摘要
目的比较混合放射治疗技术与调强放射治疗(Intensity Modulated Radiation Therapy,IMRT)、容积调强放射治疗(Volumetric Modulated Arc Therapy,VMAT)、三维适形放射治疗(Three dimensional Conformal Radiation Therapy,3DCRT)在全脑放疗中的剂量学差异,研究混合放疗技术在全脑放疗的可行性。方法选取25例需要全脑放疗的患者为研究对象,分别设计3DCRT计划、基于3DCRT、IMRT技术的混合计划(Hybrid-IMRT)、基于3DCRT、VMAT技术的混合计划(Hybrid-VMAT)、IMRT计划、VMAT计划。Hybrid-IMRT计划与IMRT计划、Hybrid-VMAT计划与VMAT计划均采用相同的优化参数,2个混合计划3DCRT提供60%的处方剂量(2400 cGy/20 F),IMRT或VMAT部分提供剩余40%的处方剂量(1600 cGy/20 F)。比较5组计划的靶区均匀性指数、适形度指数、靶区最大剂量、机器跳数、危及器官(晶体、眼球、视神经、视交叉、脑干)的最大剂量。结果5种计划各项指标均满足临床需求。Hybrid-IMRT、Hybrid-VMAT计划靶区均匀度、靶区剂量最大点和晶体、视交叉、脑干的受量优于IMRT、VMAT计划,且差异有统计学意义(P<0.05);HybridIMRT、Hybrid-VMAT计划靶区适形度和眼球受量相对IMRT、VMAT计划差异有统计学意义(P<0.05)。Hybrid-IMRT、Hybrid-VMAT计划的机器跳数分别比IMRT、VMAT计划减少60%和10%(P<0.05)。结论Hybrid-IMRT、Hybrid-VMAT计划的各项参数均满足临床治疗要求,其靶区均匀度更好,治疗时间更短,对距离靶区较远和靶区内部的危及器官保护更好,因此混合放射治疗技术可以应用于全脑放疗中。
Objective To compare the dosimetric differences among hybrid radiotherapy technology,intensity modulated radiotherapy(IMRT),volumetric modulate arc therapy(VMAT),and three-dimensional conformal radiotherapy(3DCRT)in whole brain radiotherapy,and to investigate the feasibility of hybrid radiotherapy technology in whole brain radiotherapy.Methods A total of 25 patients who required whole brain radiotherapy were selected and designed with 3DCRT plan,hybrid plan based on IMRT technology(Hybrid-IMRT),hybrid plan based on VMAT technology(Hybrid-VMAT),IMRT plan,and VMAT plan.The same optimization parameters were all used by the Hybrid-IMRT plan and IMRT plan,as well as the Hybrid-VMAT plan and VMAT plan.60%of the prescription dose(2400 cGy/20 F)was provided by 3DCRT portion of the two mixed plans,while the remaining 40%of the prescription dose(1600 cGy/20 F)was provided by the IMRT or VMAT portion.The target homogeneity index,conformity index,maximum dose to the target area,monitor unit,and the maximum dose to organs at risk(lenses,eyeballs,optic nerves,optic chiasm,and brainstem)of the five plans were compared.Results All indicators of the five plans met the clinical requirements.The homogeneity of target area,maximum dose point of target area,dose of crystal,optic chiasma and brainstem of Hybrid-IMRT and Hybrid-VMAT plans were better than those of IMRT and VMAT plans,and the differences were statistically significant(P<0.05).Compared with IMRT and VMAT plans,there were significant differences in target conformity and eyeball receptivity(P<0.05).The monitor units of Hybrid IMRT and Hybrid VMAT plans decreased by 60%and 10%respectively compared to IMRT and VMAT plans(P<0.05).Conclusion The parameters of Hybrid-IMRT and Hybrid-VMAT plans can meet the requirements of clinical treatment,with better homogeneity of target area,shorter treatment time,and better protection of endangered organs far away from and within the target area.Therefore,hybrid irradiation technology can be applied to whole brain radiotherapy.
作者
高层层
杨磊
GAO Cengceng;YANG Lei(Department of Equipment Information,Pingdu District,The Affiliated Hospital of Qingdao University,Qingdao Shandong 266000,China;Department of Radiotherapy Technology,Pingdu District,The Affiliated Hospital of Qingdao University,Qingdao Shandong 266000,China)
出处
《中国医疗设备》
2024年第9期43-47,61,共6页
China Medical Devices
关键词
全脑放疗
混合放疗技术
剂量学
调强放疗技术
容积旋转调强放疗技术
whole brain radiotherapy
hybrid radiotherapy technology
dosimetry
intensity modulated radiation therapy(IMRT)
volumetric modulate arc therapy(VMAT)
