食管癌SIB-IMRT与3DCRT的剂量学疗效比较

Comparison of Dosimetry Curative Effect between SIB-IMRT and 3DCRT for Esophageal Carcinoma

目的比较食管癌同期加量调强放疗(SIB-IMRT)与三维适形放疗(3DCRT)的剂量学疗效。方法选择2 0 1 0年1月-2012年12月于我院接受3DCRT治疗的60例食管癌患者作为3DCRT组,按1:1比例选取2013年1月-2016年2月于我院接受SIBIMRT治疗的60例患者作为SIB-IMRT组,收集所有患者的临床资料,比较两组靶区剂量分布及靶区适形度指数(CI)、剂量均匀指数(HI)及危及器官组织受量,比较SIB-IMRT、3DCRT治疗的效果及安全性。结果 (1)SIB-IMRT组靶区Dmin、Dmean、V95、D95%及靶区肿瘤体积(GTV)Dmin、Dmean与计划靶体积(PTV)Dmax、Dmin、Dmean均高于3DCRT组(P﹤0.05);(2)SIBIMRT组CI高于3DCRT组,其HI低于3DCRT组(P﹤0.05);(3)SIB-IMRT组脊髓Dmax、肺V30低于3DCRT组,其肺V5高于3DCRT组(P﹤0.05);(4)SIB-IMRT组放射性食管炎发生率低于3DCRT组(P﹤0.05)。结论采用SIB-IMRT放疗计划治疗食管癌靶区剂量分布均匀性高,适形度好,危及器官受量低,安全性高。

Objective To compare the dosimetry curative effect between simultaneous integrated boost intensity-modulated radiation therapy（SIB-IMRT） and threedimensional conformal radiation therapy（3 DCRT） for esophageal carcinoma. Methods 60 cases of patients with esophageal carcinoma who were treated by 3 DCRT in our hospital during January 2010 to December 2012 were included into 3 DCRT group, and another 60 cases treated by SIB-IMRT during January 2013 to February 2016 were included into SIB-IMRT group. The clinical data of all patients were collected. The dose distribution and conformal index（CI） of target region, dose homogeneity index（HI） and the dose received by involved organs were compared between the two groups, and the efficacy and safety of SIB-IMRT and 3 DCRT were compared. Results（1）Dmin, Dmean, V95 and D95% of target region, Dmin and Dmean of the gross tumor volume（GTV）, Dmax, Dmin and Dmean of planning target volume（PTV） in SIB-IMRT group were higher than those in 3 DCRT group（P〈0.05）.（2）CI in SIB-IMRT group was higher than that in 3 DCRT group while HI was lower than that in 3 DCRT group（P〈0.05）.（3）The spinal cord Dmax and lung V30 in SIB-IMRT group were lower than those in 3 DCRT group and the lung V5 was higher than that in 3 DCRT group（P〈0.05）.（4）The incidence of radiation esophagitis in SIB-IMRT group was lower than that in 3 DCRT group（P〈0.05）. Conclusion The treatment of esophageal carcinoma with SIB-IMRT is with high homogeneity, good conformity, low dose received by involved organs and high safety.