螺旋断层同步加量技术在实体瘤中的应用效果

Application effect of spiral fault simultaneous integrated boost technology in solid tumors

目的探索螺旋断层同步加量(SIB)技术治疗短径>5 cm实体瘤的可行性。方法选取2018年1月至2019年6月科内放疗的52例实体瘤患者,多模态影像结合勾画ITV。TOMO planning station制定两组计划(Field Width=2.50 cm,MF=3.00,Pitch=0.10)。单剂量组:PTV DT 40 Gy/8 f/10 d;螺旋断层SIB组:PTV DT 40 Gy/8 f/10 d,ITV∩DT 48 Gy/8 f/10 d,ITV_(ITV∩-2)cm DT 64 Gy/8 f/10 d。比较两组机器物理参数和正常敏感组织受量,计算肿瘤增量比与危及器官(OAR)附加损伤量,并观察急、慢性毒副反应。结果52例实体瘤患者中,36例为肝肿瘤,16例为肺肿瘤。病灶体积163.64~724.74 cc,中位病灶体积390.97 cc。单剂量组与螺旋断层SIB组的机器调数、照射时间、肝肺受量、脊髓受量比较,差异均有统计学意义(P<0.05)。使用螺旋断层SIB技术肿瘤增量比可达到60%;OAR附加损伤量均不超过7%。螺旋断层SIB组患者均未出现4级急、慢性毒副反应。结论螺旋断层SIB技术可明显提高实体肿瘤的BED,安全可控,值得关注。

Objective To explore the feasibility of spiral fault simultaneous integrated boost(SIB)technology in the treatment of solid tumors with short diameter>5 cm.Methods A total of 52 patients with solid tumors treated with radiotherapy in department from January 2018 to June 2019 were selected,and multi-modal imaging was combined to delineate ITV.The plans(Field Width=2.50 cm,MF=3.00,Pitch=0.10)of the two groups were made by TOMO planning station,the single-dose group:PTV DT 40 Gy/8 f/10 d;the spiral fault SIB group:PTV DT 40 Gy/8 f/10 d,ITV∩DT 48 Gy/8 f/10 d,ITV_(ITV∩-2) cm DT 64 Gy/8 f/10 d.The mechanical physical parameters and normal sensitive tissue dose of the two groups were compared,the tumor increment ratio and organs at risk(OAR)additional damage quantity were calculated,and the acute and chronic side effects were observed.Results Among the 52 patients with solid tumors,36 were liver tumors and 16 were lung tumors.The lesion volume was 163.64-724.74 cc,and the median lesion volume was 390.97 cc.There were significant differences in machine modulation,irradiation time,liver lung dose and spinal cord dose between the single-dose group and the spiral fault SIB group(P<0.05).Using spiral fault SIB technology,the tumor increment ratio can reach 60%;the OAR additional danage quantity was not more than 7%.There were no acute and chronic side effects at grade 4 in the spiral fault SIB group.Conclusion The spiral fault SIB technology can significantly improve the BED of solid tumors,which is safe,controllable and deserves attention.