[1]吕明月,李萍,陈韦翔,等. 不同射野入射角度对食管癌放射治疗剂量学的影响[J].中国医学物理学杂志,2019,36(8):908-913.[doi:DOI:10.3969/j.issn.1005-202X.2019.08.009]
　LÜ,Mingyue,LI Ping,et al. Effect of different incidence angles on dosimetric parameters of radiotherapy for esophageal cancer[J].Chinese Journal of Medical Physics,2019,36(8):908-913.[doi:DOI:10.3969/j.issn.1005-202X.2019.08.009]
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 不同射野入射角度对食管癌放射治疗剂量学的影响()
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《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
36卷
期数:
2019年第8期
页码:
908-913
栏目:
医学放射物理
出版日期:
2019-08-26

文章信息/Info

Title:
 Effect of different incidence angles on dosimetric parameters of radiotherapy for esophageal cancer
文章编号:
1005-202X（2019）08-0908-06
作者:
 吕明月; 李萍; 陈韦翔; 王奕鸣
 暨南大学附属第一医院肿瘤科， 广东 广州 510630
Author(s):
 LÜ Mingyue;  LI Ping;  CHEN Weixiang;  WANG Yiming
 Department of Oncology, the First Affiliated Hospital of Ji’nan University, Guangzhou 510630, China
关键词:
 ; 食管癌; 三维适形放射治疗; 调强放射治疗; 剂量学比较
Keywords:
 ; Keywords: esophageal cancer;  three-dimensional conformal radiotherapy;  intensity-modulated radiotherapy;  dosimetric comparison
分类号:
R812；R735.1
DOI:
DOI:10.3969/j.issn.1005-202X.2019.08.009
文献标志码:
A
摘要:
 目的：比较不同入射角度的食管癌放射治疗计划间的剂量学差异，从而选取一种既能最优化靶区剂量又能使危及器官损伤最小的计划。方法：选择11例食管癌患者，为每例患者制定4套放疗计划，包括三维适形放射治疗（3D-CRT）、4野调强放射治疗（4F-IMRT）、7野调强放射治疗（7F-IMRT）和9野调强放射治疗（9F-IMRT）。PTVg和计划靶区（PTV）的处方剂量分别为60 Gy/27 F和50 Gy/27 F。比较不同计划中的靶区和危及器官的剂量学参数。结果：4F-IMRT计划中PTVg的CI和PTV的HI、CI优于3D-CRT计划，4F-IMRT计划中PTV的CI优于7F-IMRT，差异具有统计学意义（P<0.05）。肺的受照剂量中，4F-IMRT计划中V20低于3D-CRT计划，V20、V30低于7F-IMRT计划，V5低于9F-IMRT计划，差异具有统计学意义（P<0.05）。4组计划中的脊髓Dmax<45 Gy，心脏V33<46%，均达到计划要求。结论：4F-IMRT计划与7F-IMRT、9F-IMRT计划相比，心脏、脊髓剂量差异不显著，但是肺的受量明显降低且患者接受照射的时间较7F-IMRT、9F-IMRT计划减少2~3倍。4F-IMRT计划能提高靶区适形度，更好地保护危及器官，显著减少肺低剂量区体积。
Abstract:
 Abstract: Objective To compare the dosimetric differences among esophageal cancer plans with different incidence angles for determining an optimal plan which can optimize target doses and minimize the damages to organs-at-risk. Methods Eleven patients with esophageal cancer were enrolled in this study. Four radiotherapy plans, namely three-dimensional conformal radiotherapy (3D-CRT), 4-field intensity-modulated radiotherapy (4F-IMRT), 7-field intensity-modulated radiotherapy (7F-IMRT) and 9-field intensity-modulated radiotherapy (9F-IMRT), were designed for each patient. The prescription dose of PTVg and planning target volume (PTV) was 60 Gy/27 F and 50 Gy/27 F, respectively. The dosimetric parameters of target areas and organs-at-risk in different plans were compared. Results 4F-IMRT plan was superior to 3D-CRT plan in the conformity index (CI) of PTVg and the CI and homogeneity index (HI) of PTV, and was superior to 7F-IMRT plan in the CI of PTV, with statistical differences (P<0.05). The V20 of lung in 4F-IMRT plan was lower than that in 3D-CRT plan; the V20 and V30 of lung in 4F-IMRT plan were lower than those in 7F-IMRT plan; and the V5 of lung in 4F-IMRT plan was lower than that in 9F-IMRT plan, with significant differences (P<0.05). In the 4 kinds of plans, the maximum dose of spinal cord was less than 45 Gy and the V33 of the heart was less than 46%, which met the clinical requirements (P>0.05). Conclusion The doses of the heart and spinal cord in 4F-IMRT plan are similar to those in 7F-IMRT and 9F-IMRT plans, but the lung dose of 4F-IMRT plan is significantly reduced and the radiation time was 2-3 times less than that of 7F-IMRT and 9F-IMRT plans. 4F-IMRT plan can not only improve target conformity, but also better protect organs-at-risk and significantly reduce the low-dose volume of lung.

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备注/Memo

备注/Memo:
 【收稿日期】2019-02-25
【作者简介】吕明月，硕士，研究方向：放射物理，E-mail: lvmingyue2004
@163.com
【通信作者】王奕鸣，主任医师，副教授，研究方向：肿瘤放射治疗，E-mail: twangym@jnu.edu.cn
更新日期/Last Update: 2019-08-26