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时间:2020-05-04
《三维适形放疗与调强放疗治疗原发性肝癌伴门静脉癌栓的剂量学比较-论文.pdf》由会员上传分享,免费在线阅读,更多相关内容在应用文档-天天文库。
1、周媛媛,等.三维适形放疗与调强放疗治疗原发-陛肝癌伴门静脉癌栓的剂量学比较245三维适形放疗与调强放疗治疗原发性肝癌伴门静脉癌栓的剂量学比较周媛媛,张思杏,郑青平,石成良,罗展雄,李旌,于斌,李中华(柳州市人民医院肿瘤放疗科,广西柳州545006)摘要:目的评估三维适形放疗(3DCRT)与调强放疗(IMRT)2种不同放疗技术在原发性肝癌伴门静脉癌栓放射治疗中的优缺点。方法20例不能手术的原发性肝癌并门静脉癌栓的患者分别进行3DCRT和IMRT2种放疗计划设计,处方剂量均为40Gy/20f。比较2组计划的靶区与危及器官剂量学参数及加速器跳数(MU)。2组问比较采用
2、t检验。结果IMRT在计划靶体积(V)的剂量覆盖、均一性及适形度均优于3DCRT(P<0.05);3DCRT与IMRT的肝V30Gy及肝V20Gy分别为33.55±5.67vs29.41±2.67(P=0.001)和44.244-6.17vs41.28±4.59(P=0.021)。2组的正常肝组织低剂量区范围与胃、小肠、脊髓、双。肾的受照射剂量并无显著性差异。3DCRT与IMRT的MU分别为303.74-35.8和377.44-33.2(P=0.000)。结论与3DCRT相比,IMRT有较满意的P11V高剂量覆盖及均匀的剂量分布。在危及器官保护方面,IMRT的肝
3、脏高剂量区范围明显低于3DCRT,而不足的是,IMRT的治疗时间显著长于3DCRT。关键词:肝肿瘤;放射疗法,适形;放射疗法,调强适形;放射治疗剂量中图分类号:R735.7文献标志码:A文章编号:1001—5256(2014)03—0245—04Dosimetriccomparisonof3DCRTandIMRTintreatmentofprimaryhepatocellularcarcinomawithportalveintumorthrombusZHOUYuanyuan,ZHANGSixing,ZHENGQingping,eta1.(D~artmemofRa
4、diotherapy,LiuzhouPeoplesHospital,Liuzhou,Guangxi545006,China)Abstract:ObjectiveTocomparethree—dimensionalconformalradiotherapy(3DCRT)andintensity—modulatedradiotherapy(IMRT)intermsoftheiradvantagesofdisadvantagesinthetreatmentofprimaryhepatocellularcarcinoma(PHC)withportalveintumort
5、hrombus(PVTT).MethodsTwentypatientswithPHCaccompaniedbyPV.rrwereenrolledinthisstudy.Eachpatientunderwent3DCRTandIM—RTwithaprescribeddoseof40Gy/20fractions.Theparametersincludedtheconformityindex(CI),homogeneityindex(HI),meandose(Dmean),minimumdose(Dmin),maximumdose(Dmax),V95%,V100%,a
6、ndV105%forplanningtargetvolume(PTV),thenun—berofmonitorunits(MUs)forevaluatingplanningefficiency,andDmean,Dmax,andDminfortheorgansatrisk(OAR).Thepercentageofthenormallivervolumereceiving1>30,>20,>10,and>5Gy(V30Gy,V20Gy,V10Gy,andV5Gy,respectively)werecalculat-edtodeterminelivertoxicit
7、y.ThetworadiotherapyregimenswerecomparedintermsofthedosimetricparametersforP1andOAR,aswellasnumberofMUs.ResultsIMRThadsignificantlyhigherDmin,Dmean,V95%,andV100%andsignificantlybetterHIandCIcon—paredwith3DCRT(P<0.05).TheliverV30GyandV20Gywere33.55±5.67and44.24±6.17,respectively,for3D
8、CRT,versus29
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