摘要
目的目的介绍一种简单调强放疗技术(sIMRT)。方法sIMRT技术是指单射野的子野数目平均≤5个、子野面积≥10cm^2、子野照射机器跳数≥10MU的调强放疗技术。该技术应用过程中的计划设计和治疗实施环节与IMRT相同,但考虑到其子野面积和子野机器跳数已接近三维适形技术(3DCRT)的相应值,其计划验证环节可与3DCRT相同。该技术的应用过程和应用效果用1例直肠癌病例做了演示。结果对于直肠癌,sIMRT计划在靶区均匀性及对危及器官的保护方面均显著优于3DCRT计划,但稍逊于IMRT计划。sIMRT计划的治疗实施时间与3DCRT计划相当,大约是IMRT计划的一半。临床应用情况表明,该技术可广泛应用于胸腹部肿瘤,如肺癌、食管癌和前列腺癌。结论sIMRT适用于3DCRT不能满足临床要求且>25个子野的IMRT又不能进一步显著改善计划质量的情况,为临床实际工作提供了一个新的性价比高的解决方案。
Objective To introduce a simplified intensity modulated radiation therapy(sIMRT) technique for certain difficult clinical cancer condition. Methods For sIMRT, the average number of segments per beam should be no more than 5. The segment area is no less than 10 cm^2, and the number of machine monitor for each segment is no fewer than 10. In its application process, treatment planning procedure and treatment delivery procedure are the same as those of IMRT. However, the treatment verification procedure could be set as that of three-dimensional conformal radiotherapy(3DCRT) because the area and number of monitor units of each segment were close to those values for CRT. The application of sIMRT was demonstrated in a patient with rectum cancer. Results For rectal cancer case, aiming at target dose uniformity and sparing of organs at risk, sIMRT plan was obviously superior to 3DCRT plan, but slightly inferior to IMRT plan. In terms of treatment delivery time, sIMRT plan was almost the same as 3DCRT plan. Compared with 3DCRT, slMRT did not require the use of wedges, and consequently, it alleviated the labor intensity, fully avoiding accidents of wedge falloff. Its application in our clinic showed that it was mainly applied to thoracic and abdominal tumors (e. g. lung, esophagus and prostate cancers). Conclusions The simplified intensity modulated radiation therapy introduced here is applicable to the situation that 3DCRT is unable to meet clinical requirements and condition for which IMRT requires more than 25 segments but still can not significantly improve the treatment outcome. It provides a clinical solution with high ratio of performance-to- cost benefit. Further check-up by radiation colleaques is advised.
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2006年第5期411-415,共5页
Chinese Journal of Radiation Oncology
基金
首都医学发展科研基金(2002-3003)
关键词
简单调强
调强放射疗法
放疗技术
Simplified intensity-modulated
Intensity-modulated radiation therapy
Radiotherapy techniques