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西安交通大学第二附属医院 放疗科,西安,710004
纸质出版日期:2021,
网络出版日期:2021-7-20,
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何, 赟, 李宇星, 等. 不同射野数目在宫颈癌调强放疗中的剂量学研究[J]. 西南医科大学学报, 2021,44(4):338-344.
A dosimetric study of different field numbers in intensity-modulated radiotherapy for cervical cancer[J]. Journal of Southwest Medical University, 2021,44(4):338-344.
何, 赟, 李宇星, 等. 不同射野数目在宫颈癌调强放疗中的剂量学研究[J]. 西南医科大学学报, 2021,44(4):338-344. DOI: 10.3969/j.issn.2096-3351.2021.04.006.
A dosimetric study of different field numbers in intensity-modulated radiotherapy for cervical cancer[J]. Journal of Southwest Medical University, 2021,44(4):338-344. DOI: 10.3969/j.issn.2096-3351.2021.04.006.
目的比较不同射野数目对宫颈癌调强放疗计划的剂量学特点。方法选取我院2020年8月至12月20例接受调强放疗的宫颈癌患者,每个病例分别设计5野和7野两组调强放疗治疗计划,5野入射度为45°、115°、180°、245°、315°(PlanA);7野入射角度为0°、50°、100°、150°、210°、260°、310°(PlanB),采用等效均匀剂量优化法,在膀胱、直肠以及小肠罚分值≠0时,尽量使骨盆剂量降低,使100%等剂量线刚好覆盖95%靶体积,比较其靶区和危及器官的剂量学差异。结果两组放疗计划靶区的适形度指数CI和均匀性指数HI,PlanB优于PlanA,且均具有统计学意义(P<0.001)。危及器官直肠V10、V50以及膀胱V10、V50无统计学意义(P>0.05);直肠V20、V30、V40、Dmean、膀胱V20、V30、V40、Dmean、小肠V30、V40、V50、Dmean、骨盆V20、V30、V40、V50、Dmean,PlanB优于PlanA;对于小肠V10、V20以及骨盆V10,PlanA优于PlanB,且均具有统计学意义(P<0.05);机器跳数和出束时间PlanA略少于PlanB,且具有统计学意义(P<0.001)。结论两组计划均能满足临床需要,小肠及骨盆在高低剂量区各自具有其优势,但是综合考虑发生放射损伤相关性研究结果以及剂量学结果PlanB更适合于临床应用。
Objective To investigate the dosimetric characteristics of different field numbers in intensi⁃ty-modulated radiotherapy for cervical cancer. Methods A total of 20 patients with cervical cancer who received in⁃tensity-modulated radiotherapy in our hospital from August to December 2020 were enrolled;and two intensi⁃ty-modulated radiotherapy plans with 5 and 7 fields were designed for each patient. The incidence angles were 45°, 115°,180°,245°,and 315°in the plan with 5 fields(Plan A)and were 0°,50°,100°,150°,210°,260°,and 310°in the plan with 7 fields(Plan B). The equivalent uniform dose optimization method was used;and when the cost val⁃ues of the bladder;the rectum;and the small intestine were not equal to zero and the dose of the pelvis was mini⁃mized so that the 100% isodose contour covered 95% of the target volume;the target area and the organs at risk were compared in terms of dosimetry. Results Plan B had significantly better conformity index and homogeneity in⁃dex of the planning target than Plan A(P<0.001). There were no significant differences in V10 and V50 of the organs at risk(rectum and bladder)between the two plans(P>0.05). Compared with Plan A,Plan B had significantly bet⁃ter V20,V30,V40,and Dmean of the rectum;V20,V30,V40,and Dmean of the bladder,V30,V40,V50,and Dmean of the small intes⁃tine and V20,V30,V40,V50,and Dmean of the pelvis;while Plan A had significantly better V10 and V20 of the small intes⁃tine and V10 of the pelvis than Plan B(P<0.05). Compared with Plan B;Plan A had a significantly lower number of monitor units and a significantly shorter beam-on time than Plan B(P<0.001). Conclusion Both plans can meet clinical needs and have their own advantages in the high-and low-dose areas of the small intestine and the pelvis;however,considering the association with radiation injury and the results of dosimetric analysis,Plan B is more suit⁃able for clinical application.
不同射野数目等效均匀剂量优化法宫颈癌调强放疗计划剂量学
Field numberEquivalent uniform dose optimizationIntensity-modulated radiothera⁃py for cervical cancerDosimetric study
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