摘要
目的比较射波刀治疗颅内肿瘤两种计划方案的剂量学差异,以便为头部肿瘤制定最佳放射治疗方案。方法选取21例行射波刀治疗的单病灶头部肿瘤患者资料,分别同时设计2组治疗计划,即内环治疗计划和内缩治疗计划。所有计划均采用70%~80%的等剂量曲线包绕95%以上PTV剂量作为处方剂量。分别对两组D_(max)、D_(min)、D_(mean)、GI、CI、n CI、HI、MUs以及V5 Gy、V12 Gy、V24 Gy所对应的体积进行评估比较,同时观察危及器官的受量变化。结果内缩治疗计划组V5 Gy、V12 Gy、V24 Gy剂量体积均明显低于内环计划组(P<0.05),GI减低范围为1.18%~19.95%,两组间GI均值差异显著(P<0.05);同时PTV适形性变好,CI、HI差异均具统计学意义(P<0.05);靶区内D_(max)与D_(mean)具明显优势(P<0.05);且射线束与总MUs也明显低于内环计划组(P<0.05),治疗时间缩短12~35 min;双侧晶体、脑干、视交叉最大、最小及平均受照剂量差异均显著(P<0.05),且均未超过临床最大剂量限值范围。结论内缩计划方案能更好地增加靶区周围正常组织的剂量跌落,同时增加靶区适形性,缩减治疗时间,降低危及器官受照剂量,可为临床计划方案的制定提供科学依据。
Objective To compare the dose characteristics in cyberknife for treating intracranial tumors evaluated by two different plan schemes,and to provide the optimal radiotherapeutic plans for intracranial tumors.Methods The 21 patients with single intracranial tumor were selected into this study. Two plans were generated respectively for each case： inner shell plans and inward plans. The prescription dose was required to cover more than 95% of the PTV with 70%-80% isodose in all treatment plans. Parameters such as D_（max）,D_（min）,D_（mean）,GI,CI,HI,MUs,PTV,V5 Gy,V12 Gy and V24 Gy were evaluated and compared. Meanwhile,the dose variation of organs at risk were observed too. Results The dose-volume of V5 Gy,V12 Gy and V24 Gy in inward plans were significantly lower than that in inner shell plans（all P0.05）. The GI reduction ranged from 1.18% to 19.95% and there was significant difference between the two groups（P0.05）. Additionally,inward planning showed a better conformity in PTV. Better CI and HI were observed for inward plans and the differences were statistically significant（all P 0.05）. The maximum and mean doses in PTV showed a distinct advantage（all P0.05）. And the beams and total MUs were also significantly lower than the inner shell plans（all P0.05）. Additionally,the range of treatment time decrease was 12-35 min. The maximum,minimum and mean doses of lens,brain stem and optic chiasma between the two plans had significant difference（all P 0.05）,and didn＇t exceed the maximum dose limit. Conclusion Compared with inner shell plans,inward plans are better able to increase the dose falloff on normal brain tissue,increase target conformal,reduce treatment time as well as decrease radiation dose on organ at risk,which can provide scientific evidences for the establishment of treatment plans.
作者
姜鹏
于伟娜
刘汉臣
王东
马建军
JIANG Peng;YV Wei-na;LIU Han-chen(Noninvasive Tumor Diagnosis and Treatment Center ofWhole-army,the 107th Hospital of People＇s Liberation Army,Yantai,Shandong 264002,China)
出处
《实用医药杂志》
2018年第8期692-695,共4页
Practical Journal of Medicine & Pharmacy
关键词
射波刀
颅内肿瘤
剂量分布
Cyberknife
Intracranial tumors
Dose distribution
