3d-crt、imrt和rapidarc行小细胞肺癌全脑预防性照射的剂量学比较

《3d-crt、imrt和rapidarc行小细胞肺癌全脑预防性照射的剂量学比较》由会员上传分享，免费在线阅读，更多相关内容在行业资料-天天文库。

1、3D-CRT、IMRT和RapidArc行小细胞肺癌全脑预防性照射的剂量学比较【摘要】目的比较小细胞肺癌（SCLC）全脑预防性照射（PCI）3D-CRT、IMRT、RapidArc三种计划方式的剂量学差异，为制定最佳PCI放疗方案提供指导。方法选取10例SCLC患者颅脑CT，分别设计3D-CRT、IMRT及RapidArc3种放疗计划行PCI。根据剂量体积直方图，评价靶区的D2%、D98%、V95%、V100%、均匀性指数（HI）、适形性指数（CI）以及危及器官（OAR）受量；比较机器跳数（MU）的差异。结果IMRT及Ra

2、pidArc的靶区剂量学参数（CI、HI、D2%、D98%、V95%、V100%、）均优于3D-CRT，差异均具有统计学意义（P﹤0.05）。IMRT及RapidArc较3D-CRT显著降低双侧视神经、腮腺及脑干的受量，差异均具有统计学意义（P﹤0.05）；相反，3D-CRT能显著减少双侧晶体及眼球的受量，差异均具有统计学意义（P﹤0.05）。IMRT及RapidArc在靶区和危及器官受量方面均无显著性差异（P>0.05）。3D-CRT、IMRT和RapidArc计划的平均MU分别为287.80、1388.80和346.6

3、0。结论IMRT及RapidArc较3D-CRT进行PCI具有一定的剂量学优势。但3D-CRT能减少晶体及眼球的受量，并且治疗时间短。[关键词]三维适形放疗；调强放疗；全脑预防性照射；剂量学Dosimetriccomparisonofthere-dimensionalconformalradiotherapy,intensity-modulatedradiotherapyandRapidArcforprophylacticcranialirradiationinsmallcelllungcancerpatients[Abs

4、tract]ObjectiveThepurposeofthisstudyistocomparethecharacteristicsofthere-dimensionalconformalradiotherapy(3D-CRT),fixed-fieldintensity-modulatedradiotherapy(IMRT)andRapidArcforprophylacticcarnialirradiation(PCI)insmallcelllungcancer(SCLC)patients.MethodsTenpatient

5、swithSCLCwereenrolledintothisstudy.3D-CRT，9-fieldIMRT(IMRT)anddoublearcRapidArcplansweregeneratedandoptimizedforeachpatient.Thegoalwastodeliver25Gyto≥95%oftheplanningtargetvolume(PTV)whilemeetingthesamenormal-tissuedoseconstraints.Thedosedistributionandconformalin

6、dex(CI),homogeneityindex(HI)oftargetvolume,themaximumdose(D2%),theminimumdose(D98%),targetcoverageofPTV(V95%andV100%),andDmeanandDmaxoforgansatrisk(OAR)wereanalyzedbyusingthedosevolumehistogram(DVH).Themonitorunitsanddeliverytimewerealsoevaluated.ResultsAllplansme

7、ttheclinicalrequirements.PTVdosimetryparameters（CI,HI,D2%,D98%,V95%andV100%）ofRapidArcandIMRTweresuperiorto3D-CRTwithsignificantdifference(P﹤0.05).Thedosestotheopticnerves,parotidglandsandbrainstemoftheIMRTandRapidArcplanswereallsignificantlylowerthanthoseofthe3D-

8、CRTplan(P﹤0.05),while3D-CRTplanprovidedthelowestdoseofthelensandeyes(P﹤0.05).ComparedwithIMRTplan,noobviousadvantageinPTVdosimetricparameterscouldbeobse