[1]龙雨松,谭军文,贺先桃,等. 肺癌固定剂量率旋转调强和容积旋转调强的剂量学分析[J].中国医学物理学杂志,2018,35(2):176-182.[doi:DOI:10.3969/j.issn.1005-202X.2018.02.011]
　LONG Yusong,TAN Junwen,HE Xiantao,et al. Dosimetric analysis of intensity-modulated arc radiotherapy with fixed dose rate versus volumetric modulated arc therapy for lung cancer[J].Chinese Journal of Medical Physics,2018,35(2):176-182.[doi:DOI:10.3969/j.issn.1005-202X.2018.02.011]
点击复制

 肺癌固定剂量率旋转调强和容积旋转调强的剂量学分析()
分享到：

《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:
176-182
栏目:
医学放射物理
出版日期:
2018-02-08

文章信息/Info

Title:
 Dosimetric analysis of intensity-modulated arc radiotherapy with fixed dose rate versus volumetric modulated arc therapy for lung cancer
文章编号:
1005-202X（2018）02-0176-07
作者:
 龙雨松; 谭军文; 贺先桃; 梁卫学; 王占宇; 李钢; 冯永富
 广西医科大学第四附属医院肿瘤科， 广西 柳州 545005
Author(s):
 LONG Yusong;  TAN Junwen;  HE Xiantao;  LIANG Weixue;  WANG Zhanyu;  LI Gang;  FENG Yongfu
 Department of Oncology, the Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou 545005, China
关键词:
 ; 肺癌; 容积旋转调强放疗; 旋转调强放疗; 固定剂量率
Keywords:
 ; Keywords: lung cancer;  volumetric modulated arc therapy;  intensity-modulated arc radiotherapy;  fixed dose rate
分类号:
R815.6
DOI:
DOI:10.3969/j.issn.1005-202X.2018.02.011
文献标志码:
A
摘要:
 目的：通过对肺癌固定剂量率旋转调强放疗（IMAT）计划和容积旋转调强放疗（VMAT）计划的剂量学分析，为临床应用中肺癌VMAT放疗剂量率方式的选取提供参考。 方法：取11例肺癌患者，用RayStation计划系统设计IMAT和VMAT计划，比较其剂量学、机器跳数（MU）和治疗时间的差异。 结果：（1）11例肺癌患者的双弧IMAT和VMAT计划均能满足临床要求，IMAT和VMAT计划的靶区最小剂量D98%、最大剂量D2%、平均剂量（Dmean）、靶区均匀性指数、靶区适形度指数相近，无明显差异。靶区覆盖率VMAT计划好于IMAT计划。（2）危及器官受量：全肺的V5、V10、V20、Dmean和心脏的V20，VMAT计划比IMAT计划低。全肺的V30、心脏的V30、脊髓的最大剂量D1%，两种计划之间无明显差异。（3）正常组织在低剂量部分V5、V10、V15和Dmean，VMAT计划低于IMAT计划；V20、V25两种计划无明显差异；接近处方剂量部分V30、V35、V40，VMAT计划高于IMAT计划。（4）出束时间和MU：VMAT计划相比于IMAT计划，治疗出束时间大大减少，VMAT计划出束时间仅为IMAT计划出束时间的62%。两者的MU无明显差异。（5）两种计划的剂量验证通过率均大于95%，达到98.72%以上，能满足治疗要求。VMAT计划的剂量验证通过率略低于IMAT计划，相差约0.44%。 结论：VMAT技术相较于IMAT技术，其计划调制能力更强，可得到更优的靶区剂量分布，提高治疗效率，可以更好地保护危及器官，尤其是减少肺的低剂量照射体积。因此，在肺癌的旋转调强放射治疗中，VMAT技术相较于IMAT技术存在较大的优势。
Abstract:
 Objective To analyze the dosimetric differences between intensity-modulated arc radiotherapy (IMAT) with fix dose rate and volumetric modulated arc radiotherapy (VMAT) for lung cancer, and provide reference for the selection of dose rate mode of VMAT for lung cancer. Methods IMAT and VMAT plans were designed for 11 patients with lung cancer using RayStation treatment planning system, and the differences in dosimetric parameters, monitor unit and delivery time were compared. Results Both dual arc IMAT and VMAT plans for lung cancer in 11 patients met the clinical requirements, and no significant differences were found in the minimum dose D98%, the maximum dose D2%, the average dose Dmean, homogeneity index and conformal index of target areas. However, the target coverage rate of VMAT plan was better than that of IMAT plan. The V5, V10, V20, Dmean of whole lung and the V20 of heart in VMAT were lower than those in IMAT plan, and the differences in the V30 of whole lung, the V30 of heart and the D1% of spine between IMAT and VMAT plans were not obvious. Compared with IMAT plan, VMAT plan had lower V5, V10 and V15 of normal tissues in the low-dose area, and normal tissues-Dmean, but higher V30, V35, V40 of normal tissues; two plans had no significant differences in the V20 and V25 of normal tissues. The delivery time of VMAT plan was greatly reduced, only 62% of that of IMAT plan. Two plans had similar monitor unit, without statistical differences. Though the dose passing rate of VMAT plan was slightly lower than that of IMAT plan, with a difference of about 0.44%, both the dose passing rates of the two plans were more than 98.72%, meeting treatment requirements. Conclusion Compared with IMAT, VMAT for lung cancer has a stronger plan modulation ability, can obtain better target dose distribution, improve the efficiency of treatment, and protect the organs-at-risk better, especially reducing the low-dose irradiation volume of lung. VMAT can bring more benefits to patients with lung cancer.

相似文献/References:

[1]史贵连,叶福丽.肺癌调强放疗计划的设计[J].中国医学物理学杂志,2015,32(03):361.[doi:10.3969/j.issn.1005-202X.2015.03.013]
[2]朱夫海,吴伟章,王 勇,等.肺癌螺旋断层放疗计划设计的初步研究[J].中国医学物理学杂志,2014,31(04):4979.[doi:10.3969/j.issn.1005-202X.2014.04.002]
[3]翁邓胡,王 建,尹中明,等.基于锥形束CT研究肺癌图像引导放疗的内靶区外放边界值[J].中国医学物理学杂志,2014,31(04):5012.[doi:10.3969/j.issn.1005-202X.2014.04.009]
[4]彭莹莹,张书旭,谭剑明,等.基于PCNN的PET/CT图像分割在肺癌靶区勾画中的应用[J].中国医学物理学杂志,2014,31(04):5022.[doi:10.3969/j.issn.1005-202X.2014.04.011]
[5]王 涛,王运来.基于4D-CT和Mimics软件模拟分析肺癌肿瘤的呼吸运动规律[J].中国医学物理学杂志,2014,31(05):5132.[doi:10.3969/j.issn.1005-202X.2014.05.008]
[6]周 琼,周剑良,张一戈,等.基于锥形束CT肺癌放射治疗两种体位固定技术摆位误差的研究[J].中国医学物理学杂志,2014,31(06):5258.[doi:10.3969/j.issn.1005-202X.2014.06.008]
[7]张矛,金海国,苏清秀,等.肺癌静态调强与容积旋转调强放射治疗间比较[J].中国医学物理学杂志,2013,30(05):4364.[doi:10.3969/j.issn.1005-202X.2013.05.006]
[8]罗焕丽,靳富,王颖,等.肿瘤放疗中体外误差与体内误差的关联性[J].中国医学物理学杂志,2016,33(1):10.[doi:DOI:10.3969/j.issn.1005-202X.2016.01.003]
　[J].Chinese Journal of Medical Physics,2016,33(2):10.[doi:DOI:10.3969/j.issn.1005-202X.2016.01.003]
[9]王琳婧,张书旭,袁克虹,等.基于图像变形配准的肺癌自适应放疗剂量学研究[J].中国医学物理学杂志,2016,33(1):16.[doi:DOI:10.3969/j.issn.1005-202X.2016.01.004]
　[J].Chinese Journal of Medical Physics,2016,33(2):16.[doi:DOI:10.3969/j.issn.1005-202X.2016.01.004]
[10]李政良,等.4DCT下肺癌大体肿瘤的变化及相关因素分析[J].中国医学物理学杂志,2016,33(2):208.[doi:10.3969/j.issn.1005-202X.2016.02.021]
[11]刘洪源,彭威,杨锐,等. 锥形束CT离线校正肺癌摆位误差[J].中国医学物理学杂志,2016,33(6):573.[doi:10.3969/j.issn.1005-202X.2016.06.007]
　[J].Chinese Journal of Medical Physics,2016,33(2):573.[doi:10.3969/j.issn.1005-202X.2016.06.007]
[12]黄啸天,张俊,周云峰,等. 方差分析法在肺癌立体定向放射治疗摆位误差及计划靶区外放边界中的应用[J].中国医学物理学杂志,2017,34(6):579.[doi:DOI:10.3969/j.issn.1005-202X.2017.06.008]
　[J].Chinese Journal of Medical Physics,2017,34(2):579.[doi:DOI:10.3969/j.issn.1005-202X.2017.06.008]
[13]雷伟杰,曹瑞芬,贾婧,等. 基于几何不确定性鲁棒性优化在肺癌容积旋转调强计划中的应用[J].中国医学物理学杂志,2017,34(9):865.[doi:DOI:10.3969/j.issn.1005-202X.2017.09.001]
　[J].Chinese Journal of Medical Physics,2017,34(2):865.[doi:DOI:10.3969/j.issn.1005-202X.2017.09.001]
[14]刘致滨,石锦平,张利文,等. Acuros XB与AAA算法在肺癌调强放疗计划设计中的比较[J].中国医学物理学杂志,2017,34(10):984.[doi:DOI:10.3969/j.issn.1005-202X.2017.10.003]
　[J].Chinese Journal of Medical Physics,2017,34(2):984.[doi:DOI:10.3969/j.issn.1005-202X.2017.10.003]
[15]张彦秋,韩阿蒙,李金旺,等. 容积旋转调强放射治疗肺癌患者放射性肺炎发生的相关因素分析[J].中国医学物理学杂志,2018,35(7):771.[doi:DOI:10.3969/j.issn.1005-202X.2018.07.006]
　ZHANG Yanqiu,HAN Ameng,LI Jinwang,et al. Analysis of factors predicting radiation pneumonitis in volumetric modulated arc therapy of lung cancer[J].Chinese Journal of Medical Physics,2018,35(2):771.[doi:DOI:10.3969/j.issn.1005-202X.2018.07.006]
[16]李玉成,陈维军,单国平,等. 摆位误差对立体定向放射治疗计划剂量学验证的影响[J].中国医学物理学杂志,2018,35(8):869.[doi:DOI:10.3969/j.issn.1005-202X.2018.08.001]
　LI Yucheng,CHEN Weijun,et al. Effects of setup errors on dosimetric verification of stereotactic body radiotherapy plan[J].Chinese Journal of Medical Physics,2018,35(2):869.[doi:DOI:10.3969/j.issn.1005-202X.2018.08.001]
[17]王警建,李娜,王龙龙,等. 能谱CT鉴别肺部炎性病变和肺癌的临床价值[J].中国医学物理学杂志,2018,35(10):1164.[doi:DOI:10.3969/j.issn.1005-202X.2018.10.010]
　WANG Jingjian,LI Na,WANG Longlong,et al. Clinical value of energy spectrum CT for the differential diagnosis of pulmonary inflammatory lesion and lung cancer[J].Chinese Journal of Medical Physics,2018,35(2):1164.[doi:DOI:10.3969/j.issn.1005-202X.2018.10.010]
[18]胡晓伟,史玉静,李金凯,等. 共面与非共面的VMAT在肺癌放疗中的剂量学比较[J].中国医学物理学杂志,2018,35(11):1246.[doi:DOI:10.3969/j.issn.1005-202X.2018.11.002]
　HU Xiaowei,SHI Yujing,LI Jinkai,et al. Dosimetric comparison of coplanar and non-coplanar volumetric modulated arc therapy for lung cancer[J].Chinese Journal of Medical Physics,2018,35(2):1246.[doi:DOI:10.3969/j.issn.1005-202X.2018.11.002]
[19]孙晓欢,谭丽娜,王中飞,等. 肺癌立体定向体部放疗以靶区为准进行锥形束CT在线配准的可行性研究[J].中国医学物理学杂志,2019,36(3):282.[doi:DOI:10.3969/j.issn.1005-202X.2019.03.007]
　SUN Xiaohuan,TAN Lina,WANG Zhongfei,et al. Feasibility of CBCT online registration by target areas in stereotactic body radiotherapy for lung cancer[J].Chinese Journal of Medical Physics,2019,36(2):282.[doi:DOI:10.3969/j.issn.1005-202X.2019.03.007]
[20]王毅,赖清泉,黄美铃,等. 磁共振体素内不相干运动在肺良恶性肿瘤的诊断效能及肺癌化疗疗效评估的应用[J].中国医学物理学杂志,2019,36(6):682.[doi:DOI:10.3969/j.issn.1005-202X.2019.06.012]
　WANG Yi,LAI Qingquan,HUANG Meiling,et al. Application of MR-IVIM in the diagnosis of benign and malignant lung tumors and the evaluation of chemotherapeutic efficacy in lung cancer[J].Chinese Journal of Medical Physics,2019,36(2):682.[doi:DOI:10.3969/j.issn.1005-202X.2019.06.012]

备注/Memo

备注/Memo:
 【收稿日期】2017-10-27
【作者简介】龙雨松，工程师，主要从事肿瘤放射物理学方面的研究，E-mail: liuzhouie@126.com
【通信作者】王占宇，工程师，主要从事肿瘤放射治疗物理和技术方面的研究，E-mail: wzyliuzhou@163.com
更新日期/Last Update: 2018-01-29