[1]岳堃,姚原,贾晓斌,等.基于smart LMC算法的动态调强技术在舌癌术后放疗中的剂量学研究[J].中国医学物理学杂志,2019,36(11):1255-1260.[doi:DOI:10.3969/j.issn.1005-202X.2019.11.003]
　YUE Kun,YAO Yuan,JIA Xiaobin,et al.Dosimetric study on dynamic IMRT technology based on smart LMC in postoperative radiotherapy for tongue cancer[J].Chinese Journal of Medical Physics,2019,36(11):1255-1260.[doi:DOI:10.3969/j.issn.1005-202X.2019.11.003]
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基于smart LMC算法的动态调强技术在舌癌术后放疗中的剂量学研究()
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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11期
页码:
1255-1260
栏目:
医学放射物理
出版日期:
2019-11-25

文章信息/Info

Title:
Dosimetric study on dynamic IMRT technology based on smart LMC in postoperative radiotherapy for tongue cancer
文章编号:
1005-202X（2019）11-1255-06
作者:
岳堃1; 2; 姚原1; 贾晓斌1; 董晓庆3; 袁峥玺1
1.上海交通大学医学院附属第九人民医院放疗科， 上海 201900； 2.上海大学通信与信息工程学院， 上海 200444； 3.同济大学附属第十人民医院放疗科， 上海 200072
Author(s):
YUE Kun1; 2;  YAO Yuan1;  JIA Xiaobin1;  DONG Xiaoqing3;  YUAN Zhengxi1
1. Department of Radiotherapy, the Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 201900, China; 2. School of Communication and Information Engineering, Shanghai University, Shanghai 200444, China; 3. Department of Radiotherapy, the Tenth People’s Hospital of Tongji University, Shanghai 200072, China
关键词:
舌癌; smart LMC; 动态调强; 静态调强; 速锋刀; 术后放疗
Keywords:
tongue cancer;  smart leaf motion calculator;  dynamic intensity-modulated radiotherapy;  step-and-shoot intensity-modulated radiotherapy;  EDGE;  postoperative radiotherapy
分类号:
R815.6
DOI:
DOI:10.3969/j.issn.1005-202X.2019.11.003
文献标志码:
A
摘要:
目的：探讨Varian速锋刀EDGE上，动态调强放疗（Sliding Window, SW）、静态调强放疗（Step-and-Shoot, SS）与基于smart LMC算法的新动态调强放疗（SW-smart）3种技术在舌癌术后放疗中的剂量学差异及适用性。方法：选取26例舌癌（分期为T2-3N1-2M0）术后的病人，在13.6版本的Eclipse上进行SS、SW、SW-smart计划设计，对3种计划的靶区和危及器官剂量分布进行比较和统计学分析，包括靶区的近似最小剂量D98%，近似最大剂量D2%，中位剂量D50%，均匀性指数及适形度指数以及正常组织脊髓、脑干的最高剂量，喉的平均剂量及50 Gy剂量线包绕的体积，左右腮腺平均剂量及30 Gy剂量线包绕的体积，咽缩肌和唇的平均剂量。记录比较3种计划的机器跳数和治疗时间。结果：SW、SW-smart的PTV的D50%、适形度和均匀性指数均优于SS，结果具有统计学意义，SW-smart略优于SW，却没有统计学意义；SW-smart的D2%最低，SW次之，SS的D2%最高，对热点的控制最差，三者之间均有统计学差异。在正常组织保护上，SW与SS之间没有统计学差异，仅SW-smart具有统计学意义上的优势；喉的V50及左右腮腺的V30，3种计划优化结果相互之间均不存在统计学差异。SS的跳数最少，治疗用时最长，SW-smart和SW没有明显差异。结论：基于Varian速锋刀和新版本Eclipse中smart LMC算法的动态调强技术，与传统静态及动态调强相比，可提供更好的靶区剂量分布和正常组织保护，在舌癌术后放疗计划的优化上具有明显的优势。 【关键词】舌癌；smart LMC；动态调强；静态调强；速锋刀；术后放疗
Abstract:
To investigate dosimetric differences and applicability of different Varian EDGE-based intensity-modulated radiotherapy (IMRT), namely sliding window IMRT (SW), step-and-shoot IMRT (SS) and the novel dynamic IMRT based on smart leaf motion calculator (SW-smart), in the postoperative radiotherapy for tongue cancer. Methods Twenty-six postoperative patients with tongue cancer (stage of T2-3N1-2M0) were enrolled in the study. The plans of SS, SW and SW-smart were designed on Eclipse (version 13.6). The dose distribution of target areas and organs-at-risk among 3 plans were compared and statistically analyzed, and the comparison parameters includes the D98%, D2%, D50%, homogeneity index and conformity index of target areas and the Dmax of spinal cord and brainstem, the Dmean of larynx, parotid-L, parotid-R, pharyngeal constrictors and lip, the V50 of larynx and the V30 of parotid-L and parotid-R. The monitor units and delivery time of 3 plans were also recorded and compared. Results The D50%, conformity index and homogeneity index of planning target volume in SW and SW-smart were superior to those in SS, and the results were statistically significant. SW-smart was slightly better than SW, but there was no statistical significance. SW-smart had the lowest D2% of target areas, followed by SW and SS which had the worst capability to control high dose, and there were significant differences among 3 groups. SW-smart had statistical advantages over SW and SS in normal tissue sparing, and no statistical difference was found in normal tissue sparing between SW and SS. The V50 of larynx and the V30 of parotid-L and parotid-R were similar in 3 plans, without statistical differences. SS had the fewest monitor units and the longest delivery time, and there was no significant difference in monitor units and delivery time between SW-smart and SW. Conclusion Compared with the traditional static and dynamic IMRT, the novel dynamic IMRT technique based on Varian EDGE and smart LMC of new version of Eclipse can provide better target dose distribution and normal tissue sparing, having obvious advantages in postoperative radiotherapy for tongue cancer.

相似文献/References:

[1]陈之锋,邓旋,卢振泰.一种新的舌癌图像快速自动分割方法[J].中国医学物理学杂志,2020,37(8):1022.[doi:DOI:10.3969/j.issn.1005-202X.2020.08.016]
　CHEN Zhifeng,DENG Xuan,LU Zhentai.A new and fast method for automatic tongue cancer image segmentation[J].Chinese Journal of Medical Physics,2020,37(11):1022.[doi:DOI:10.3969/j.issn.1005-202X.2020.08.016]

备注/Memo

备注/Memo:
【收稿日期】2019-06-18 【基金项目】国家自然科学基金（11575108） 【作者简介】岳堃，硕士，博士在读，主管工程师，放射物理师，研究方向：医学物理学，E-mail: yuekunrt@163.com 【通信作者】姚原，博士，主任医师，研究方向：放射肿瘤学和放射生物学，E-mail: yao95yuan@163.com
更新日期/Last Update: 2019-11-28