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目的建立一种新的等中心旋转切线调强照射技术,在保持调强技术靶区剂量均匀性不变情况下,试图进一步减少患侧肺组织及心脏卷入射野的体积和剂量。方法根据等中心旋转切线照射的物理原理,使用PinnacleVersion7.4的子野优化软件做治疗计划。旋转切线野沿靶区等中心切线设置,相邻切线野的机架转角间隔5°、10°、15°,切线野的内缘和外缘分别与靶区内缘(胸壁)和靶区外缘相切,起始野和终止野处设立一对穿野,旋转等中心一般设置在与弯形靶区中心(即剂量归一点)相对应的胸壁附近。利用BEV视图设置每个切线野的形状和大小。对每个切线野预设7个子野。按临床治疗要求设置靶区、重要器官(肺和心脏)的剂量处方。结果靶区内处方剂量50Gy的体积V50为95.1%。靶处方剂量的95%、105%、110%及115%以上的相应等剂量线面包围的体积V95%、V105%、V110%、V115%分别为0.98、0.84、0.53、0.18。患、健侧肺和心脏的V10、V20、V30、V40、V50值都很低。结论旋转切线调强技术不仅能得到靶区内很好的剂量均匀性和较高的靶区剂量适合度,而且能更好地保护患侧心脏和肺组织的受量大小和受量范围。定位摆位相对简单。在任何带有子野优化的治疗计划系统上都可作为该技术的计划设计。如果配以限制或跟随胸廓运动的措施,将会更充分地发挥该技术的优点。
OBJECTIVE To establish a new isocenter rotational tangential beam intensity-modulated irradiation technique, trying to further reduce the volume and dose of ipsilateral lung tissue and cardiac involvement field while keeping the dose uniformity of IMRI target unchanged. Methods According to the physical principle of isocenter rotation and tangent irradiation, the treatment plan was made using the subfield optimization software of Pinnacle Version 7.4. The tangent of the rotation tangent line is set along the tangent of the center of the target zone. The tangent angles of the adjacent tangent fields are 5 °, 10 ° and 15 °. The inner edge and the outer edge of the tangent field are respectively close to the inner edge of the target region (chest wall) Edge tangent, the starting field and the termination of the wild to set up a pair of wild, rotation and other centers are generally located in the center of the curved target area (ie dose point) in the vicinity of the chest wall. Use the BEV view to set the shape and size of each tangent field. Seven tandem fields are preset for each tangent field. According to clinical treatment requirements set the target area, important organs (lung and heart) dose prescription. Results The volume V50 of 50 Gy in the target area was 95.1%. The target dose of 95%, 105%, 110% and 115% of the corresponding isodose line volume surrounded by V95%, V105%, V110%, V115% were 0.98,0.84,0.53,0.18. V10, V20, V30, V40, V50 values for affected, contralateral lungs and heart are low. Conclusion Rotary tangent IMRT not only achieves good dose uniformity and high target dose fitness in the target region, but also protects the affected heart and lung tissue from exposure and exposure. Positioning positioning is relatively simple. The design of this technology can be used in any treatment planning system with subfield optimization. If accompanied by measures to limit or follow the chest movement, will be more fully play the advantages of the technology.