[1]鞠孟阳,史玉静,田甜,等. 全脑全脊髓放疗过程中射野重叠区对计划的影响[J].中国医学物理学杂志,2018,35(2):131-134.[doi:DOI:10.3969/j.issn.1005-202X.2018.02.002]
 JU Mengyang,SHI Yujing,TIAN Tian,et al. Effect of overlapping areas on craniospinal irradiation plans[J].Chinese Journal of Medical Physics,2018,35(2):131-134.[doi:DOI:10.3969/j.issn.1005-202X.2018.02.002]
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 全脑全脊髓放疗过程中射野重叠区对计划的影响()
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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:
131-134
栏目:
医学放射物理
出版日期:
2018-02-08

文章信息/Info

Title:
 Effect of overlapping areas on craniospinal irradiation plans
文章编号:
1005-202X(2018)02-0131-04
作者:
 鞠孟阳1史玉静1 田甜2孙新臣2
 1.南京医科大学特种医学系, 江苏 南京 210009; 2.南京医科大学第一附属医院放疗科, 江苏 南京 210009
Author(s):
 JU Mengyang1 SHI Yujing1 TIAN Tian2 SUN Xinchen2
 1. Department of Medicine in Specific Environments, Nanjing Medical University, Nanjing 210009, China; 2. Department of Radiation Oncology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210009, China
关键词:
 全脑全脊髓放疗射野重叠区摆位误差适形指数均匀指数
Keywords:
 craniospinal irradiation overlapping area setup error conformity index homogeneity index
分类号:
R739.4;R815.6
DOI:
DOI:10.3969/j.issn.1005-202X.2018.02.002
文献标志码:
A
摘要:
 目的:设置全脑全脊髓放疗计划设计过程中不同重叠区大小及摆位误差,试图找出重叠区大小对计划的影响。 方法:回顾性收集进行全脑全脊髓放疗的病例共8例。设置重叠区长度为1、2、4、6、8、10 cm等6个类别,分别进行计划设计,比较计划质量及执行情况。在以上6类的基础上模拟头脚方向摆位误差后再进行计划优化,比较计划重叠区长度及摆位误差对计划的影响。 结果:8例患者共制定272个治疗计划。对这272个计划进行分析:计划重叠区长度在1、2、4、6、8、10 cm时计划均能满足处方要求。但是重叠区为1 cm时,处方剂量分布在(95.2±1.0)%,低于其他几个类别(P=0.000)。重叠区长度由2 cm增加到10 cm时CI值逐渐增大,而HI指数逐渐减小(P=0.03)。同时,摆位误差≥±0.5 cm时,重叠区剂量明显分布不均。 结论:在全脑全脊髓放疗中,射野重叠省去了治疗过程中射野的移动,降低了治疗过程中的随机系统误差。但是重叠区长度存在适宜区间,就研究设置的6类来分析,重叠区区间∈[4,10]时,计划均能较好地满足计划需求。同时,摆位误差控制在0.5 cm以下时,对计划几乎不产生影响。
Abstract:
 Objective To set different sizes of overlapping areas and setup errors during the design of craniospinal irradiation (CSI) plan and analyze the effects of overlapping lengths on CSI plans. Methods Eight patients treated with CSI were retrospectively collected. Six overlapping lengths, namely 1, 2, 4, 6, 8 and 10 cm, were set to design CSI plans, and the qualities and implementations of plans with different overlapping lengths were compared. Based on the above six lengths, we simulated different setup errors in head-feet direction, and then conducted the plan optimization. The effects of overlapping lengths and setup errors on plans were compared. Results A total of 272 treatment plans were designed for 8 patients. When the overlapping lengths were 1, 2, 4, 6, 8 and 10 cm, all plans were able to meet prescribed requirements (95%-107% PTV was covered). However, the prescribed dose coverage rate was 95.2%±1.0% in plans with the overlapping length of 1 cm, smaller than the other plans (P=0.000). With the overlapping lengths increasing from 2 cm to 10 cm, the conformity index increased, while the homogeneity index decreased (P=0.03). When the setup errors were ±0.5 cm or larger, the dose distribution in overlapping areas was obviously uneven. Conclusion The overlapping of irradiation field which in a proper range avoids the movement of irradiation field during CSI, reducing the system error. Considering the six overlapping lengths above, when the overlapping length raises from 4 cm to 10 cm, the plans meet the plan requirements. Moreover, the setup errors smaller than 0.5 cm scarcely affect the plan.

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备注/Memo

备注/Memo:
 【收稿日期】2017-10-25
【基金项目】国家自然科学基金(81472809, 81502653, 81672983, 8170
3028)
【作者简介】鞠孟阳,硕士,研究方向:放射治疗的质量控制和效果保证,E-mail:DrJmy2017@163.com
【通信作者】孙新臣,博士,主任医师,博士生导师,研究方向:胸部肿瘤的放射治疗,E-mail:13770662828@163.com
更新日期/Last Update: 2018-01-29