[1]杨涛,张丹丹,胡强,等.肺部靶区占比对非小细胞肺癌计划中肺剂量体积的影响[J].中国医学物理学杂志,2022,39(3):283-288.[doi:DOI:10.3969/j.issn.1005-202X.2022.03.004]
　YANG Tao,ZHANG Dandan,HU Qiang,et al.Effects of proportion of lung target area on lung dose-volume parameters in treatment planning of non-small cell lung cancer[J].Chinese Journal of Medical Physics,2022,39(3):283-288.[doi:DOI:10.3969/j.issn.1005-202X.2022.03.004]
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肺部靶区占比对非小细胞肺癌计划中肺剂量体积的影响()
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《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
39卷
期数:
2022年第3期
页码:
283-288
栏目:
医学放射物理
出版日期:
2022-03-28

文章信息/Info

Title:
Effects of proportion of lung target area on lung dose-volume parameters in treatment planning of non-small cell lung cancer
文章编号:
1005-202X（2022）03-0283-06
作者:
杨涛1; 张丹丹2; 胡强1; 金晓峰1; 王楚云1; 王艺璇2
1.鄂东医疗集团黄石市中心医院放疗中心， 湖北 黄石 435000； 2.中山大学肿瘤防治中心（华南肿瘤学国家实验室/肿瘤医学协同创新中心）放疗科， 广东 广州 510060
Author(s):
YANG Tao1;  ZHANG Dandan2;  HU Qiang1;  JIN Xiaofeng1;  WANG Chuyun1;  WANG Yixuan2
1. Radiotherapy Center, Huangshi Central Hospital, Edong Healthcare, Huangshi 435000, China 2. Department of Radiation Oncology, Sun Yat-sen University Cancer Center (State Key Laboratory of Oncology in South China/Collaborative Innovation Center for Cancer Medicine), Guangzhou 510060, China
关键词:
非小细胞肺癌; 容积调强放射治疗; 靶区大小; 均匀性; 肺剂量体积参数
Keywords:
Keywords: non-small cell lung cancer volumetric modulated arc therapy size of target area homogeneity lung dose-volume parameter
分类号:
R811.1
DOI:
DOI:10.3969/j.issn.1005-202X.2022.03.004
文献标志码:
A
摘要:
目的：探究非小细胞肺癌（NSCLC）通过降低靶区均匀性从而获得更好的肺剂量学参数策略中肿瘤体积大小的影响，为制定容积调强（VMAT）计划时限定肺剂量参数提供参考依据。方法：选取NSCLC病例VMAT计划共32例，计划靶区PTV1、PTV2处方剂量分别为50.83和44.20 Gy。将原计划设定为A组；取消原计划靶区高剂量罚分来放松PTV均匀性要求，其他条件不变，进行优化获得B组。A、B组进行剂量归一处理后，定量分析肺组织接受高于5和20 Gy剂量照射的体积百分比（V5和V20）、肺体积与靶区的体积比（LTR）、肺体积与肺内靶区的体积比（LOTR）以及靶区的均匀性指数（HI）、适形度指数（CI）等参数，并采用散点图来分析肺V5、V20随肿瘤体积大小的变化所呈现的变化规律。结果：B组计划肺部V5、V20相较A组计划分别平均降低1.02%、1.34%（P值分别为0.020和0.001）。当肺体积与靶区PTV1、PTV2的体积比值LTR1和LTR2高于11和6时，B组肺V5、V20较原始计划呈一致性下降。肺体积与肺内靶区的比值LTOR1大于30，LTOR2大于19时，B计划则能收到较好的肺部剂量改善。结论：LTR及LTOR是评估通过降低靶区均匀性改善降低肺部V5、V20剂量是否适用的两个重要指标，当LTR和LTOR高于临界值，则能有效地降低肺部的V5、V20，并为临床应用提供参考。
Abstract:
Abstract: Objective To explore the effects of size of target areas on obtaining better radiotherapy regimen through reducing target dose homogeneity, thereby providing references for limiting the lung dose-volume parameters in the volumetric modulated arc therapy (VMAT) planning of non-small cell lung cancer (NSCLC). Methods A total of 32 NSCLC patients treated with VMAT were randomly selected. The prescription doses for PTV1 and PTV2 were 50.83 and 44.20 Gy, respectively. The original plan was taken as group A and group B was obtained by easing the requirements for PTV homogeneity through canceling the high-dose penalty of target areas in the original plan. After dose normalization, several parameters were analyzed quantitatively, including the volume percentage of normal lung tissues receiving radiation dose above 5 and 20 Gy (V5, V20), as well as the ratio of the lung volume to the PTV (LTR), the ratio of the lung volume to the overlap volume between PTV and lung (LOTR), homogeneity index (HI) and conformity index (CI). Moreover, the variations of lung V5 and V20 with tumor volume were analyzed using scatter plots. Results The lung V5 and V20 in group B were lower by 1.02% and 1.34% than those in group A (P=0.020, 0.001). When LTR1 and LTR2 (the ratio of lung volume to PTV1 or PTV2) were higher than 11 and 6, respectively, the lung V5 and V20 in group B showed an obvious downward trend as compared with the original plan. When LTOR1 and LTOR2 (the ratio of the lung volume to the overlap volume between PTV1 or PTV2 and lung) were greater than 30 and 19, respectively, plan B had a better lung dose reduction. Conclusion LTR and LTOR are two important indicators for assessing whether the strategy of lowering the V5 and V20 of the lungs by reducing target homogeneity works or not. When LTR and LTOR exceed certain critical values, lung V5 and V20 can be effectively reduced, which provides a reference for the clinical practice.

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备注/Memo

备注/Memo:
【收稿日期】2021-07-18 【基金项目】国家自然科学基金（11905303） 【作者简介】杨涛，硕士，主管技师，研究方向：肿瘤放射物理学，E-mail: 121027542@qq.com 【通信作者】张丹丹，博士，助理研究员，研究方向：肿瘤放射物理学，E-mail: zhangdd@sysucc.org.cn
更新日期/Last Update: 2022-03-28