旋转容积调强技术和固定野适形调强放疗治疗鼻咽癌剂量学差异对比分析

Comparative Analysis of Dosimetry Differences between Volumetric Modulated Arc Therapy and Intensity Modulated Radiation Therapy in the Treatment of Nasopharyngeal Carcinoma

目的:比较旋转容积调强技术(VMAT)和固定野适形调强放疗(IMRT)治疗鼻咽癌的剂量学差异。方法:以海南医学院第二附属医院2019年1月至2021年12月收治的114例鼻咽癌放疗患者为研究对象,分为A、B两组各57例,A组采用VMAT放疗,B组采用IMRT放疗。比较两组患者的疗效、靶区剂量、风险器官(OAR)受量、治疗效率(加速器跳数、治疗时间)、不良反应。结果:治疗后,两组患者治疗总缓解率、靶区剂量比较差异无统计学意义(均P>0.05);A组患者视神经、晶体、腮腺、下颌骨受量低于B组,差异有统计学意义(均P<0.05);A组治疗中加速器跳数、治疗时间均少于B组,差异有统计学意义(均P<0.05);两组治疗期间不良反应发生率比较差异无统计学意义(P>0.05)。结论:VMAT、IMRT治疗鼻咽癌患者效果相当,但应用VMAT可减少病灶周围正常器官的受量,对提升治疗效率及安全性有利。

Objective:To compare the dosimetry differences between volumetric modulated arc therapy(VMAT)and intensity modulated radiation therapy(IMRT)in the treatment of nasopharyngeal carcinoma.Methods:A total of 114 patients with nasopharyngeal carcinoma undergoing radiotherapy who were treated in the Second Affiliated Hospital of Hainan Medical University from January 2019 to December 2021 were selected as the research subjects,and they were divided into group A and group B according to the random number table method,with 57 cases in each group.Group A received VMAT radiotherapy while group B was given radiotherapy with IMRT.The efficacy,target dose,organ at risk(OAR)dose,treatment efficiency(the number of accelerator monitor units,treatment time),and adverse reactions were compared between the two groups of patients.Results:After treatment,there were no statistical differences in the total treatment remission rate and target dose between the two groups(all P>0.05).The doses of optic nerve,lens,parotid gland and mandible of group A were less than those of group B(all P<0.05).The number of accelerator monitor units and treatment time in group A were less or shorter compared with those in group B(all P<0.05).The differences in the incidence rates of adverse reactions were not statistically significant between the two groups during treatment(P>0.05).Conclusion:VMAT and IMRT have similar effects in the treatment of patients with nasopharyngeal carcinoma,but the application of VMAT can reduce the doses of normal organs around the lesions,and it is beneficial to improving the treatment efficiency and safety.