分段优化方法在鼻咽癌调强计划临床应用的可行性研究

The feasibility of clinical application of piecewise optimization methods used in nasopharyngeal carcinoma intensity modulated plan design

目的:介绍一种分段优化方法在鼻咽癌调强计划设计中的应用。方法:分段优化方法是指将调强计划分两段计划优化和执行,第一段计划优化靶区包括肿瘤区、阳性淋巴结区、高危区和预防照射区,执行同期小野加量治疗,第二段计划只针对肿瘤区进行缩野推量。该方法的应用过程和效果用1例鼻咽癌病例做演示。结果:对于鼻咽癌,分段优化方法的调强计划设计相对传统同期小野加量调强计划设计可以提高高危区和预防区单次剂量,靶区剂量分布更加均匀,减少重要器官受量,同时减少计划投射跳数。结论:分段优化方法可以在鼻咽癌调强计划设计中应用。

Objective：To introduce a piecewise optimization methods used in nasopharyngeal carcinoma intensity modula- ted plan design. Methdos ： Piecewise optimization are the methods to carry out the intensity modulated plan in two pro- grams, the first program optimization include the tumor area, positive lymph nodes area, high-risk area and prophylactic area, the second program only irradiates the tumor area. The application of piecewise optimization methods was demonstra- ted in a patient with nasopharyngeal carcinoma. Results：For nasopharyngeal carcinoma, pieeewise optimization intensity modulated and improved the single dose of the prophylactic and high-risk irradiation area, made the target dose distribu- tion more uniformed, reduced the dose of organs at risk and reduced the treatment delivery time. Conclusions ： The piece- wise optimization methods can be used in nasopharyngeal carcinoma intensity modulated plan design.