双眶Grave’s眼病三种放射治疗技术比较

Comparison of three radiotherapy techniques for bilateral Grave's ophthalmopathy

目的探讨三维适形(含电子线照射野)的照射技术治疗双眶Grave’s眼病的实施方法及其剂量学优势。方法10例确诊为双侧Grave’s眼病的患者,均用三维适形(含电子线照射野)照射技术、传统的对穿野照射技术以及近年来主流的调强照射技术等三种技术完成治疗计划,比较计划靶区(planning target volume,PTV)和危及器官(organ at risk,OAR)的剂量分布图、剂量体积直方图和剂量学参数。结果对于PTV的参数D98%、V95%、Dmean、CI和HI,双侧晶体的参数Dmin、Dmean和Dmax,双侧泪腺的参数Dmin和Dmean,三维适形和调强技术二者与对穿野技术相比差异均具有统计学意义(P<0.05),但三维适形与调强技术相比差异无统计学意义。对于PTV的参数D2%和双侧泪腺的参数Dmax,则三种技术之间比较差异均无统计学意义。结论三维适形(含电子线照射野)和调强技术与传统的对穿野技术相比都有着同样的剂量学优势,在患者不愿意接受调强技术昂贵的价格或者没有调强设备的时候,可以用三维适形技术代替。

Objective To study the implementation and dosimetric advantages of three-dimensional conformal irradiation （3DCRT） including electron beam irradiation field in the treatment of bilateral Grave ’ s ophthalmopathy .Methods All the ten pa-tients diagnosed as having bilateral Grave ’ s ophthalmopathy were scheduled for such three techniques including three -dimensional con-formal irradiation , the conventional opposing field irradiation （ OF） and the mainstream intensity modulated irradiation （ IMRT） in re-cent years .Dose distribution diagrams , dose volume histograms and dosimetric parameters of the planning target volume （ PTV） and or-gans at risk （OARs） were compared.Results For D98%,V95%,Dmean, CI and HI in PTV parameters, Dmin, Dmean and Dmax in bilateral lens parameters , Dmin,Dmean in bilateral lacrimal glands parameters , 3DCRT and IMRT compared with OF were statisti-cally significantly different （P〈0.05）, while no significant difference was found between 3DCRT and IMRT technique,for D2% in PTV parameters and Dmax in bilateral lacrimal glands parameters , the comparison between such three technologies were not statistically significantly different （P＆gt;0.05）.Conclusions 3DCRT （including electron beam irradiation field ） and IMRT technology have as many dosimetric advantages as OF technology .This technology can replace IMRT technology if patients are unwilling to accept IMRT due to its price or no IMRT equipment can be acquired .