摘要
目的:探讨基于螺旋断层放射治疗(TomoHD)设备的螺旋断层治疗(HT)与断层径照(TD)技术在实施女性全中枢照射(CSI)中不同计划设计方法的剂量学差异。方法:选取10例接受全中枢照射的女性患者,分别勾画靶区及危及器官(卵巢保护区域定义为VIP)。对10例患者按照对卵巢区域保护计划的方式不同,将计划分为对照组和观察组,对照组采用常规HT计划,使用射野屏蔽方法对卵巢区域进行保护;观察组采用HT与TD分段计划方式,即上段计划采用HT技术,下段计划采用TD技术实现对卵巢区域保护,比较两组计划剂量学参数。结果:两组靶区适形指数(CI)分别为0.86±0.03和0.65±0.10,其差异有统计学意义(t=5.501,P<0.05);两组靶区均匀性指数(HI)分别为1.09±0.02和1.06±0.00,其差异具有统计学意义(t=3.044,P<0.05);卵巢保护区两组最大剂量(Dmax)分别为(18.53±4.72)Gy和(7.26±1.15)Gy,其差异具有统计学意义(t=6.298,P<0.05);观察组的计划执行效率明显优于对照组。结论:TD技术是一种引入临床的新型治疗技术,其应用对于女性CSI卵巢保护患者计划体现出一定优势,分段式计划方式为女性CSI患者提供了一种新选择。
Objective: To discuss the dosimetric differences between different planning methods of helical tomotherapy (HT) and tomodirect (TD) technique based on Tomo HD equipment in implementing craniospinal irradiation (CSI) for female patients. Methods: 10 female patients who received CSI were selected, and the target region and organ at risk (OAR) of them were respectively delineated (The protection area of ovarian was defined as VIP). The plans were divided into control group and observation group as different methods of protection planning for ovarian area of 10 patients. Control group adopted routine HT planning, and the ovarian areas of patients were protected by using field shield. Observation group adopted segment planning of HT and TD, that meant the HT intensity modulation mode was used in upper segment plan and the TD intensity modulation mode was used in lower segment plan in protecting ovarian area. The dosimetric parameters of two group were further compared. Results: The difference of conformal index (CI) of target area between the two groups (0.86±0.03, 0.65±0.10) was significant (t=5.501, P<0.05). And difference of homogeneity index (HI) of target area between the two groups (1.09±0.02 and 1.06±0.00) was significant (t=3.044, P<0.05). It showed that Dmax of protection area of ovary in control group and observation group were (18.53±4.72)Gy and (7.26±1.15)Gy, respectively, and the difference of them was significant (t=6.298, P<0.05). And the execution efficiency of planning of observation group was significantly better than that of control group. Conclusion: TD is a new type of treatment technique that is introduced into the clinical practice. It's application shows certain advantages for female patients whose ovaries need to be protected in receiving CSI. And the segment planning method provides a new option for female patients who receives CSI.
作者
丛小虎
解传滨
徐寿平
葛瑞刚
巩汉顺
戴相昆
曲宝林
CONG Xiao-hu;XIE Chuan-bin;XU Shou-ping(Department of Radiation Oncology,First Clinical Center of Chinese PLA General Hospital,Beijing 100853,China)
出处
《中国医学装备》
2019年第4期16-20,共5页
China Medical Equipment
基金
国家重点研发计划(2017YFC0112105)"基于肿瘤精确放疗设备的临床应用需求分析与质控评价体系建设的研究"
解放军总医院临床科研扶持基金(2017FC-WJFWZX-04)"基于旋转调强全中枢照射的临床研究"
