食管癌放射治疗计划的剂量学比较

熊绮丽; 徐刚; 石勇; 倪千喜; 顾强

doi:10.11889/j.1000-3436.2016.rrj.34.050201

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食管癌放射治疗计划的剂量学比较

辐射生物学与医学 | 更新时间：2021-12-10

- 食管癌放射治疗计划的剂量学比较
- Dosimetric comparing four kinds of radiation treatment planning for esophagus cancer
- 辐射研究与辐射工艺学报 2016年34卷第5期
- 作者机构：
  
  1.中国科学院上海应用物理研究所嘉定园区上海 201800
  2.上海大学上海 200444
  3.中南大学湘雅医学院附属肿瘤医院长沙 410013
  4.中南大学湘雅三医院长沙 410013
- 作者简介：
  
  [ "熊绮丽, 女, 1991年9月出生, 2016年于上海大学获得硕士学位, E-mail:xiongqili@sinap.ac.cn", "XIONG Qili (female) was born in September 1991 and graduated with a master degree from Shanghai University in 2016.E-mail:xiongqili@sinap.ac.cn" ]
  顾强, 博士, 研究员, E-mail:guqiang@sinap.ac.cnPh.D. GU Qiang, professor, E-mail:guqiang@sinap.ac.cn
- 基金信息：
  
  国家自然科学基金(11175112)
- DOI：10.11889/j.1000-3436.2016.rrj.34.050201
  中图分类号：
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熊绮丽, 徐刚, 石勇, 等. 食管癌放射治疗计划的剂量学比较[J]. 辐射研究与辐射工艺学报, 2016,34(5):050201-7.

Qili XIONG, Gang XU, Yong SHI, et al. Dosimetric comparing four kinds of radiation treatment planning for esophagus cancer[J]. Journal of Radiation Research and Radiation Processing, 2016,34(5):050201-7.
熊绮丽, 徐刚, 石勇, 等. 食管癌放射治疗计划的剂量学比较[J]. 辐射研究与辐射工艺学报, 2016,34(5):050201-7. DOI： 10.11889/j.1000-3436.2016.rrj.34.050201.

Qili XIONG, Gang XU, Yong SHI, et al. Dosimetric comparing four kinds of radiation treatment planning for esophagus cancer[J]. Journal of Radiation Research and Radiation Processing, 2016,34(5):050201-7. DOI： 10.11889/j.1000-3436.2016.rrj.34.050201.

摘要

比较食管癌患者应用螺旋断层（TomoHelical，TH）、径照断层（TomoDirect，TD）、容积旋转调强（Volumetric modulated arc therapy，VMAT）和固定野动态调强（Intensity modulated radiation therapy，IMRT）4种放疗计划的剂量学差异。选取18例食管癌患者，利用Pinnacle9.2计划系统设计单弧360°VMAT放疗计划和5野IMRT放疗计划。利用TomoHDTM2.0.7计划系统设计TH放疗计划和5野TD放疗计划。利用剂量体积直方图（Dose volume histogram，DVH）统计靶区剂量参数、适形性指数（Conformity index，,CI,）和均匀性指数（Heterogeneity index，,HI,），肺、心脏、脊髓剂量体积参数，出束时间和治疗跳数。TH计划靶区适形性和靶区均匀性略优于TD计划，VMAT计划靶区适形性和靶区均匀性略优于IMRT计划，且前两种计划明显优于后两种；TH计划和VMAT计划肺,V,20Gy,、,V,30Gy,，心脏,V,30Gy,、,V,40Gy,分别优于TD计划和IMRT计划；但是TD计划肺,V,5Gy,具有其他计划都不具有的优势。TH计划优于TD计划优于VMAT计划优于IMRT计划。但如果考虑性价比，本研究认为对于食管癌VMAT计划是首选；如果考虑放射治疗计划的质量，TH计划是首选；但如果靶区体积比较大，肺的低剂量无法达到临床要求时，可以考虑用TD计划解决这一难题。

Abstract

Dose differences among TomoHelical (TH), TomoDirect (TD), Volumetric modulated arc therapy (VMAT) and intensity modulated radiation therapy (IMRT) for esophagus cancer were compared. Eighteen esophageal patients were chosen. The Pinnacle 9.2 treatment planning system was used to generate the VMAT plan and the five field IMRT plan. For comparison, the TH plan and five field TD plan were generated by TomoHDTM 2.0.7 treatment planning system. It was available to adopt the dose volume histograms to investigate the dose parameters of target, the statistics of conformity index (,CI,), the heterogeneity index (,HI,) of planning target volume (PTV), the dose volumetric parameters of lung, and the spinal cord and heart, total accelerator output monitor units and total treatment time. The results showed that the ,CI, and ,HI, of TH plan was better than TD plan, and VMAT plan was better than IMRT plans, and the first two plans were better than the latter two; the lung's ,V,20Gy, and ,V,30Gy, heart's ,V,30Gy, and ,V,40Gy, of TH plan and VMAT plan were better than those of TD plan and IMRT plan. However, the lung's ,V,5Gy, of TD plan had a greater advantage among them. The TH plan was better than TD plan, TD plan was better than VMAT plan, VMAT plan was better than IMRT plan. Taken the cost into consideration, the esophageal VMAT plan is preferred, and considering the therapeutic effect and quality of survival, the TH plan is preferred. When the target volume is relatively large, the low-dose lung is unavailable to achieve the clinical requirements. Therefore it is proposed to use the TD plans to cure the patients. Dose volume histograms are adopted for the statistics of ,CI, HI, of PTV, dose volumetric parameters of lung, spinal cord and heart, total accelerator output monitor units and total treatment time.

关键词

食管癌螺旋断层径照断层容积旋转调强固定野动态调强剂量学比较

Keywords

Esophagus cancerTomoHelicalTomoDirectVolumetric modulated arc therapyIntensity modulated radiation therapyDosimetric comparison

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