摘要
目的:应用放射治疗计划系统比较四种肝癌动态调强放疗计划的靶区及肝组织的剂量学分布,探讨最佳的布野模式。方法:共研究15例行调强放疗的肝脏肿瘤患者,对每例患者分别制定两种共面野计划和两种非共面野计划。评估的剂量学参数包括:PTV的适形指数(CI)和均匀指数(HI),正常肝脏接受≥40、30、20、10体积的百分数(V40、V30、V20、V10),正常肝脏的平均剂量(MDTNL)以及脊髓和肾脏的剂量分布。结果:非共面野调强计划相对于共面调强计划而言,可在不影响靶区剂量分布的情况下,明显降低正常肝脏组织的平均剂量,对肝脏的V10、V20、V30具有明显优势,而对肝脏V40,脊髓和肾脏的剂量分布无明显影响。结论:在肝脏肿瘤的放射治疗过程中,非共面野调强计划可能在减少肝组织的受照剂量,降低放射性肝病发生的危险性上具有一定优势。
Objective: To select reasonable treatment methods for liver tumor,the dose distribution by three- dimensional treatment planning system( TPS) for target area and normal liver around liver tumor in four intensity modulated radiation therapy plans were assessed. Methods: Selected 15 patients with liver tumor,Four IMRT plans were designed for each patient: Two coplanar intensity modulated radiation therapy plans( plan A,plan B) and two non-coplanar intensity modulated radiation therapy plans( plan C,plan D). The same physical objective function was applied for the same patient in four plans. Compared the dose distribution of the target area and the mean dose,V10,V20,V30,V40 for the normal liver. Results: Compared to IMRT,non- coplanar intensity modulated radiation therapy( NC-IMRT) significantly reduced the volume of normal liver V10,V20,V30 and mean dose of the normal liver. Without obvious variations in CI,HI,spinal cord and kidney. However,the volume of liver V40 did not significantly change. Conclusion: During radiotherapy for patients with liver tumor,NC- IMRT might reduced the irradiated dose of the normal liver,which would allow the risk of radiation induced liver disease( RILD).
出处
《现代肿瘤医学》
CAS
2016年第22期3600-3602,共3页
Journal of Modern Oncology
关键词
肝脏肿瘤
调强放射治疗
非共面
剂量学
liver tumor
intensity-modulated radiation therapy
non-coplanar
dosimetry