胸中段食管癌静态调强放疗与容积旋转调强放疗的靶区及危及器官的剂量学参数比较

Static intensity-modulated radiotherapy versus volumetric modulated arc therapy in dosimetric parameters of target area and organs at risk for middle thoracic esophageal cancer

  • 摘要: 目的 比较胸中段食管癌静态调强放疗(sIMRT)和容积旋转调强放疗(VMAT)的靶区及危及器官的剂量学参数。 方法 选取22例胸中段食管癌患者,采用Pinnacle 10.0 治疗计划系统进行靶区及危及器官勾画。设计sIMRT、VMAT计划,并对其剂量学参数进行分析。 结果 原发灶(PGTV)的比较中, sIMRT的2%体积的肿瘤靶区受到的照射剂量(D2)、肿瘤靶区受到照射的中位剂量(D50)、肿瘤靶区的均匀性指数(HI)均高于VMAT, 肿瘤靶区的适应性指数(CI)低于VMAT, 差异有统计学意义(P<0.05); 计划靶区(PTV)的比较中, sIMRT的98%肿瘤靶区所受照射剂量(D98)、CI低于VMAT, HI高于VMAT, 差异有统计学意义(P<0.05)。VAMT的全肺受到5 Gy照射的体积的百分比(V5)、V10V15V20V30V40和平均照射剂量(Dmean)均低于sIMRT, 其中V30V40比较差异无统计学意义(P>0.05), 其他指标差异均有统计学意义(P<0.05)。VMAT的心脏V25V30V35V40Dmean低于sIMRT, 差异有统计学意义(P<0.05)。 结论 胸中段食管癌sIMRT和VMAT均能满足临床需求,但VMAT的CI与HI更优,对肺、心脏、脊髓的保护效果也优于sIMRT。

     

    Abstract: Objective To compare the dosimetric parameters of target area and organs at risk for middle thoracic esophageal cancer between static intensity-modulated radiotherapy(sIMRT)and volumetric modulated arc therapy(VMAT). Methods Totally 22 patients with middle thoracic esophageal cancer were selected. The target area and organs at risk were delineated by Pinnacle 10.0 therapeutic plan system. The sIMRT and VMAT plans were designed and the dosimetric parameters were analyzed. Results In the comparison of PGTV, the dose of 2% volumetric tumor target area for radiation(D2), the median dose of tumor target area for radiation(D50)and the uniformity index(HI)of tumor target area by treatment of sIMRT were significantly higher than those by VMAT, while conformal index(CI)of tumor target area was significantly lower than VMAT(P<0.05). In the comparison of PTV, the dose of 98% of tumor target area for radiation(D98)and CI by sIMRT were significantly lower than those by VMAT, while HI was significantly higher than that by VMAT(P<0.05). The percentage of volume of whole lung exposed to 5 Gy radiation(V5), V10, V15, V20, V30, - V40 and average radiation dose(Dmean)by VAMT were lower than those by sIMRT, and except for V30 and V40, there were significant differences in V5, V10, V15, V20 and Dmean between VAMT and sIMRT(P<0.05). The cardiac V25, V30, V35, V40 and Dmean by VMAT were significantly lower than those by sIMRT(P<0.05). Conclusion Both sIMRT and VMAT can meet the clinical needs, but the CI and HI of VMAT are better, and VMAT has better of effect than sIMRT in protection of lung, heart and spinal cord.

     

/

返回文章
返回