螺旋断层固定野调强放疗技术在中段食管癌放疗中的效果观察

Effect of spiral fault fixed field intensity modulated radiation therapy on esophageal cancer in middle segment

目的探讨螺旋断层固定野调强放疗技术在中段食管癌中的应用效果。方法选取接受IMRT放疗和TD放疗的中段食管癌患者共83例,通过布野及定位拍片,应用Pinnacle39.0治疗计划系统分别进行IMRT放疗和TD放疗,最后评估平均剂量、5%器官体积所受剂量、95%器官体积所受剂量、心脏受到30~40 Gy剂量的体积、脊髓的最大剂量、双肺受到5、20和30 Gy剂量的体积、正常组织的平均剂量、适形性指数和均匀性指数等指标。结果 TD计划下靶区适形性和靶区均匀性均显著优于IMRT计划(P<0.05),5%器官体积所受剂量也显著优于IMRT计划(P<0.05)。在危及器官受量比较中,IMRT计划在患者双肺受到20和30 Gy剂量的体积受量显著大于TD计划(P<0.05),二者在其他指标上无显著差异(P>0.05)。结论与调强放疗技术相比,螺旋断层固定野调强放疗技术可以更好地提高靶区适形性和靶区均匀性,同时降低双肺的最大受量。

Objective To investigate the application effect of spiral fault fixed field intensity modulated radiation therapy（IMRT） in middle segment esophageal carcinoma.Methods A total of 83 IMRT and TD patients received radiotherapy in our hospital for middle esophageal cancer were selected,and IMRT and TD radiotherapies were applied by Pinnacle 39.0 treatment planning system by cloth field and location shooting,The average dose,acceptable dosages of 5％ and 95％ organ volume,30 ～ 40 Gy dosage volume of heart,the maximum dose of spinal cord,the volumes of lungs with doses of 5,20 and 30 Gy,average dose of normal tissue,conformal index and evenness index were assessed.Results TD plan had superior target area conformal and evenness indicators,and acceptable dosages of 5 ％ organ volume as compared to IMRT （P ＜ 0.05）.The comparison of organs at risk showed that IMRT plans had larger volumes of lungs with doses of 20 and 30Gy than TD plan （P ＜0.05）,but no significant difference was seen in other indexes （P ＞ 0.05）.Conclusion Compared with intensity modulated radiation therapy,helical tomographic fixed field intensity-modulated radiation therapy can better improve target area conformal and evenness indicators,and reduce maximum dose of both lungs.