TOMO治疗与直线加速器VMAT治疗鼻咽癌的效果分析

Analysis of the Effect of TOMO Treatment and Linear Accelerator VMAT Treatment for Nasopharyngeal Carcinoma

目的评估螺旋断层调强放疗(helical tomotherapy,TOMO)治疗与直线加速器容积调强放射疗法(volumemodulated arc therapy,VMAT)治疗鼻咽癌的效果。方法纳入2022年1月—2023年1月在厦门大学附属第一医院就诊的60例鼻咽癌患者,根据对原发部位及周围区域剂量进行评估,比较PTV的剂量学参数包括D2、D50、D98,符合性/一致性指数(conformity index,CI)和均一性指数(homogeneity index,HI)。结果VMAT的PTV的剂量学参数D2为(78.38±1.23)Gy、D98为(63.43±2.23)Gy,TOMO的剂量学参数D2为(77.62±1.35)Gy、D98为(64.38±2.46)Gy,差异有统计学意义(P<0.05)。TOMO组CI高于VMAT组,适形度更好;TOMO组HI低于VMAT组,靶区剂量分布更均匀。TOMO治疗的PTV CI和HI优于VMAT治疗,差异有统计学意义(P<0.05)。两者相比TOMO治疗在数值上实现了较高的原发肿瘤区PTV的覆盖范围。结论TOMO放疗应用于鼻咽癌患者时显现出更高的PTV剂量覆盖,TOMO计划更符合鼻咽癌放射治疗的要求,但仍然需要更多的随机临床试验的支持。

Objective To evaluate the efficacy of helical tomotherapy(TOMO) and linear accelerator volume-modulated arc therapy(VMAT) for nasopharyngeal carcinoma.Methods A total of 60 patients with nasopharyngeal carcinoma admitted to the First Affiliated Hospital of Xiamen University from January 2022 to January 2023 were included.Dosimetric parameters for comparison of PTV include D2,D50,D98,conformity index(CI)and homogeneity index(HI).Results The dosimetric parameters D2 of PTV for VMAT were(78.38±1.23) Gy and D98 were(63.43±2.23) Gy,and the dosimetric parameters D2 of TOMO were(77.62±1.35) Gy and D98 were(64.38±2.46) Gy,and the differences were statistically significant(P<0.05).CI in TOMO group was higher than VMAT group,and the fitness was better.The HI in TOMO group was lower than that in VMAT group,and the dose distribution in the target area was more uniform.PTV CI and HI in TOMO treatment were better than VMAT treatment,and the difference was statistically significant(P<0.05).Compared with VMAT therapy,TOMO therapy numerically achieved a higher PTV coverage of the primary tumor area.Conclusion TOMO radiotherapy has shown higher PTV dose coverage in patients with nasopharyngeal cancer,and the TOMO program is more consistent with the requirements of radiotherapy for nasopharyngeal cancer,but more randomized clinical trials are needed to support it.