全脑全脊髓放疗中静态调强和容积调强的剂量学对比

辐射防护通讯 ›› 2020, Vol. 40 ›› Issue (3): 15-18.

全脑全脊髓放疗中静态调强和容积调强的剂量学对比

朱俐颖¹, 胡小洋², 孙磊¹, 汪洋^1,2

1.复旦大学附属华山医院放射治疗中心,上海, 200235;
2.上海伽玛医院放疗科,上海, 200235

收稿日期:2019-03-31 出版日期:2020-06-20 发布日期:2021-01-15
通讯作者: 汪洋,janetcyj@163.com
作者简介:朱俐颖(1978—),女,2016年毕业于同济医学影像专业,现从事放射治疗工作。放疗技师。E-mail:473439771@qq.com

Dosimetric Comparison of Volume Modulated Arc Therapy and(Step and Shoot) Intensity Modulated Radiotherapy in Craniospinal Irradiation

Zhu Liying¹, Hu Xiaoyang², Sun Lei¹, Wang Yang^1,2

1. Department of Radiation Oncology, Shanghai Huashan Hospital, Shanghai, 200235;
2. Department of Radiation Oncology, Shanghai GAMMA Knife Hospital, Shanghai, 200235

Received:2019-03-31 Online:2020-06-20 Published:2021-01-15

摘要/Abstract

摘要： 回顾性选取2019年在我院放疗中心接受全脑全脊髓照射(CSI)的病人20例,勾画靶区和危及器官(OAR)后,传输至Oncentra 4.1治疗计划系统,对全脑全脊髓放疗采用静态调强(ss-IMRT)和容积调强(VMAT)两种放疗技术进行计划,分别计算两种技术的适形指数(CI)、均匀指数(HI)、107%处方剂量线所包含的靶区体积(V₁₀₇)、靶区内最大剂量点剂量值(D_max)、危及器官受量、正常组织(NT)受量、机器跳数和治疗时间并进行比较,比较两种调强方法的剂量学差异。结果表明,采用VMAT技术,靶区覆盖度、CI、HI、V₁₀₇、D_max、OAR受照量等参数优于ss-IMRT技术,治疗时间和机器跳数也明显减少。但靶区外正常组织(NT)低剂量的辐射区域增大。说明在CSI中,VAMT优于ss-IMRT 具有优势,但接受CSI患者大多是儿童,低剂量的辐射区域是否增加不良反应及其对临床影响有待于进一步研究。

关键词: 全脑全脊髓放疗, 静态调强, 容积调强

Abstract: A retrospective study was conducted on 20 patients who received craniospinal irradiation in our hospital's radiotherapy center in 2019. After sketching the target area and organs at risk (OAR), the scanning CT images were transmitted to Treatment Planning System (TPS),Oncentra 4.A clinically feasible radiotherapy plan was designed for ss-IMRT and VMAT. Conformality index (CI), homogeneity index (HI), V₁₀₇, maximum dose (D_max), organ at risk (OAR) dose volume level, monitor units and treatment time were used to analyze in these groups.In VAMT group CI, HI, V₁₀₇, D_max and OAR of target areas were significantly superior to ss-IMRT group, the organ at risk dose volume level in the VAMT group was lower than the ss-IMRT groups. The VAMT group also had the less monitor units and the shorter treatment time. Dose radiation is extended and the overall dose is increased. Illustration VAMT has advantages over ss-IMRT in whole brain and spinal cord radiotherapy, but most of the patients undergoing CSI irradiation are children. Whether the increase of low dose radiation area brings adverse reactions and its clinical effects need to be further observed and studied.

Key words: Craniospinal irradiation (Step and shoot), Intensity modulated radiotherapy, Volumetric modulated arc therapy

中图分类号:

R144

朱俐颖, 胡小洋, 孙磊, 汪洋. 全脑全脊髓放疗中静态调强和容积调强的剂量学对比[J]. 辐射防护通讯, 2020, 40(3): 15-18.

Zhu Liying, Hu Xiaoyang, Sun Lei, Wang Yang. Dosimetric Comparison of Volume Modulated Arc Therapy and(Step and Shoot) Intensity Modulated Radiotherapy in Craniospinal Irradiation[J]. RADIATION PROTECTION BULLETIN, 2020, 40(3): 15-18.

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