherapy;  rectal cancer
分类号:
R815.2；R735.37
DOI:
DOI:10.3969/j.issn.1005-202X.2018.02.010
文献标志码:
A
摘要:
 目的：比较基于广义等效均匀剂量（gEUD）优化的容积旋转调强和固定野调强技术直肠癌放疗的生物学参数和剂量学特点，为临床选择提供一定依据。 方法：选取10名经过医生勾画靶区的直肠癌患者，对每位患者分别设计5野调强计划（5FIMRT）、7野调强计划（7FIMRT）和容积旋转调强计划（RapidArc），处方剂量为50 Gy/25 F。比较3组计划的平均剂量体积直方图和机器跳数，靶区适形度、均匀性，危及器官的正常组织并发症概率（NTCP）及靶区和危及器官的gEUD和物理剂量。 结果：3组计划的靶区剂量均能达到临床要求。在适形度与均匀性上，RapidArc优于5 FIMRT和7 FIMRT（P<0.05）。在小肠和膀胱保护方面，7FIMRT和RapidArc无差异（P>0.05），且均优于5FIMRT（P<0.05）；对于双侧股骨头，RapidArc优于7FIMRT（P<0.05），7FIMRT优于5FIMRT（P<0.05）。RapidArc的机器跳数远小于5FIMRT和7FIMRT（P<0.05）。 结论：在基于gEUD优化的计划中，容积旋转调强计划和7野调强计划均优于5野调强计划。容积旋转调强计划和7野调强计划相比，在靶区适形度与均匀性，以及股骨头受量和效率方面具有优势。
Abstract:
 Objective To compare the biological and dosimetric differences of volumetric modulated arc therapy (RapidArc) and fixed-field intensity-modulated radiotherapy (IMRT) based on generalized equivalent uniform dose (gEUD) optimization for rectal cancer and provide some reference for clinical decision. Methods Ten patients with rectal cancer were selected, and three kinds of plans were designed for each patient, namely five-field IMRT (5FIMRT), seven-field IMRT (7FIMRT) and RapidArc plans, with the same prescription dose of 50 Gy/25 F for planning target volume (PTV). Finally, we applied paired t test to compare the differences among three plans in the mean dose-volume histogram and monitor unit, the conformity index (CI) and homogeneity index (HI) of PTV, the normal tissue complication possibility of organs-at-risk, the gEUD and physical dose of PTV and organs-at-risk. Results All the target dose distribution in three plans met the clinical requirement. The CI and HI of RapidArc were better than those of 5FIMRT and 7FIMRT (P<0.05). In the protection of small intestine and bladder, 7FIMRT and RapidArc had no significant differences (P>0.05), and both of the two plans are better than 5FIMRT (P<0.05). For the protection of bilateral femoral head, RapidArc was superior to 7FIMRT (P<0.05), and 7FIMRT was better than 5FIMRT (P<0.05). RapidArc had significantly less monitor units as comparison with 5FIMRT and 7FIMRT (P<0.05). Conclusion In the plans based on gEUD optimization, RapidArc and 7FIMRT were superior to 5FIMRT, moreover, RapidArc had advantages in CI and HI of PTV, sparing of femoral head and delivery efficiency compared to 7FIMRT.

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备注/Memo

备注/Memo:
 【收稿日期】2017-07-12
【作者简介】左宇浩，在读硕士研究生，主要研究方向：放射治疗剂量，E-mail: zuoyuhao1993@163.com
【通信作者】周剑良，E-mail: 13327341099@189.cn；杨振，E-mail: yangzhen@188.com
更新日期/Last Update: 2018-01-29