文章摘要
武雅琴,韩晶晶,朱必清,黄 健,陆谔梅.宫颈癌腹主动脉旁淋巴结转移静态调强放疗与容积旋转调强放疗的剂量学比较[J].南京医科大学学报,2018,(9):1275~1279,1291
宫颈癌腹主动脉旁淋巴结转移静态调强放疗与容积旋转调强放疗的剂量学比较
Dosimetric study of intensity modulated radiotherapy and volumetric⁃modulated arc radio⁃therapy for cervical cancer with para⁃aortic lymph node metastasis
投稿时间:2018-01-01  
DOI:10.7655/NYDXBNS20180920
中文关键词: 宫颈癌  腹主动脉旁淋巴结转移  放射治疗  静态调强放疗  容积旋转调强放疗
英文关键词: cervical cancer  para⁃aortic lymph node metastasis  radiotherapy  IMRT  VMAT
基金项目:江苏省六大人才高峰项目(2016?WSW?020)
作者单位
武雅琴 江苏省肿瘤医院江苏省肿瘤防治研究所南京医科大学附属肿瘤医院放疗科江苏 南京 210008 
韩晶晶 江苏省肿瘤医院江苏省肿瘤防治研究所南京医科大学附属肿瘤医院放疗科江苏 南京 210008 
朱必清 江苏省肿瘤医院江苏省肿瘤防治研究所南京医科大学附属肿瘤医院放疗科江苏 南京 210008 
黄 健 江苏省肿瘤医院江苏省肿瘤防治研究所南京医科大学附属肿瘤医院放疗科江苏 南京 210008 
陆谔梅 江苏省肿瘤医院江苏省肿瘤防治研究所南京医科大学附属肿瘤医院放疗科江苏 南京 210008 
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中文摘要:
      目的:比较静态调强放疗(intensity modulated radiotherapy,IMRT)与容积旋转调强放疗(volumetric modulated arc therapy,VMAT)在宫颈癌伴腹主动脉旁淋巴结(para?aortic lymph node,PALN)转移患者放疗中的剂量学参数,为局部晚期宫颈癌放疗方式的选择提供参考依据。方法:对20例病理学证实经PET?CT检查诊断为宫颈鳞癌PALN转移接受放疗的患者,对同一CT图像分别进行IMRT和VMAT计划设计,比较两种放疗计划的靶区剂量和危及器官(organ at risk,OAR)的剂量学差异、靶区适形性指数(conformity index,CI)、均匀性指数(homogeneity index,HI)、加速器跳数(number of monitor units,MU)和治疗时间。结果:IMRT和VMAT组计划的靶区剂量均能够满足剂量学要求,在靶区CI和HI上,VMAT计划优于IMRT计划。OAR保护方面,VMAT 计划中两侧肾脏平均剂量低于IMRT计划,直肠V40、直肠V50、小肠V40和膀胱V40的剂量均低于IMRT计划(P<0.05)。VMAT计划的MU(859.92 ± 248.47)低于IMRT计划(1 649.50±167.44,t=11.836,P<0.001)。VMAT 计划的治疗时间[(304.30 ± 41.98)s]明显短于IMRT计划[(435.90 ± 37.52)s,t=12.750,P<0.001]。结论:宫颈癌伴PALN转移患者,采取IMRT和VMAT技术均可达到临床靶区剂量要求和OAR的剂量保护,而VMAT计划在靶区CI和HI上优于IMRT计划,同时VMAT具有降低OAR剂量的优势,MU明显降低,照射时间缩短,提高了患者放疗的耐受性,提升了宫颈癌放射治疗的效率。
英文摘要:
      Objective:To compare dosimetric difference between the intensity modulated radiotherapy(IMRT)and volumetric modulated arc therapy(VMAT)of cervical cancer with para?aortic lymph node metastasis,and to provide the reference basis for selecting the reasonable radiotherapy approach of locally advanced cervical cancer patients. Methods:Twenty patients of cervical cancer with para?aortic lymph node(PALN)metastasis whom confirmed by PET?CT examination and diagnosis and received radiotherapy were selected,and the same CT image was designed by IMRT and VMAT respectively. Then,we compared the parameters of target,organ at risk(OAR),homogeneity index(HI),conformity index(CI),the number of monitor units(MU)and treatment times between two plans. Results:The target dose of IMRT plan and VMAT plan could meet the dosimetric requirement. The CI and HI of planning target volume(PTV) for VMAT plan were superior to IMRT plan(P<0.05). Compared with the IMRT plan,the mean dose of kidney for VMAT plan were lower(P<0.05). The V40 and V50 of the rectum,V40 of the small intestine and the bladder of VMAT plan were better than those of IMRT plan(P < 0.05). The number of MU for VMAT plan(859.92 ± 248.47)were lower than IMRT plan(1 649.50 ± 167.44)(t=11.836,P<0.001). The treatment time for VMAT plan[(304.30 ± 41.98)s]were shorter than IMRT plan[(435.90 ± 37.52)s,t=12.750,P<0.001]. Conclusion:Both of the IMRT and VMAT plans can achieve the clinical dosimetric demands and protect the OARs of cervical cancer with PALN. VMAT has the best performance on CI and HI,and protect the OARs better. VMAT plans have fewer MU and significantly improve the treatment efficiency. Thus it will improve the patient's radiotherapy tolerance,enhance the efficiency of radiotherapy.
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