[1]刘娟,李双双,高山宝,等. 宫颈癌螺旋断层放疗与静态调强技术的剂量学比较[J].中国医学物理学杂志,2019,36(1):23-28.[doi:DOI:10.3969/j.issn.1005-202X.2019.01.005]
　LIU Juan,LI Shuangshuang,GAO Shanbao,et al. Dosimetric comparison of helical tomotherapy versus fixed-field intensity-modulated radiotherapy for cervical cancer[J].Chinese Journal of Medical Physics,2019,36(1):23-28.[doi:DOI:10.3969/j.issn.1005-202X.2019.01.005]
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 宫颈癌螺旋断层放疗与静态调强技术的剂量学比较()
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《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
36卷
期数:
2019年第1期
页码:
23-28
栏目:
医学放射物理
出版日期:
2019-01-25

文章信息/Info

Title:
 Dosimetric comparison of helical tomotherapy versus fixed-field intensity-modulated radiotherapy for cervical cancer
文章编号:
1005-202X（2019）01-0023-06
作者:
 刘娟1; 李双双1; 高山宝1; 闫婧1; 侯震2; 朱丽晶1
 1.南京大学医学院附属鼓楼医院肿瘤中心， 江苏 南京 210000； 2.东南大学生物科学与医学工程学院生物电子学国家重点实验室、医学电子学实验室， 江苏 南京 210096
Author(s):
 LIU Juan1;  LI Shuangshuang1;  GAO Shanbao1;  YAN Jing1;  HOU Zhen2;  ZHU Lijing1
 1. Cancer Center, Nanjing Drum Tower Hospital Affiliated to Medical School of Nanjing University, Nanjing 210000, China;
2. Laboratory for Medical Electronics, State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, Nanjing 210096, China
关键词:
宫颈癌; 放射治疗; 螺旋断层放射治疗; 调强放射治疗; 剂量学
Keywords:
 ; Keywords: cervical cancer;  radiotherapy;  helical tomotherapy;  intensity-modulated radiotherapy;  dosimetry
分类号:
R811.1
DOI:
DOI:10.3969/j.issn.1005-202X.2019.01.005
文献标志码:
A
摘要:
 目的：比较宫颈癌盆腔照射螺旋断层放射治疗（Helical Tomotherapy, HT）计划与七野-静态调强放疗（7F-IMRT）计划的靶区和危及器官的剂量学差异。 方法：选取2015年3月~2017年10月行HT治疗的25例宫颈癌患者，均采用俯卧位，憋尿状态。分别进行HT和7F-IMRT两种计划设计，比较两种计划模式之间靶区和危及器官之间的剂量学参数及机器输出跳数。 结果：（1）计划靶区（PTV）：HT组CI和HI均优于7F-IMRT组，具有统计学差异（0.898±0.017 vs 0.834±0.013, P<0.001；0.062±0.012 vs 0.109±0.019, P<0.001）；HT组PTV的D1、D2均低于7F-IMRT组（P<0.001），Dmean、D98、D95均较7F-IMRT组高（P=0.048, P<0.001, P=0.015）。（2）对于正常组织，HT组小肠、结肠、直肠和膀胱的Dmax、Dmean、V30、V40以及直肠V50均显著低于7F-IMRT组（P<0.001, P<0.001, P<0.001, P=0.001, P=0.006），其余V50略低，无统计学差异（P=0.130）；HT组双侧股骨头V25、D5、Dmean、Dmax也显著低于7F-IMRT组（P<0.001）；但是，HT组的机器输出量明显高于7F-IMRT组。 结论：HT计划在适形度、均匀性及周围正常组织保护上显著优于7F-IMRT计划，在充分保证靶区剂量的同时又不增加患者放疗毒副反应；但其机器输出量高于7F-IMRT计划，对射束的利用率不高。在后续治疗实施过程中，HT系统作为影像引导放射治疗技术，确保每次治疗过程中的精准度，值得临床应用。
Abstract:
 Abstract: Objective To compare the dosimetric differences of target areas and organs-at-risk between helical tomotherapy (HT) and 7-field intensity-modulated radiotherapy (7F-IMRT) for cervical cancer. Methods Twenty-five patients with cervical cancer who underwent helical tomography between March 2015 and October 2017 were enrolled in this study. All enrolled patients were treated in prone position, with a full bladder. Both HT planning and 7F-IMRT planning were carried out for each patient. The dosimetry parameters of target areas and organs-at-risk, and monitor units (MU) were compared between two planning modes. Results HT plan was better than 7F-IMRT plan in conformity index and homogeneity index ［0.898±0.017 vs 0.834±0.013, P<0.001; 0.062±0.012 vs 0.109±0.019, P<0.001］. The D1 and D2 of planning target volume in HT group were lower than those in 7F-IMRT group (all P<0.001) , while Dmean, D98 and D95 in HT group were higher than those in 7F-IMRT group (P=0.048, P<0.001, P=0.015). The Dmax, Dmean, V30 and V40 of small intestine, colon, rectum and bladder and the V50 of rectum were significant lower (P<0.001, P<0.001, P<0.001, P=0.001, P=0.006), and the V50 of the other organs-at-risk was slightly lower (P=0.130) in HT group as compared with 7F-IMRT group. Moreover, the V25, D5, Dmean and Dmax of femoral heads in HT group were significantly lower than those in 7F-IMRT group (all P<0.001). However, compared with 7F-IMRT group, HT group had a much higher MU. Conclusion HT plan which ensures the target dose without increasing the radiotherapy toxicity is superior to 7F-IMRT plan in conformity index, homogeneity index and organs-at-risk sparing. However, the MU of HT plan is higher than that of 7F-IMRT plan, which indicates a lower utilization rate of beams in HT plan. As an image-guided radiotherapy technology, HT system is worthy of application for it can ensure the accuracy of each radiotherapy.

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备注/Memo

备注/Memo:
 【收稿日期】2018-08-11
【基金项目】江苏省自然科学基金青年项目（BK20150102）
【作者简介】刘娟，硕士，主管技师，研究方向：医学物理和肿瘤放射治疗，E-mail: liuuar0813@163.com
【通信作者】朱丽晶，博士，副主任医师，副教授，研究方向：妇科肿瘤的综合治疗，E-mail: zhulj@hotmail.com
更新日期/Last Update: 2019-01-24