[1]安义均,赵彪,余立丹,等. 胸中段食管癌VMAT与IMRT的心脏及其亚结构剂量学比较[J].中国医学物理学杂志,2018,35(6):648-653.[doi:DOI:10.3969/j.issn.1005-202X.2018.06.006]
　AN Yijun,ZHAO Biao,YU Lidan,et al. Comparison of doses of heart and substructures in VMAT versus IMRT for middle thoracic esophageal cancer[J].Chinese Journal of Medical Physics,2018,35(6):648-653.[doi:DOI:10.3969/j.issn.1005-202X.2018.06.006]
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 胸中段食管癌VMAT与IMRT的心脏及其亚结构剂量学比较()
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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6期
页码:
648-653
栏目:
医学放射物理
出版日期:
2018-06-22

文章信息/Info

Title:
 Comparison of doses of heart and substructures in VMAT versus IMRT for middle thoracic esophageal cancer
文章编号:
1005-202X（2018）06-0648-06
作者:
 安义均1; 赵彪1; 余立丹2; 和丽秋1; 赵玉涛1; 杨毅1
 1.昆明医科大学第三附属医院/云南省肿瘤医院放疗中心， 云南 昆明 650118； 2.昆明医科大学研究生院， 云南 昆明 650500
Author(s):
 AN Yijun1;  ZHAO Biao1;  YU Lidan2;  HE Liqiu1;  ZHAO Yutao1;  YANG Yi1
 1. Department of Radiation Oncology, the Third Affiliated Hospital of Kunming Medical University & Yunnan Cancer Hospital, Kunming 650118, China; 2. Graduate School, Kunming Medical University, Kunming 650500, China
关键词:
 ; 食管癌; 容积调强; 静态调强; 心脏; 剂量学
Keywords:
 ; Keywords: esophageal cancer;  volumetric modulated arc therapy;  intensity-modulated radiotherapy;  heart;  dosimetry
分类号:
R735.1
DOI:
DOI:10.3969/j.issn.1005-202X.2018.06.006
文献标志码:
A
摘要:
 目的：比较胸中段食管癌VMAT与IMRT的心脏及心脏亚结构的剂量学差异，寻找对心脏保护更佳的放疗技术。 方法：对15例病理确诊的胸中段食管癌患者在相同标准下进行靶区及危及器官勾画，同时分别行7野IMRT计划和单弧全弧VMAT计划，并对两计划的心脏及心脏亚结构剂量进行比较。 结果：在满足靶区相似覆盖的情况下，心脏及心脏亚结构高剂量区：全心V20~V40、心包V20和V25、左心房 V40、右心房V25和V30、右心室V20~V30、右冠脉计划危险体积的V20~V30等比较上VMAT更低，差异具有统计学意义（P<0.05）。相比IMRT，VMAT在全心、左心室、右心室、右冠脉计划危险体积等Dmean上也更低（P<0.05）。而低剂量区比较上右心室V5则VMAT更高，但是在左冠脉前降支计划危险体积的V5、V10上却相反（P<0.05）。其余参数比较则不具有统计学意义（P>0.05）。 结论：VMAT与IMRT均能满足胸中段食管癌患者的放疗要求，但VMAT较IMRT能提供更好的心脏保护，从剂量学方面降低了放疗导致的心脏损伤。
Abstract:
 Abstract: Objective To compare the differences in the doses of heart and substructures in volumetric modulated arc therapy (VMRT) and intensity-modulated radiotherapy (IMRT) of middle thoracic esophageal cancer, and investigate a better radiotherapy technology for heart protection. Methods Fifteen patients with middle thoracic esophageal cancer confirmed by pathology were enrolled in this study. The target areas and organs-at-risk were delineated with the same criterion, and meanwhile 7-fields IMRT and 1-arc VMAT plan were designed for each patient. The dose of heart and substructures were compared between the two plans. Results Under the same target coverage, compared with IMRT plan, VMAT plan had significant reductions in the high-dose regions of heart and substructures, particularly in V20-V40 of the whole heart, V20 and V25 of pericardium, V40 of left atrium, V25 and V30 of right atrium, V20-V30 of right ventricle, V20-V30 of planning risk volume-right coronary artery (PRV-RCA) (all P<0.05). Moreover, the mean dose of the whole heart, left ventricle, right ventricle and PRV-RCA in VMAT plan were much lower than those in IMRT plan (P<0.05). The comparison in low-dose regions revealed that the V5 of right ventricle was higher and the V5 and V10 of PRV-LAD were lower in VMAT plan as compared with IMRT plan (P<0.05). No statistical differences were found in other parameters (P>0.05). Conclusion Both VMAT and IMRT can meet the radiotherapy needs of middle thoracic esophageal cancer patients, but VMAT can further decrease the doses of heart and substructures and reduce the heart injuries caused by radiotherapy.

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备注/Memo

备注/Memo:
 【收稿日期】2018-01-15
【作者简介】安义均，硕士，E-mail: yijunan@126.com
【通信作者】杨毅，主任医师，主要研究方向：胸部肿瘤放射治疗，E-mail: yiyangkm@sina.com
更新日期/Last Update: 2018-06-22