期刊文献+

晚期肺癌非共面和共面IMRT剂量学比较研究 被引量:6

Comparative study of coplanar and non-coplanar intensity-modulated radiotherapy in advanced lung cancer
原文传递
导出
摘要 目的 比较研究晚期肺癌非共面IMRT计划剂量学分布特点,并观察计划执行安全性.方法 对14例晚期肺癌患者优化设计共面和非共面5、7个野IMRT计划,对比共面、非共面各组内及组间计划优化结果.观察4例患者非共面7个野计划的执行过程.结果 随射野数目增加共面及非共面靶区CI均改善(P值均为0.000),非共面野靶区Dmean、Dmax、V95%、HI亦有改善(P=0.001、0.001、0.009、0.000);共面野全肺、患、健肺V5增加(P =0.000、0.002、0.000)及全肺Dmean增加(P=0.000),相反非共面野全肺、健肺V5降低(P =0.001、0.005).组间非共面7个野较共面5个野计划靶区各指标均改善(P值均为0.000);各肺V20均降低(P值均为0.000)且全肺Dmean、V30及健肺V5降低(P=0.000、0.001、0.000),脊髓Dmax亦有减少(P=0.033);但患肺V5及心脏Dmean增加(P =0.000、0.003).较共面7个野计划患肺V5及心脏Dmean亦增加(P =0.000、0.048),但全肺及健肺V5均降低(所有P =0.000).4例患者均顺利完成非共面IMRT,全程未发生碰撞风险.结论 非共面7个野IMRT计划改善了靶区剂量分布,降低肺V20、Dmean也控制了低剂量肺体积增加趋势且临床实施安全有效,值得推荐. Objective To study the dosimetry and safety of the non-coplanar IMRT plan for advanced lung cancer.Methods The two groups IMRT plans were designed with coplanar (5,7F) and non-coplanar field (5,7F-n) for patients.To compare the dosimetry of two groups and perform 4 patients F7-n IMRT plan.Results With the increase of the fields in each group PTV's CI were improved (all P =0.000),especially the 7F-n plan PTV's Dmean,Dmax,V95% and HI also were improved (P=0.001,0.001,0.009,0.000) ; in the coplanar group each lung' s V5 increased (P =0.000,0.002,0.000) and whole lung's Dmean increased (P =0.000),but non-coplanar group whole lung's and contralateral lung's V5 reduce (P =0.001,0.005).Between the groups,7F-n plan PTV's indicators were all improved to compared with 5F plan (all P =0.000),and each lung's V20 reduced (all P =0.000),and whole lung's Dmean,V30,contralateral lung' s V5 reduced (P =0.000,0.001,0.000),and spinal cord' s Dmax also reduced (P =0.033),but ipsilateral lung's V5 and heart's Dmean increased (P =0.000,0.003);with compared to 7F plan,the 7F-n's ipsilateral lung's V5 and heart's Dmean also increased (P =0.000,0.048),but whole lung' s and contralateral lung's V5 decreased (all P =0.000).Four patients were performed successfully non-coplanar IMRT treatment,no collision occurred.Conclusions 7 fields non-coplanar IMRT plan not only improve the dose distribution of PTV,but also effectively control the volume of low dose lung increase,lung V20 and Dmean reduce too.Thus recommended to use this design in patients with advanced lung cancer for radiotherapy
出处 《中华放射肿瘤学杂志》 CSCD 北大核心 2015年第1期74-77,共4页 Chinese Journal of Radiation Oncology
关键词 肺肿瘤/调强放射疗法 非共面 剂量学 Lung neoplasm/intensity-modulated radiotherapy Non-coplanar Dosimetry
  • 相关文献

参考文献13

  • 1王绿化,张红星,陈东福.第六篇胸部肿瘤第二章肺癌[A]//殷蔚伯,余子豪,许国镇,等.肿瘤放射治疗学(第四版)[M].北京:中国协和医科大学出版社,2008:578-609.
  • 2王澜,吕冬婕,韩春,李晓宁,高超.胸部肿瘤同期放化疗患者肺功能及剂量学参数对急性肺损伤的预测价值[J].中华放射肿瘤学杂志,2011,20(1):40-44. 被引量:24
  • 3Yorke ED, Jackson A, Rosenzweig KE, et al. Correlation ofdosimetric factors and radiation pneumonitis for non-small cell lungcancer patients in a recently completed dose escalation study [ J].Int J Radiat Oncol Biol Phys, 2005,63 (3 ) : 672-682. DOI: 10.1016/j. ijrobp. 2005.03.026.
  • 4Paddick I. A simple scoring ratio to index the conformity of radio-surgical treatment plans. Technical note [J]. J Neurosurq,2000,93 ( 3 ): 219-222. DOI: 10. 3171/jns. 2000. 93. supplement3. 0219.
  • 5Murshed H,Liu HH,Liao Z,et al. Dose and volume reduction fornormal lung using intensity-modulated radiotherapy for advanced-stage non-small-cell lung cancer [ J ]. Int J Radiat OncolBiolPhys,2004,58(4) :1258-1267. D01:10.1016/j. ijrobp. 2003.09.086.
  • 6Willner J,Jost A,Baier K,et al. A little to a lot or a lot to a little.An analysis of pneumonitis risk from dose-volume histogramparameters of the lung in patient with lung cancer treated with 3-Dconformal radiotherapy [ J] . Strahlenther Onkol, 2003,179 ( 8 ):548-556.
  • 7Hernando ML, Marks LB, Bentel GC, et al. Radiation-inducedpulmonary toxicity : a dose-volume histogram analysis in 201patients with lung cancer [ J]. Int J Radiat Oncol Biol Phys,2001,51(3) :650-659. DOI: 10.1016/S0360-3016(01 )01685-6.
  • 8Chen X,Jin D, Wang S,et al. Noncoplanar intensity-modulatedradiation therapy for young female patients with meditationallymphomas [J]. J Appl Clin Med Phy,2012,13(6): 147-156.DOI: 10.1120/jacmp. vl3i6. 3769.
  • 9Chapet 0,Khodri M,Jalade P,et al. Potential benefits of using noncoplanar field and intensity modulated radiation therapy to preservethe heart in irradiation of lung tumors in the middle and lower lobes[J]. Radiother Oncol, 2006,80 (3 ) : 333-340. DOI: 10. 1016/j.radonc. 2006.07.009.
  • 10Krayenbuehl J, Davis JB, Ciemik IF. Dynamic intensity-modulatednon-coplanar arc radiotherapy ( INCA) for head and neck cancer[J]. Radiother 0ncol,2006,81 (2) :151-157. DOI: 10. 1016/j.radonc. 2006.09.004.

二级参考文献19

  • 1Schallenkamp JM, Miller RC, Brinkmann DH, et al. Incidence of radiation pneumonitis after thoracic irradiation : dose-volume correlates. Int J Radiat Oncol Biol Phys,2007 ,67 :410-416.
  • 2Yorke ED, Jackson A. Correlation of dosimetric factors and radiation pneumonitis for non-small cell lung cancer patients in a recently completed dose escalation study. J Radiat Oncol Biol Phys, 2005,63:672-682.
  • 3Gopal R, Tucker SL, Komaki R, et al. The relationship between local dose and loss of function for irradiated lung. J Radiat Oncol Biol Phys ,2003,56 : 106-113.
  • 4Wang S, Liao Z, Wei X, et al. Analysis of clinical an dosimetric factors associated with treatment-relatedpneumonitis (TRP) in patients with non-small-cell lung cancer (NSCLC) treated with concurrent chemotherapy and three-dimensional conformal radiotherapy (3DCRT). Int J Radiat Oncol Biol Phys,2006,66:1399-1407.
  • 5Sibley GS, Mundt A J, Shapiro C, et al. The treatment of stage Ⅲ non-small cell lung cancer using high dose conformal radiotherapy. Int J Radiat Oncol Biol Phys,1995,33:1001-1007.
  • 6Xia TY, Li HQ, Sun Qx, et al. Promising clinical outcome of stereotactic body radiation therapy for patients with inoperable stage Ⅰ/Ⅱ non-small cell lung cancer. Int J Radiat Oncol Biol Phys, 2006,66 : 117-125.
  • 7Bradley JD, Ieumwananonthachai N, Purdy JA, et al. Grosstumor volume,critical prognosic factor in patients treated with three-dimensional conformal radiation therapy for non-small cell lung carcinoma. Int J Radiat Oncol Biol Phys,2002,52:49-57.
  • 8Bradley J, Graham MV, Winter K, et al. Toxicity and outcome resuits of RTOG 9311 : a phase Ⅰ- Ⅱ dose-escalation study using three-dimensional conformal radiotherapy in patients with inoperable non-small cell lung carcinoma. Int J Radiat Oncol Biol Phys, 2005,61:318-328.
  • 9Tsujino K, Hirota S, Endo M, et al. Predictive value of dose-volum e histogram parameters for predicting radiation pneumonitis after concurrent ehemoradiation for lung cancer. Int J Radiat Oncol Biol Phys ,2003,55:110-115.
  • 10Herenando ML, Marks LB, Bentel GC, et al. Radiation-induced pulmonary toxicity: a dose-volume histogram analysis in 201 patients with lung cancer. Int J Radiat Oncol Biol Phys, 2001,51: 650-659.

共引文献48

同被引文献34

引证文献6

二级引证文献19

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部