[1]赵洪利,刘晖,钟亚华,等. TomoDirect技术在鼻咽癌放疗中的剂量学研究[J].中国医学物理学杂志,2018,35(2):166-170.[doi:DOI:10.3969/j.issn.1005-202X.2018.02.009]
　ZHAO Hongli,LIU Hui,ZHONG Yahua,et al. Dosimetric study of TomoDirect technology in radiotherapy for nasopharyngeal carcinoma[J].Chinese Journal of Medical Physics,2018,35(2):166-170.[doi:DOI:10.3969/j.issn.1005-202X.2018.02.009]
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 TomoDirect技术在鼻咽癌放疗中的剂量学研究()
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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:
166-170
栏目:
医学放射物理
出版日期:
2018-02-08

文章信息/Info

Title:
 Dosimetric study of TomoDirect technology in radiotherapy for nasopharyngeal carcinoma
文章编号:
1005-202X（2018）02-0166-05
作者:
 赵洪利; 刘晖; 钟亚华; 谢丛华; 王骁踊
 武汉大学中南医院肿瘤放化疗科， 湖北 武汉 430071
Author(s):
 ZHAO Hongli;  LIU Hui;  ZHONG Yahua;  XIE Conghua;  WANG Xiaoyong
 Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
关键词:
 ; 鼻咽癌; TomoDirect技术; 固定野调强; 螺旋断层调强; 剂量学
Keywords:
 ; nasopharyngeal carcinoma;  TomoDirect technology;  fixed-field intensity-modulated radiotherapy;  TomoHelical technology;  dosimetry
分类号:
R815
DOI:
DOI:10.3969/j.issn.1005-202X.2018.02.009
文献标志码:
A
摘要:
 目的：研究鼻咽癌患者应用TomoDirect（TD）、TomoHelical（TH）及常规加速器固定野调强技术（FF-IMRT）设计的计划的剂量学差异。 方法：选取10例鼻咽癌患者，对患者CT图像分别设计TH、TD和FF-IMRT计划，评估靶区、危及器官和正常组织的剂量分布。采用单因子方差分析法比较TH、TD、FF-IMRT计划的剂量学参数差异，并用LSD法进行两两比较。 结果：TD技术设计的计划，靶区剂量学与TH、FF-IMRT无明显差异；危及器官保护与TH相似，相比于FF-IMRT，脊髓最大剂量降低约4 Gy（P=0.000）；腮腺平均剂量降低约20%（P=0.000），[D33]、[D50]、[D60]显著低于FF-IMRT（P=0.000）；口腔、喉的平均剂量分别比FF-IMRT降低约7 Gy（P=0.000）和20 Gy（P=0.000）；颞颌关节的最大剂量比FF-IMRT降低10 Gy（P=0.000）；而在视神经、视交叉的保护上，TD与TH均不如FF-IMRT；靶区外正常组织受照剂量，TD计划具有一定优势。 结论：鼻咽癌患者TD计划的剂量学参数与TH计划相似，整体优于FF-IMRT计划，完全满足临床剂量学要求，可以作为一种新的治疗手段。
Abstract:
 Objective To evaluate the dosimetric differences of TomoDirect (TD), TomoHelical (TH) and fixed-field intensity-modulated radiotherapy (FF-IMRT) plans for nasopharyngeal carcinoma (NPC). Methods Ten patients with NPC were enrolled in this study, and based on their CT images, three plans were designed for each patient, namely TH, TD and FF-IMRT plans. The dose distribution in target areas, organs-at-risk and normal tissues were evaluated. Furthermore, the dosimetric differences were compared among three plans by single factor analysis of variance, and compared in pairs by LSD method. Results For dosimetric parameters in target areas, TD plans didn’t showed any statistical differences with TH and FF-IMRT plans. TD and TH plans showed significant improvement over IMRT plans in terms of OAR protection. Compared with FF-IMRT plan, the maximum dose of spinal cord in the other two plans was reduced by about 4 Gy (P=0.000); the mean dose of parotid gland was decreased by about 20% (P=0.000) and the D33, D50 and D60 were significantly lower (P=0.000); the mean dose of oral cavity and larynx were reduced by about 7 Gy and 20 Gy, respectively (P=0.000, 0.000); and the maximum dose of temporomandibular joint was lower by 10 Gy (P=0.000). However, FF-IMRT plan was superior to TD and TH plans in the protection of optic nerve and chiasm. Besides, TD plans showed certain advantages in the irradiation dose of the normal tissues outside the target areas. Conclusion For patients with NPC, the differences in dosimetric parameters between TD and TH plans were trivial, and both TD and TH plans showed significant improvements over IMRT plans, completely meeting the clinical requirements. TD technology is feasible to treat patients with NPC.

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备注/Memo

备注/Memo:
 【收稿日期】2017-09-03
【作者简介】赵洪利，硕士，物理师，研究方向：放射物理及精确放疗，E-mail: 2511988634@qq.com
【通信作者】王骁踊，物理师，研究方向：医学物理及精确放疗，E-mail：wangxy_06@hotmail.com
更新日期/Last Update: 2018-01-29