[1]闫冰,吴爱东,张洪波,等. 肝细胞癌共面和非共面容积旋转调强放疗与螺旋断层放疗的剂量学研究[J].中国医学物理学杂志,2019,36(8):877-881.[doi:DOI:10.3969/j.issn.1005-202X.2019.08.003]
　YAN Bing,WU Aidong,ZHANG Hongbo,et al. Dosimetric study on coplanar and noncoplanar volumetric modulated arc therapy and helical tomotherapy for hepatocellular carcinoma[J].Chinese Journal of Medical Physics,2019,36(8):877-881.[doi:DOI:10.3969/j.issn.1005-202X.2019.08.003]
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 肝细胞癌共面和非共面容积旋转调强放疗与螺旋断层放疗的剂量学研究()
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《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
36卷
期数:
2019年第8期
页码:
877-881
栏目:
医学放射物理
出版日期:
2019-08-26

文章信息/Info

Title:
 Dosimetric study on coplanar and noncoplanar volumetric modulated arc therapy and helical tomotherapy for hepatocellular carcinoma
文章编号:
1005-202X（2019）08-0877-05
作者:
 闫冰; 吴爱东; 张洪波; 刘磊; 薛旭东; 沈琦
 中国科学技术大学附属第一医院（安徽省立医院）放疗科， 安徽 合肥 230001
Author(s):
 YAN Bing;  WU Aidong;  ZHANG Hongbo;  LIU Lei;  XUE Xudong;  SHEN Qi
 Department of Radiation Oncology, the First Affiliated Hospital of USTC (Anhui Provincial Hospital), Hefei 230001, China
关键词:
 ; 肝细胞癌; 共面容积旋转调强放疗; 非共面容积旋转调强放疗; 螺旋断层放射治疗; 剂量学
Keywords:
 ; Keywords: hepatocellular carcinoma;  coplanar volumetric modulated arc therapy;  noncoplanar volumetric modulated arc therapy;  helical tomotherapy;  dosimetry
分类号:
R735.7；R815
DOI:
DOI:10.3969/j.issn.1005-202X.2019.08.003
文献标志码:
A
摘要:
 目的：分析肝细胞癌共面和非共面容积旋转调强放疗（VMAT）与螺旋断层放疗（HT）的剂量学特点，比较三者在正常肝脏组织保护和靶区剂量分布的差异。方法：选取10例肝细胞癌患者，分别设计共面VMAT（C-VMAT）、非共面VMAT（NC-VMAT）和HT计划，通过DVH图评估不同计划的靶区和危及器官剂量学的差异。结果：HT靶区的最大剂量、平均剂量、D2以及均匀性指数（HI）均优于C-VMAT和NC-VMAT（P?0.05），3种计划在最小剂量、D98以及适形度指数（CI）方面无统计学意义。C-VMAT与NC-VMAT相比，两者仅在D98参数上具有统计学意义（P?0.05）。正常肝脏的低剂量区体积参数V5、V10，NC-VMAT具有明显优势，而肝脏高剂量区体积参数V40、V50，HT与C-VMAT和NC-VMAT相比具有一定优势。NC-VMAT的脊髓最大剂量与C-VMAT的相应值之间差异有统计学意义且最低。NC-VMAT的左、右肾Dmean优于C-VMAT计划，差异显著（P?0.05），3组计划的其余正常组织参数之间无明显差异。结论：3组计划均能满足处方剂量要求，HT产生更高的靶区均匀性的同时能够明显降低正常肝脏组织高剂量区的体积，而NC-VMAT计划可以减少患者正常肝脏低剂量区的体积。
Abstract:
 Abstract: Objective To compare the differences in normal liver tissue sparing and target dose distribution among coplanar volumetric modulated arc therapy (C-VMAT), noncoplanar VMAT (NC-VMAT), and helical tomotherapy (HT) for hepatocellular carcinoma. Methods Three plans, namely C-VMAT, NC-VMAT and HT plans, were designed for 10 patients with hepatocellular carcinoma. The dosimetric differences of target areas and organs-at-risk among different plans were evaluated with dose volume histogram. Results The maximum dose, mean dose, D2 and homogeneity index of target areas in HT plan were better than those in C-VMAT plan and NC-VMAT plan (P<0.05), while the minimum dose, D98 and conformity index of target areas were similar in 3 plans. Expect for the D98 of target areas, no statistical difference was found between C-VMAT plan and NC-VMAT plan (P?0.05). NC-VMAT plan had obvious advantages in the low-dose volume (V5 and V10) of normal liver tissues. However, HT plan was superior to C-VMAT plan and NC-VMAT plan in the high-dose volume (V40 and V50) of normal liver tissues. The maximum dose of spinal cord in NC-VMAT plan was the least, and there was significant difference in the maximum dose of spinal cord between C-VMAT plan and NC-VMAT plan. The mean doses of left and right kidneys in NC-VMAT plan were higher than those in C-VMAT plan, with significant differences (P<0.05), and no significance was found in the other dosimetirc parameters of normal tissues among 3 groups. Conclusion All of the 3 plans satisfy the requirement of prescribed dose. Compared with VMAT plans, HT plan increases the homogeneity index of target areas, and reduces the high-dose volume of normal liver tissues. However, the low-dose volume of normal liver tissues can be reduced in NC-VMAT plan.

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备注/Memo

备注/Memo:
 【收稿日期】2018-11-21
【基金项目】安徽省自然科学基金（1708085QH193）；中华医学国际交流基金（Z-2014-06-15323）
【作者简介】闫冰，硕士，工程师，研究方向：放射物理，E-mail: cpreo@126.com
【通信作者】吴爱东，博士，正高级工程师，研究方向：放射物理，E-mail: flkaidongwu@163.com
更新日期/Last Update: 2019-08-26