原发性肝癌患者螺旋断层放射与三维适形放射治疗剂量分布比较

Spiral tomography and three-dimensional conformal radiation therapy in patients with primary liver cancer: comparison of dose distribution

目的探讨原发性肝癌患者螺旋断层放射与三维适形放射治疗剂量分布情况。方法选择2018年6月~2019年6月在我院行放疗治疗的原发性肝癌患者30例为研究对象,均行CT平扫。分别制定三维适形放射治疗(3DCRT)方案与螺旋断层放射治疗(HT)方案。比较两种放射方法靶区放射剂量分布情况以及危及器官放射剂量分布情况。结果(1)两种放射治疗方法靶区(PTV)剂量分布:95%、100%处方剂量覆盖的靶区体积两组方法比较差异无统计学意义(P>0.05);HT放射治疗方法CI显著高于3DCRT,HI显著低于3DCRT(P<0.05),提示HT放射治疗方法适形度与靶区剂量分布均匀性均优于3DCRT。(2)HT照射方法对危及器官照射剂量的分布上正常肝脏组织平均照射剂量、肝脏V30显著低于3DCRT(P<0.05);HT对双肾的照射剂量显著高于3DCRT(P<0.05)。结论螺旋断层放射与三维适形放射治疗原发性肝癌,对PTV剂量分布没有显著差异,但是HT放射治疗的适形度与靶区照射剂量的均匀性要优于3DCRT。对危及器官照射剂量分布显示,两者在胃组织以及脊髓组织的照射剂量没有显著差异,HT在正常肝组织的平均照射剂量要低于3DCRT,但是对双肾的照射剂量要高于3DCRT。

Objective To investigate the dose distribution of spiral tomography and three-dimensional conformal radiation therapy in patients with primary liver cancer.Methods Thirty patients with primary liver cancer who underwent radiotherapy in our hospital from June 2018 to June 2019 were selected as the research subjects,and all underwent plain CT scans.The therapy schedule of three-dimensional conformal radiation therapy(3DCRT)and helical tomography(HT)were developed separately.The radiation dose distribution of the planning target volume(PTV)and the organ at risk(OAR)were compared between the two therapy schedules.Results(1)The dose distribution of PTV of the two radiotherapy methods:the target volume covered by 95%and 100%of the prescribed dose was not significantly different between the two methods(P>0.05);the CI of the HT radiotherapy method was significant higher than that of 3DCRT,HI was significantly lower than that of 3DCRT(P<0.05),suggesting that the conformity and the uniformity of target dose distribution of HT radiotherapy were better than those of 3DCRT.(2)In the dose distribution of HT radiotherapy to OAR,the average dose of normal liver tissues and liver V30 were significantly lower than that of 3DCRT(P<0.05);the dose of HT to both kidneys was significantly higher than that of 3DCRT(P<0.05).Conclusion HT and 3DCRT for primary liver cancer have no significant difference in the dose distribution of PTV,but the conformity of HT radiation therapy and the uniformity of target radiation dose are better than those of 3DCRT.The dose distribution of OAR showed that there was no significant difference between the two in gastric tissue and spinal cord tissue.The average radiation dose of HT in normal liver tissue was lower than that of 3DCRT,but the radiation dose to both kidneys was higher than that of 3DCRT.