食管癌旋转容积调强与螺旋断层调强的靶区和危及器官的剂量学研究
| 作者: |
1袁美芳,
1赵彪,
1杨毅,
2汤可维,
3安义均
1 昆明医科大学第三附属医院，云南省肿瘤医院放射治疗科，昆明 650118 2 岳阳市第一人民医院肿瘤科， 湖南 岳阳 414000 3 昭通市第一人民医院血管肿瘤科，云南 昭通 657099 |
| 通讯: |
杨毅
Email: yiyangrt@126.com |
| DOI: | 10.3978/j.issn.2095-6959.2019.05.010 |
摘要
目的：探讨食管癌旋转容积调强(volumetr ic modulated arc therapy，VMAT)与螺旋断层调强(TomoHel ical ，T H)两种放射治疗(简称“放疗”)方案的靶区和危及器官的剂量学特点。 方法：选取食管癌患者12例，分别设计VMAT和TH两种放疗方案，比较两种方案的靶区和肺、心、脊髓的剂量学参数。结果：在靶区方面，除大体肿瘤靶区(gross tumor volume，GTV)与计划靶区(planning target volume，PTV)的D98%外其余参数比较，差异均具有统计学意义(P<0.05)。而在危及器官的剂量学方面，对左肺、右肺及双肺的V5，V10，V15，Dmean而言，VMAT显著优于TH(P<0.05)，同样，心脏的V10，VMAT也显著低于TH(P<0.05)，但心脏的V20，V25，V30的比较上，TH计划明显优于VMAT；另外TH也明显降低了脊髓的D2。结论：VMAT和TH两种方案均能满足临床治疗要求，但TH在靶区上更具有优势，而危及器官的保护上两种方案各有特点，整体上VMAT对肺和心脏的低剂量区的保护上更具优势。
关键词：
食管癌；旋转容积调强；螺旋断层调强；放射治疗剂量学
Dosimetric study on target areas and organs at risk between volumetric modulated arc therapy and TomoHelical for esophageal cancer
CorrespondingAuthor: YANG Yi Email: yiyangrt@126.com
DOI: 10.3978/j.issn.2095-6959.2019.05.010
Abstract
Objective: To compare the dose distribution of volumetric modulated arc therapy (VMAT) versus TomoHelical (TH) for esophageal cancer in the target area and organs at risk (OARs). Methods: Twelve patients with esophageal cancer were selected, VMAT and TH plans were designed respectively. The dosimetric parameters of target area, lung, heart and spinal cord were analyzed. Results: For target areas, there were statistically significant differences except gross tumor volume (GTV) D98% and planning target volume (PTV)’s D98% (P<0.05). For OARs, VMAT is superior to TH in V5, V10, V15, Dmean of left lung, right lung and both lungs (P<0.05). VMAT is significantly lower than TH in V10 of heart, but for V20, V25 and V30 of heart, TH is better; for the spinal cord’s D2%, TH is lower. Conclusion: VMAT and TH plans can meet the clinical treatment requirements, but the TH plan has advantages in the target area. Both plans have different advantages in OARs sparing, but VMAT has an advantage in protecting the low-dose areas of the lungs and heart.
Keywords：
esophageal cancer; volumetric modulated arc therapy; TomoHelical; radiotherapy dosimetry