肝脏肿瘤螺旋断层、静态调强和三维适形放疗的剂量学研究

Helical tomotherapy,step and shoot intensity-modulated radiation therapy and 3-dimensional conformal radiation therapy for liver tumor: A bibliometric study

  • 摘要: 目的 探讨螺旋断层放疗(helical tomotherapy,HT)与静态调强放疗(step and shoot intensity-modulated radiotherapy,SaS-IMRT)和三维适形放疗(three-dimensional conformal radiation therapy,3D-CRT)在肝脏肿瘤放疗中的剂量学特性及高危器官保护方面存在的差异。 方法 选取16例在我科行肝脏肿瘤放疗患者的CT图像,由同一医生勾画靶区及正常器官,统一处方剂量60Gy/20F,每例图像分别实施HT、SaS-IMRT和3D-CRT(5野)治疗计划。 结果 HT、SaS-IMRT和3D-CRT组的靶区适形度(conformity index,CI)和剂量均匀指数(homogeneity index,HI)分别为0.796±0.076和1.044±0.019、0.663±0.108和1.059±0.164、0.540±0.075和1.077±0.010(P=0.000 0)。肝脏的平均剂量和V10-V50HT组低于SaS-IMRT组、SaS-IMRT组低于3D-CRT组(P=0.024和P=0.000);右肾和胃接受的最大剂量、平均剂量以及脊髓接受的最大剂量HT组低于SaS-IMRT组和3D-CRT组、SaS-IMRT组低于3D-CRT组。 结论 在肝脏肿瘤放疗中,处方剂量覆盖的靶区体积、靶区CI、剂量HI及对正常组织保护方面的优势依次为HT组、SaS-IMRT组和3D-CRT组。

     

    Abstract: Objective To study the dosimetric characteristics of helical tomotherapy(HT),step and shoot intensity-modulated radiation therapy(SaS-IMRT) and 3-dimensional conformal radiation therapy(3D-CRT) for liver tumor and their difference in protecting high risk organs. Methods CT images of 16 patients with liver tumor who underwent radiation therapy in our department were selected.Target area and normal organs on each image were underlined by the same physician.HT,SaS-IMRT and 3D-CRT(five fields) were performed for each patient at the dose of 60Gy/20 fractions. Results The conformity index(CI) and homogeneity index(HI) in HT,SaS-IMRT and 3D-CRT groups were 0.796±0.076 and 1.044±0.019,0.663±0.108 and 1.059±0.164,0.540±0.075 and 1.077±0.010,respectively(P=0.005).The average dose and V10-V50 of liver were lower in HT group than in SaS-IMRT and 3D-CRT groups(P=0.005).The maximal and average doses for the right kidney and stomach,and the maximal dose for the spinal cord were lower in HT group than in SaS-IMRT and 3D-CRT groups,and in SaS-IMRT group than in 3D-CRT group(P=0.005). Conclusion The volume,CI and HI covered by the prescribed dose for liver tumor radiotherapy are advantageous for HT group,followed by SaS-IMRT group and 3D-CRT group.

     

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