摘要
目的:探究胃癌术后不同布野方案对调强放疗剂量分布的影响。方法:选择42例行胃癌术后放疗的患者,采用7野等角度均分静态调强计划(方案A,射野方向为0°、52°、104°、156°、214°、256°、308°)、5野等角度均分静态调强计划(方案B,射野方向为0°、72°、144°、216°、288°)及4野固定照射野静态调强计划(方案C,射野方向为20°、90°、180°、310°),比较不同布野方式下靶区、危及器官受量及靶区适形度指数、均匀性指数差异。结果:不同射野计划方案靶区受量指数及均匀性指数比较差异无统计学意义(P>0.05),但方案A的适形度指数显著优于方案B、C(P<0.05)。不同射野计划方案脊髓Dmax及Dmean、肝脏V30和Dmean、左右肾脏V20和Dmean等方面差异具有统计学意义(P<0.05)。方案A的脊髓Dmax及Dmean、肝脏V30以及右肾V20等参数优于方案B(P<0.05);方案C的肝脏V30和Dmean以及左右肾脏V20和Dmean均显著优于方案A、B(P<0.05)。结论:在胃癌术后放疗中,4野静态调强计划能在保证靶区剂量的同时,可更好地保护危及器官。
Objective To investigate the effects of different field arrangements on the dose distribution of intensity-modulated radiotherapy(IMRT)after the operation for gastric cancer.Methods Atotal of 42 gastric cancer patients scheduled for postoperative radiotherapy were enrolled in the study.The plan schemes for enrolled gastric cancer patients included static 7-field IMRT(plan A,with beam orientations of 0°,52°,104°,156°,214°,256°,308°),static 5-field IMRT(plan B,with beam orientations of 0°,72°,144°,216°,288°)and static 4-field IMRT(plan C,with beam orientations of 20°,90°,180°,310°).The differences in the doses to target areas and organs-at-risk as well as the conformity index and homogeneity index of target areas were compared among 3 plans with different field arrangements.Results The comparison on the doses to target areas and homogeneity index showed that there was no significant difference among different plans(P>0.05),but the conformity index of planAwas significantly higher than that of plans B and C(P<0.05).There were statistical differences in the Dmax and Dmean of spinal cord,the V30and Dmean of liver,the V20 and Dmean of left and right kidneyamong 3 plans with different field arrangements(P<0.05).The Dmax and Dmean of spinal cord,the V30of liver and the V20of right kidney in planAwere superior to those in plan B(P<0.05),and the V30 and Dmean of liver as well as the V20 and Dmean of left and right kidney in plan C were significantly better than those in plans A and B(P<0.05).Conclusion Static 4-field IMRT as the postoperative radiotherapy for gastric cancer can better protect the organs-at-risk while ensuring the doses to target areas.
作者
胡志纲
刘勇强
任建
张红
HU Zhigang;LIU Yongqiang;REN Jian;ZHANG Hong(Department of Radiotherapy,Baoji Central Hospital,Baoji 721000,China)
出处
《中国医学物理学杂志》
CSCD
2019年第12期1400-1405,共6页
Chinese Journal of Medical Physics
基金
陕西省自然科学基金(2014JM4191)
关键词
胃癌
调强放射治疗
布野方案
剂量学
gastric cancer
intensity-modulated radiotherapy
field arrangement
dosimetry
