摘要
目的:比较质子调强放疗(intensity modulated proton therapy,IMPT)技术与螺旋断层放疗(helical tomotherapy,HT)、容积旋转调强放疗(volumetric modulated arc therapy,VMAT)2种光子旋转调强放疗技术实施全中枢照射(cranio spinal irradiation,CSI)的剂量学差异。方法:选取12例接受CSI患者的CT定位图像,完成靶区及危及器官(organ at risk,OAR)勾画,对所有病例均分别设计VMAT、HT及IMPT 3种放疗计划,并定义为VMAT组、HT组及IMPT组。分析比较靶区及各器官剂量学参数并探讨3种技术实施CSI的剂量学差异。数据采用SPSS 22.0软件进行统计学分析。结果:3组计划均能满足靶区处方剂量的要求,其中VMAT组与HT组D95均高于IMPT组。对于D2、Dmean 2种指标,IMPT组略优于2种光子旋转调强放疗组,且仅HT组与IMPT组的Dmean比较差异无统计学意义,而3组的D98比较差异均无统计学意义。VMAT、HT及IMPT 3组计划的靶区剂量适形度指数(conformity index,CI)和靶区剂量均匀性指数(homogeneity index,HI)比较,仅VMAT组与IMPT组的CI差异有统计学意义(t=2.298,P=0.031)。在各OAR的保护上,IMPT组在低剂量区域(V5、V10)体现出明显优势。3组计划正常组织(normal tissue,NT)的Dmean仅VMAT组与HT组差异无统计学意义(t=0.292,P=0.782),IMPT组与其他2组比较差异均具有统计学意义(P均=0.000)。结论:VMAT、HT及IMPT 3种技术在CSI中均能实现较好的靶区剂量分布,在正常器官保护上,IMPT技术相较于2种光子旋转调强放疗技术具有明显的优势。
Objective To compare the dosimetry differences between intensity modulated proton therapy(IMPT)and helical tomotherapy(HT)and volumetric modulated arc therapy(VMAT)in cranio spinal irradiation(CSI).Methods CT localization images of 12 patients undergoing CSI were selected and the target area and organ at risk(OAR)were outlined.Three types of radiotherapy plans(VMAT,HT and IMPT)were designed for all the cases,and enrolled into a VMAT group,a HT group and an IMPT group.Dosimetric parameters of the target area and organs were analyzed and compared and the dosimetric differences between the three techniques for CSI were investigated.SPSS 22.0 software was used for statistical analysis.Results All the three groups met the requirements of the prescribed dose in the target area,with the VMAT and HT groups having higher D95 than the IMPT group.For the D2 and Dmean indexes,the IMPT group was slightly better than the other two groups,and the difference in Dmean was not statistically significant only between the HT and IMPT groups,while there were no statistically significant differences in D98 of the three groups.As for the conformity index(CI)and the homogeneity index(HI)of the target dose in the VMAT,HT and IMPT groups,only the difference in CI between the VMAT and IMPT groups was statistically significant(t=2.298,P=0.031).In the protection of the OARs,the IMPT group showed a clear advantage in the low dose region(V5,V10).The Dmean for planned normal tissue(NT)was statistically insignificant only in the VMAT group compared to the HT group(t=0.292,P=0.782)and statistically significant in the IMPT group compared to the other 2 groups(both P=0.000).Conclusion VMAT,HT and IMPT all behave well in dose distribution in the target area in CSI.In terms of normal organs protection,IMPT gains advantages over the VMAT and HT.
作者
解传滨
杨涛
王子申
方春锋
徐寿平
曹林
曲宝林
XIE Chuan-bin;YANG Tao;WANG Zi-shen;FANG Chun-feng;XU Shou-ping;CAO Lin;QU Bao-lin(Department of Radiotherapy,the First Medical Center of Chinese PLA General Hospital,Beijing 100853,China;Department of Radiotherapy,Yizhou Cancer Hospital,Zhuozhou 072550,Hebei Province,China)
出处
《医疗卫生装备》
CAS
2021年第5期38-42,52,共6页
Chinese Medical Equipment Journal
关键词
全中枢照射
质子调强放疗
容积旋转调强放疗
螺旋断层放疗
剂量学
cranio spinal irradiation
intensity modulated proton therapy
volumetric modulated arc therapy
intensity modu-lated arc therapy
helical tomotherapy
dosimetry
