uRT-TPS和Monaco-TPS对同一直线加速器在多癌种放射剂量计算方面差异的比较

背景与目的:近年来国产放疗设备及相关软件发展迅速,检验设备和软件的功能性及稳定性是必不可少的环节,本研究主要比较uRT-治疗计划系统(treatment planning system,TPS)和Monaco-TPS在常见癌症调强适形放疗(intensity-modulated radiation therapy,IMRT)计划剂量学和危及器官(organ at risk,OAR)体积计算方面的差异,评估使用uRT-TPS对Infinity直线加速器(瑞典Elekta公司)进行剂量计算的可行性。方法:选取直肠癌、肺癌、乳腺癌和鼻咽癌共20例患者作为研究对象,分别在uRT-TPS和Monaco-TPS中对各病例完成IMRT计划制订。在计划靶区(planning target volume,PTV)处方剂量体积相同条件下比较靶区剂量均匀性、适形性和OAR的平均剂量、最大剂量等参数。在同一直线加速器中比较验证uRT-TPS和Monaco-TPS的通过率。对比uRT-TPS和Monaco-TPS在计划跳数(monitor units,MU)、源皮距(source skin distance,SSD)和OAR的重建体积差异。结果:uRT-TPS和Monaco-TPS均可获得满足临床要求的放疗计划。靶区剂量具有可比拟的均匀性和适形性,uRT-TPS在靶区的最大剂量平均降低1.1 Gy(P=0.006)。对于乳腺癌和肺癌,Monaco-TPS的正常肺组织剂量较低(P<0.05)。对于鼻咽癌,uRT-TPS在口腔和咽喉的剂量指标分别降低9.2%和5.1%。uRT-TPS和MonacoTPS的点绝对剂量(<3%)和三维面剂量(>95%)验证结果均满足临床要求。uRT-TPS感兴趣区的体积计算小于MonacoTPS(P<0.05)。结论:对于常见肿瘤的放疗计划,uRT-TPS可以优化出与Monaco-TPS同等水平的IMRT计划。使用uRTTPS对Infinity直线加速器进行剂量计算具有可行性。

Evaluation of 3D-CRT and VMAT Radiotherapy Plans for Left Breast Cancer with Regional Lymph Nodes Irradiation

Introduction: Radiation therapy after breast surgery is an integral part of the treatment of early breast cancer. The goal of radiation therapy is to achieve the best possible coverage of the planning target volume (PTV), while reducing the dose to organs at risk (OARs) which are normal tissues whose sensitivity to irradiation could cause damage that can lead to modification of the treatment plan. In the last decade, radiation oncologist started to use the Intensity Modulated Radiotherapy (IMRT) and Volumetric Modulated Arc Therapy (VMAT) for irradiating the breast, in order to achieve better dose distribution and target dose to the PTV and OAR. The aim of this study is to compare 2 external radiotherapy techniques (VMAT vs 3D) for patients with node-positive left breast cancer. Patients and Methods: We randomly selected 10 cases of postoperative radiotherapy for breast cancer in our hospital. The patients are all female, the average age was 45.4 years old, and the primary lesions are left breast. The ANOVA test was used to compare the mean difference between subgroups, and the p value Results: Dose volume histogram (DVH) was used to analyze each evaluation dose of clinical target volume (CTV) and organs at risk (OARs). Compared to 3DCRT plans, VMAT provided more uniform coverage to the breast and regional lymph nodes. The max point dose for tVMAT was lower on average (106.4% for VMAT versus 109% for 3DCRT). OAR sparing was improved with tVMAT, with a lower average V17Gy for the left lung (27.91% for VMAT versus 30.04% for 3DCRT, p and lower for V28Gy (13.75% for VMAT versus 22.34% for 3DCRT, p = 0.01). We also found a lower V35Gy for the heart on VMAT plan (p = 0.02). On the contrary, dose of contralateral breast was lower in 3DCRT than VMAT (0.59 Gy vs 3.65 Gy, p = 0.00). Conclusion: The both types of plans can meet the clinical dosimetry demands of postoperative radiotherapy for left breast cancer. The VMAT plan has a better conformity, but 3CDRT can provide a lower dose to the contralateral organs (breast and lung) to avoid the risk of secondary cancers.

Three novel rare TP53 fusion mutations in a patient with multiple primary cancers:a case report

As survival rates improve and detection technologies advance,the occurrence of multiple primary cancers(MPCs)has been increasing.Approximately 16%of cancer survivors develop a subsequent malignancy,with lung cancer often developing after esophageal cancer due to potential“field cancerization”effects.Despite this observation,the genetic heterogeneity underlying MPCs remains understudied.However,the recent emergence of genetic testing has expanded the scope of investigations into MPCs to investigate signatures underlying cancer predisposition.This report reveals 3 unprecedented TP53 fusion mutations in a Chinese patient afflicted by MPCs,namely,AP1M2–TP53(A1;T11)fusion,TP53–ILF3(T10;I13)fusion,and SLC44A2–TP53(S5;T11)fusion.This patient exhibited an extended period of survival after diagnosis of extensive-stage small cell lung cancer,which occurred 6 years after the diagnosis of esophageal squamous cell cancer.This unique reportmay provide supplementary data that enhance our understanding of the genetic landscape ofMPCs.

医学TPS中放射线剂量分布的三维可视化方法

针对放射治疗计划系统GyroRTPS需要,给出了一个放射线剂量分布三维可视化的实现方法,以帮助医师多角度查看病灶组织任意剖面上的放射线剂量分布情况。首先论述系统中对体数据和剂量数据的坐标变换、插值计算等预处理;然后根据VTK工具包中可处理的数据类型对数据进行转换,给出了基于VTK实现剂量分布三维显示及其与体数据融合显示的方法。实例测试结果和临床使用表明,基于该方法开发的软件系统运行可靠,可更好地辅助医师进行放射治疗决策。

TPS图像融合功能的临床应用研究

目的:对临床放射治疗中常用的三种TPS(Eclips、Oncentra、Xio)自动图像融合功能做比较,总结最优的融合方法并服务临床。方法:选择不同的融合范围,对比三种TPS的自动融合结果,同时记录融合时间;根据需要调整不同的窗宽窗位,对比三种TPS自动融合效果。结果:当融合范围选择包含体表轮廓时,三种TPS的自动融合效果均优于融合范围不包含体表轮廓的结果,并且三种TPS所花时间均不同;窗宽窗位对Eclipse融合结果有影响,Oncentra和Xio融合对窗宽窗位不敏感。结论:由于自动融合算法均采用最大互信息法,所以三种TPS图像融合功能差异不大,但在算法的实现上却又不相同,因此三种TPS融合过程花费的时间、对窗宽窗位的依耐性存在差别。总的来说,三种TPS虽然其融合时间、融合界面、显示方式不同,但都能满足临床的需要。

ROI体积计算:ModernTPS-Winergy与Eclipse的对比

分析对比ModernTPS-Winergy与Eclipse治疗计划系统在计算感兴趣区(ROI)体积上的差异,为物理师在临床应用不同品牌计划系统时提供参考。在CT图像上勾画正方形、圆形和三角形三种规则轮廓,手工几何计算这些规则轮廓的体积作为基准值,对比分析Winergy、Eclipse与基准值的差异。另外选取一实际患者病例,对比两家产品体积计算的差异。两家计划系统计算的正方形、圆形、三角形三种轮廓与体积基准值的差异随轮廓体积的增加而减小,Winergy与体积基准值的平均差异为3.08%,Eclipse与体积基准值的平均差异为-5.71%。Winergy计算结果相比基准值为正偏差,Eclipse计算结果相比基准值为负偏差,但两家基本都满足临床要求。

三维治疗计划系统(3D-TPS)检测

三维治疗计划系统已经成为肿瘤放射治疗的重要工具.通过研究分析三维治疗计划系统的基本功能和放射治疗的流程,对北京大学肿瘤物理诊疗中心开发的三维治疗计划系统中的剂量计算进行了实验验证测试,测试结果显示该计划系统能够满足常规放射治疗的要求,它的完成标志着我国在3D-TPS系统的使用已经进入的临床使用阶段.

uRT-TPOIS和Monaco计划系统在肺癌旋转调强放疗中的剂量学比较

目的比较u RT-TPOIS和Monaco两种治疗计划系统在肺癌旋转调强放疗(Volumetric Modulated Arc Therapy,VMAT)计划中的剂量学差异,为临床应用提供参考。方法选取16例在河南省人民医院放疗科接收治疗的肺癌患者,分别使用Monaco 5.11和u RT-TPOIS两种治疗计划系统设计VMAT计划,比较两个计划的靶区和危及器官(Organs at Risk,OARs)受照剂量、适形度指数(Conformity Index,CI)、均匀性指数以及机器跳数。结果Monaco计划较u RT-TPOIS计划的Dmean、Dmin剂量更高,差异有统计学意义(P<0.05)。Monaco计划的V95较u RT-TPOIS计划明显降低,V107明显增加,差异均有统计学意义(P<0.05)。两种计划的V110比较,差异无统计学意义(P>0.05)。u RT-TPOIS计划的CI,肺V10、V5、Dmean,心脏V30、V40、Dmean均优于Monaco计划,差异有统计学意义(P<0.05)。结论两种系统均能满足肺癌VMAT计划需要,但由于治疗计划系统算法、加速器多叶准直器厚度等影响,不同的治疗计划系统存在差异,在OARs保护及其靶区适形度方面,u RT-TPOIS计划优于Monaco计划。

对比剂对模拟定位CT辅助Monaco-TPS制定肺癌患者动态调强放射治疗剂量的影响

目的:研究对比剂对模拟定位CT辅助Monaco-放射治疗计划系统(TPS)制定肺癌患者动态调强放射治疗剂量的影响。方法:选取医院收治的80例肺癌患者,CT模拟定位均行增强扫描,对比剂为碘海醇,分别采用Monaco-TPS设计计划A和计划B两种调强放射治疗(IMRT)计划:计划A为改变大血管内对比剂电子密度(80例患者);计划B为不改变大血管内对比剂电子密度(80例患者)。分析对比两种放射治疗计划的机器跳数、靶区剂量学指标、适形度指数(CI)、均匀性指数(HI)和危及器官(OAR)剂量学指标。结果:两种计划的单次机器跳数和靶区的CI、HI、95%的靶区体积所得到的95%体积的剂量(D_(95%))、最大剂量(D_(max))以及平均剂量(D_(mean))的差异均无统计学意义。计划A中患者左肺、右肺受5 Gy剂量照射的体积百分比(V_(5))、受20 Gy剂量照射的体积百分比(V_(20))及D_(mean)比计划B低,两种计划中右肺V_(5)的比较,差异有统计学意义(t=-1.801,P<0.05),左肺的V_(5)的差异亦有统计学意义(t=-2.201,P<0.05),双肺V_(20)和D_(mean)的差异均有统计学意义(t=-2.379,t=-2.268;P<0.05)。结论:对于定位时使用对比剂的肺癌患者,设计动态调强放射治疗计划时,改变增强CT图像中大血管内对比剂的电子密度,能降低OAR受照剂量。

Predicting Delivery Error Using a DICOM-RT Plan for Volumetric Modulated Arc Therapy

The purpose of this study was to investigate the prediction of mechanical error using DICOM-RT plan parameters for volumetric modulated arc therapy (VMAT). We created plans for gantry rotation arcs of 360° and 180° (full-arc and half-arc VMAT) for six maxillary sinus cancer cases using a Monaco treatment planning system, and delivered the doses with a linear accelerator. We calculated DICOM-RT plan parameters, including gantry, multileaf collimator (MLC) positions and Monitor Units (MU). We compared plans with regard to gantry angle per MU (degrees/MU) and MLC travel per MU (mm/MU) for each segment. Calculated gantry angle/MLC position speeds and errors were evaluated by comparison with the log file. On average, the half-arc VMAT plan resulted in 47% and 35% fewer degrees/MU and mm/MU than the full-arc VMAT plan, respectively. The root mean square (r.m.s.) gantry and MLC speeds showed a linear relationship with calculated degrees/MU and mm/MU, with coefficients of determination (R2) of 0.86 and 0.72, respectively. The r.m.s. gantry angle and MLC position errors showed a linear relationship with calculated degrees/MU and mm/MU with R2 of 0.63 and 0.76, respectively. Deviations from plan parameters were related to mechanical error for VMAT, and provided quantitative information without the need for VMAT delivery. These parameters can be used in the selection of treatment planning.

Feasibility of a Direct-Conversion Method from Magnetic Susceptibility to Relative Electron Density for Radiation Therapy Treatment Planning

Recently, several institutions have been developing magnetic resonance imaging (MRI)-guided radiotherapy treatment systems. In this study, we examine whether it is possible to perform radiation therapy planning (RTP) using a magnetic susceptibility map obtained using MRI. The head of a healthy volunteer was scanned using dual-energy computed tomography (CT) and MRI. A T2-star-weighted 3D gradient echo-based sequence (GRE) with images taken at four different echo times was acquired using the MRI scanner. The CT images were converted to relative electron density (rED) using a predefined ΔCT-rED conversion table. ΔCT was derived using the energy-subtraction method. The rED map was obtained from a single-linear relationship with the ΔCT-rED conversion table, whereas the magnetic susceptibility map was obtained from quantitative susceptibility mapping (QSM) via MRI. Subsequently, to obtain the relationship between the magnetic susceptibility and the rED, the rED map was rigidly aligned to the susceptibility map and resampled at the susceptibility map’s resolution. Finally, the magnetic susceptibility rED conversion table was obtained via voxel-by-voxel mapping between the two maps. No strong relationship between magnetic susceptibility and rED was obtained in the healthy volunteer’s head or in this study. The coefficient correlation between these parameters was 0.0145. Magnetic susceptibility values may be not able to convert to rED using our proposed method in healthy volunteer’s head. In contrast to the magnetic-susceptibility values obtained from the QSM algorithm, which were strongly affected by calcification and iron content, the rED or CT number was not considerably affected by such materials.

DICOM-RT Plan Complexity Verification for Volumetric Modulated Arc Therapy

The purpose of this study was to investigate the relationship between plan parameters verified with DICOM-RT and dosimetric results for volumetric modulated arc therapy (VMAT). We investigated three treatment locations: prostate cancer (ten cases), maxillary sinus cancer (four cases), and malignant pleura mesothelioma (four cases) with treatment plans generated by a MonacoTM treatment planning system (TPS), and delivered with an Elekta SynergyTM linear accelerator. We calculated plan parameters, including gantry and multileaf collimator (MLC) positions, Monitor Units (MU), and millimeters of MLC motion per degree of gantry rotation (mm/degree), and performed quality assurance (QA) with a DICOM-RT plan verification system. We measured the VMAT dose with a two-dimensional diode array detector. The average gamma passing rate with percent dose acceptance criteria and distance to agreement criteria of 2 mm and 2% (2 mm/2%) were 97.4%, 97.8% and 92.0% for prostate cancer, maxillary sinus cancer, and malignant pleural mesothelioma, respectively. The mean 95th percentile value for DICOM-calculated mm/degree was 4.0, 5.2, and 11.1 for prostate cancer, maxillary sinus cancer, and malignant pleural mesothelioma, respectively. The gamma passing rate showed a correlation with calculated mm/degree, with a coefficient of determination (R2) of 0.60. Higher calculated mm/degree values led to increased dosimetric errors. We conclude that dose distribution calculated by a TPS is more reliable at smaller mm/degree.

Complex Target Volume Delineation and Treatment Planning in Radiotherapy for Malignant Pleural Mesothelioma (MPM)

Introduction: Radiotherapy alone or combined with surgery and/or chemotherapy is being investigated in the treatment of malignant pleural mesothelioma (MPM). This study aimed to simulate a Volumetric Modulated Arc Therapy (VMAT) treatment of a patient with MPM. Materials and Methods: CT images from a patient with intact lungs were imported via DICOM into the Pinnacle3 treatment planning (TP) system (TPS) and used as a model for MPM to delineate organs at risk (OAR) and both clinical and planning target volumes (CTV and PTV) with a margin of 5 mm. Elekta Synergy with 6 MV photons and 80 leafs MLCi2 was employed. VMAT plans were generated using two coplanar arcs with gantry rotation angles of 178° - 182°, the collimator angles of each arc were set to 90°, Octavius® 4D 729 was employed for quality assurance while the calculated and measured doses were compared using VeriSoft. Results: A TP was achieved. The Gamma volume analysis with criteria of 3 mm distance to agreement and 3% dose difference yielded the gamma passing rate = 99.9%. The reference isodose was 42.75 Gy with the coverage constraints for the PTV D95 and V95 = 95.0% of 45 Gy. The remaining dosimetric parameters met the recommendations from the clinically acceptable guidelines for the radiotherapy of MPM. Conclusion: Using well-defined TV and VMAT, a consistent TP compared to similar ones from publications was achieved. We obtained a high agreement between the 3D dose reconstructed and the dose calculated.

Comparative Study between Field-in-Field and IMRT Techniques in Prostate Cancer Radiotherapy: A Treatment Planning Study

Introduction: Field-in-Field (FIF) and Intensity Modulated Radiation Therapy (IMRT) are two advanced radiation therapy planning techniques. Both of them are being used to achieve the same two related aims which are, to expose the targeted tumor to the full radiation dose and to spare the nearby normal tissues (or organs) from being exposed to high amounts of radiation more than its tolerance dose limits. FIF is a forward planning while IMRT is an inverse planning and FIF is a forward IMRT. Aim: The purpose of this study was to compare between Field-in-Field and IMRT techniques in prostate cancer radiotherapy. Method: A treatment planning system supporting both inverse and forward planning facilities is used. Ten prostate cancer patients were planned with both FIF and IMRT planning techniques. Doses received by the Planning Target Volume (PTV) and Organs at Risk (OARs) were compared in the two methods quantitatively from Dose Volume Histograms (DVHs) and qualitatively from (axial cuts). Results: The results showed that the IMRT planning technique achieved better dose coverage to the PTV than the FIF planning technique but, except RT and LT Femoral Heads, FIF achieved a better protection to the Rectum and the Bladder (OARs) than IMRT. Conclusions: The results showed that the inverse planning based IMRT technique is better and recommended in the prostate cancer radiotherapy than the FIF technique.

Advanced Treatment Planning in Cancer Thermal Therapies

CEM43 thermal dose is a very common concept in thermal oncology.Thermal dose is the maximum amount of energy that can be transmitted during hyperthermia therapy conducted on temperature-sensitive tissue.Thermal dose is also the maximum value of local energy accumulation in human bodies,which can lead to tissue injury and pain.Thermal dose can also decrease the finishing temperature and reduce the energy to the tolerable range.There are two functions of the individualized hyperthermia treatment plan:it determines the setting and location that can realize the best tumor hyperthermia therapy;at the same time,it can decrease the effect of hyperthermia therapy on healthy tissues.There are four steps in the treatment plan of hyperthermia therapy for tumors:the first step is to establish a three dimensional human body model and its corresponding an atomical structure that can be used in numerical algorithm via medical imaging resources;the second step is to determine the volume of the electromagnetic energy accumulation.Based on the peculiarity of frequency and materials,even full-wave electromagnetic wave or quasi-static technique can be used to determine the tissue distribution.Evaluation of the therapy can be conducted based on thermal dose and the corresponding tissue damage model;the third step is to use Arrhenius model to provide direct evaluation of tissues in the thermal ablation zone,solidification zone,as well as the necrotic area;the last step is the optimization of the treatment plan.

Comparison between 4D robust optimization methods for carbon-ion treatment planning

Intensity-modulated particle therapy(IMPT)with carbon ions is comparatively susceptible to various uncertainties caused by breathing motion,including range,setup,and target positioning uncertainties.To determine relative biological effectiveness-weighted dose(RWD)distributions that are resilient to these uncertainties,the reference phase-based four-dimensional(4D)robust optimization(RP-4DRO)and each phase-based 4D robust optimization(EP-4DRO)method in carbon-ion IMPT treatment planning were evaluated and compared.Based on RWD distributions,4DRO methods were compared with 4D conventional optimization using planning target volume(PTV)margins(PTV-based optimization)to assess the effectiveness of the robust optimization methods.Carbon-ion IMPT treatment planning was conducted in a cohort of five lung cancer patients.The results indicated that the EP-4DRO method provided better robustness(P=0.080)and improved plan quality(P=0.225)for the clinical target volume(CTV)in the individual respiratory phase when compared with the PTV-based optimization.Compared with the PTV-based optimization,the RP-4DRO method ensured the robustness(P=0.022)of the dose distributions in the reference breathing phase,albeit with a slight sacrifice of the target coverage(P=0.450).Both 4DRO methods successfully maintained the doses delivered to the organs at risk(OARs)below tolerable levels,which were lower than the doses in the PTV-based optimization(P<0.05).Furthermore,the RP-4DRO method exhibited significantly superior performance when compared with the EP-4DRO method in enhancing overall OAR sparing in either the individual respiratory phase or reference respiratory phase(P<0.05).In general,both 4DRO methods outperformed the PTV-based optimization in terms of OAR sparing and robustness.

Evaluating the influence of 6 MV and 15 MV photon beams on prostate intensity-modulated radiation therapy plans

Objective We aimed to determine the effects of low- and high-energy intensity-modulated radiation therapy(IMRT) photon beams on the target volume planning and on the critical organs in the case of prostate cancer. Methods Thirty plans were generated by using either 6 MV or 15 MV beams separately, and a combination of both 6 and 15 MV beams. All plans were generated by using suitable planning objectives and dose constraints, which were identical across the plans, except the beam energy. The plans were analyzed in terms of their target coverage, conformity, and homogeneity, regardless of the beam energy. Results The mean percentage values of V_(70 Gy) for the rectal wall for the plans with 6 MV, 15 MV, and mixedenergy beams were 16.9%, 17.8%, and 16.4%, respectively, while the mean percentage values of V_(40 Gy) were 53.6%, 52.3%, and 50.4%. The mean dose values to the femoral heads for the 6 MV, 15 MV, and mixed-energy plans were 30.1 Gy, 25.5 Gy, and 25.4 Gy, respectively. The mean integral dose for the 6 MV plans was 10% larger than those for the 15 MV and mixed-energy plans. Conclusion These preliminary results suggest that mixed-energy IMRT plans may be advantageous with respect to the dosimetric characteristics of low- and high-energy beams. Although the reduction of dose to the organs at risk may not be clinically relevant, in this study, IMRT plans using mixed-energy beams exhibited better OAR sparing and overall higher plan quality for deep-seated tumors.

三维适形放疗同步TP化疗联合细胞免疫对Ⅲ期非小细胞肺癌的临床治疗效果

目的探讨三维适形放疗同步TP(紫杉醇+顺铂)并联合细胞免疫治疗对Ⅲ期非小细胞肺癌的临床治疗效果。方法收集经病理诊断为Ⅲ期非小细胞肺癌的患者110例,随机分为对照组和实验组,对照组采用三维适形放疗同步TP化疗,实验组在此基础上联合细胞免疫治疗。结果对照组与实验组在白细胞降低、血小板减少、恶性呕吐、放射性肺炎以及食管炎的发生率上差异不具统计学意义(P>0.05);实验组与对照组发热以及外周血中CD阳性细胞降低等发生率上比较,差异具有统计学意义(P<0.05)。2组患者接受治疗后的KPS评分除稳定者差异不具统计学意义外(P>0.05),其余评分差异具有统计学意义(P<0.05)。2组患者临床治疗效果对比分析发现,实验组治疗后临床缓解率显著优于对照组,其总有效率为85.5%。结论三维适形放疗同步TP化疗联合细胞免疫治疗非小细胞肺癌具有良好的临床治疗效果,且未发现增加严重的毒副作用的风险,临床上可以推广使用。

光动力疗法辅助治疗慢性牙周炎对牙龈卟啉单胞菌的影响

目的评估抗微生物光动力疗法(aPDT)辅助龈下刮治和根面平整术(SRP)对牙龈卟啉单胞菌(Porphyromonas gingivalis,P.g)检出率的影响。方法选取慢性牙周炎患者32人,随机分为实验组(光动力组)(16例)和对照组(16例),实验组进行龈下刮治和根面平整+光动力疗法,对照组进行龈下刮治和根面平整术,评价基线、治疗后3、6个月的微生物指标。采集龈下菌斑和唾液样本,对慢性牙周炎致病菌P.g进行聚合酶链式反应(polymerase chain reaction,PCR)检测,观察P.g菌的检出率。结果实验组和对照组在随访期的P.g阳性率均有所降低。对照组第3、6个月与基线相比,P.g阳性率改善不显著(P>0.05),但实验组无论在第3、6个月,与基线相比都显著降低(P<0.05),且在第3个月时两组间有统计学差异(P<0.05)。结论抗微生物光动力疗法辅助治疗慢性牙周炎可以更为有效地抑制P.g。

刮痧疗法干预腰椎间盘突出症的方案分析

目的:分析刮痧疗法干预腰椎间盘突出症的方案特点,为后续临床操作规范化提供参考。方法:检索中国知网(CNKI)、万方数据库、维普数据库(VIP)、Web of Science、PubMed和中国生物医学文献服务系统(SinoMed)自建库至2022年6月30日有关刮痧疗法干预腰椎间盘突出症的文献。运用Excel对数据进行统计整理和频次分析,并对经络和高频腧穴(频次≥9次)进行聚类分析及Apriori关联分析。结果:检索共得文献261篇,筛选后纳入文献54篇。刮痧用具多为水牛角、刮痧介质多为刮痧油,刮痧手法和时间多数未提及。经络使用频次居前3位的是足太阳膀胱经(77.78%)、督脉(70.37%)、足少阳胆经(22.22%);腧穴使用频次居前3位的是委中(55.56%)、环跳(38.89%)、肾俞(35.19%)。此外,最常使用的经络配伍为督脉→足太阳膀胱经;最常使用的腧穴配伍为环跳→委中。结论:刮痧疗法干预腰椎间盘突出症时,刮痧器具多样,刮痧手法和时间各异,经络多选用阳经,腧穴选用遵循局部取穴与远端取穴相结合的规律。