摘要
目的研究原发性肝癌质子调强放射治疗(IMPT)与光子螺旋断层放射治疗(HT)计划的剂量学特性,评估其计划质量差异,为质子技术合理应用于临床提供必要参考。方法回顾性分析12例原发性肝癌患者,分别用RayStation和Tomotherapy治疗计划系统设计IMPT与HT计划,并对靶区与各危及器官的剂量学参数进行比较分析。结果两组计划的剂量分布均能满足靶区处方要求,IMPT计划在GTV的D 1、D 99、D mean、HI方面均要优于HT计划,且差异皆具有统计学意义(P<0.05),在CI指标比较上两组计划GTV与CTV无明显差别。在正常肝组织保护方面,相较于HT技术,IMPT在平均剂量上降低将近30%,且V 5~V 40等指标皆取得了具有统计学意义上的肝脏保护优势。在空腔型危及器官胃、大肠、小肠、十二直肠,脊髓等方面无论最大剂量还是平均剂量水平,IMPT均具有相当优势。结论两种技术对于肝癌治疗来讲均能满足临床要求,但与HT相比,IMPT计划明显降低尤其是正常肝组织等危及器官的受量,具有较为明显的剂量学优势。
Objective To study the dosimetric characteristics of proton intensity modulated radiation therapy(IMPT)and photon helical tomotherapy(HT)for primary liver cancer,and to evaluate the difference of plan quality,so as to provide the necessary reference for the application of proton therapy in clinical practice.Methods Twelve patients with primary liver cancer were selected and analyzed retrospectively.IMPT and HT plans were designed with Raystation and Tomotherpy treatment planning systems,respectively.The dosimetric parameters of target and organs at risk were compared and analyzed.Results The dose distribution of the two techniques could meet the requirements of target prescription.IMPT was superior to HT in D1,D 99,Dmean and HI of GTV,and the differences were statistically significant(P<0.05).There was no significant difference in CI between the 2 techniques.In the aspect of normal liver tissue protection,compared with HT,IMPT reduced the average dose by nearly 30%,and V 5~V 40 achieved statistically significant liver sparing advantages.IMPT was superior to HT in terms of the maximum dose and average dose level of cavity organs,such as stomach,bowel,intestine,duodenum and spinal cord.Conclusion Both IMPT and HT can satisfy the clinical requirement.However,compared with HT,IMPT can significantly reduce the dose of organs at risk,especially normal liver tissue,which has the obvious dosimetric advantages.
作者
侯俊
方春锋
田飞燕
杨文
白中红
杨昊
曹林
徐寿平
HOU Jun;FANG Chunfeng;TIAN Feiyan(Hebei Yizhou Cancer Hospital,Zhuozhou,072750)
出处
《实用癌症杂志》
2021年第9期1457-1462,共6页
The Practical Journal of Cancer
基金
国家重点研发专项项目(编号:2017YFC0112105)
国家自然科学基金青年科学基金(编号:61601012)。
