论文部分内容阅读
目的探讨Eclipse(Version 10.0)治疗计划系统基准剂量补偿计划功能(base dose plan,BDP)用于食管癌术后调强放疗(intensity modulated radiation therapy,IMRT)的剂量学特点。方法食管癌术后患者12例,分别制订IMRT计划和基于基准剂量补偿的IMRT(BDP-IMRT)计划,比较2种方法下计划靶区和危及器官剂量体积参数、正常组织低剂量区域和机器跳数(monitor units,MU)。结果 BDP-IMRT下计划靶区平均剂量(Dmean)[(51.11±0.36)Gy],近似最大剂量(D2)[(52.14±0.60)Gy]低于IMRT[(51.68±0.27)、(53.36±0.46)Gy],近似最低剂量(D98)[(49.58±0.21)Gy]高于IMRT[(49.27±0.17)Gy],适形指数(conformity index,CI)(0.87±0.03)高于IMRT(0.83±0.03),剂量均匀性指数(heterogeneity index,HI)(0.05±0.01)低于IMRT(0.08±0.01),差异均有统计学意义(P<0.05);BDP-IMRT下肺V5[(72.16±14.59)%]、V10[(48.84±8.34)%]低于IMRT[(72.88±15.04)%、(50.26±9.65)%](P<0.05),V30[(6.93±3.06)%]高于IMRT[(6.43±2.70)%](P<0.05);BDP-IMRT下正常组织低剂量区域V15[(23.63±4.90)%]、V20[(16.92±4.05)%]低于IMRT[(24.17±4.95)%、(17.55±3.99)%](P<0.05),V5、V10、V30比较差异均无统计学意义(P>0.05);BDP-IMRT和IMRT下心脏Dmean、V20、V30、V40、V50比较差异均无统计学意义(P>0.05),脊髓计划区和脊髓Dmax比较差异无统计学意义(P>0.05);IMRT下MU(844.00±180.00)低于BDP-IMRT(966.00±217.00)(P<0.05)。结论 IMRT和BDP-IMRT计划均能满足食管癌术后患者临床治疗需求,与IMRT计划比较,BDP-IMRT计划提高了靶区覆盖率和适形度,剂量学优势明显。
Objective To investigate the dosimetry characteristics of the baseline dose plan (BDP) of Eclipse (Version 10.0) treatment planning system for postoperative esophageal cancer modulated radiation therapy (IMRT). Methods 12 patients with postoperative esophageal cancer were enrolled in the study. The IMRT plan and IMRT (BDP-IMRT) plan based on baseline dose compensation were developed. The target volume and organ dose volume parameters were compared between the two methods. The low dose area and the machine jump Monitor units (MU). Results The average target dose (Dmean) [(51.11 ± 0.36) Gy] and approximate maximum dose (D2) [52.14 ± 0.60 Gy] under BDP-IMRT were lower than those of IMRT [(51.68 ± 0.27) and (53.36 ± 0.46 (49.87 ± 0.17) Gy], the conformity index (CI) (0.87 ± 0.03) was higher than that of IMRT (0.83 ± 0.03). The difference of Homology index (HI) (0.05 ± 0.01) was lower than that of IMRT (0.08 ± 0.01), the difference was statistically significant (P <0.05) ) (V30 [(48.84 ± 8.34)%] were lower than those of IMRT [(72.88 ± 15.04)%, (50.26 ± 9.65)%] (6.43 ± 2.70)%] (P <0.05). The levels of V15 [(23.63 ± 4.90)%] and V20 [16.92 ± 4.05%] in normal tissue were lower than those in IMRT [(24.17 ± 4.95) %, (17.55 ± 3.99)%] (P <0.05). There was no significant difference in V5, V10 and V30 between the two groups (P> 0.05). The comparison of Dmean, V20, V30, V40 and V50 in BDP-IMRT and IMRT (P> 0.05). There was no significant difference in Dmax between spinal cord planning area and spinal cord (P> 0.05) at IMRT (P <0.05) <0.05). Conclusion Both IMRT and BDP-IMRT plans can meet the clinical needs of postoperative patients with esophageal cancer. Compared with the IMRT plan, the BDP-IMRT plan has improved the coverage and conformality of the target area, and the advantages of the dosimetry are obvious.