Dose Distribution of Body Gamma Rays Radiotherapy for Multiple Pulmonary Metastatic Tumor
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摘要: 目的 对肺多发转移瘤患者γ刀治疗的剂量分布进行研究以评估其安全性和可行性。方法 选取20例肺多发转移瘤（9~12个病灶，病灶直径≤2.3 cm）患者设计γ刀治疗计划（OUR-QGD型体部γ刀），采用仰卧体位的12例，俯卧体位的8例。在肺窗下勾画大体肿瘤靶区（gross target volume, GTV），GTV外放5 mm为计划靶区（planning target volume,PTV），50%等剂量线包绕PTV，70%等剂量线包绕90%GTV，处方剂量为50%等剂量线4 Gy/f，总剂量52 Gy，通过剂量体积直方图评估其剂量分布。结果 处方总剂量为52 Gy时，90%的GTV靶区得到相当于常规放疗94 Gy剂量的照射，仰卧体位双肺的平均剂量为8.36 Gy，V20、V10和V5分别为12.60%、24.60%和37.40%，俯卧体位双肺的平均剂量为8.15 Gy，V20、V10和V5分别为12.67%、25.10%和40.40%。结论 对于物理剂量而言，采用OUR-QGD型体部γ刀治疗数目较多的肺多发转移瘤是安全有效的。Abstract: Objective To investigate the dose distribution of OUR-QGD whole body γ rays radiotherapy for multiple pulmonary metastatic tumor and evaluate its safety and feasibility. Methods Twenty cases of lung metastatic tumor, with 9-12 foci and diameter≤2.3 cm,were treated with OUR-QGD whole body γ rays radiotherapy. Twelve cases were supine and eight cases were prone. Gross target volume(GTV) was delineated in lung window, and 5 mm was enlarged as planning target volume (PTV).50% isodose line was around PTV and 70% isodose line was around 90% of GTV.The reference dose was defi ned as 50% isodose line with 4 Gy per fraction, and the prescribed dose was 52 Gy with 13 fractions. The dose distribution was evaluated by dose volume histogram (DVH). Results 52 Gy of body γ rays radiotherapy to 90% of GTV was equivalent to 94 Gy of conventional radiotherapy to 90% of GTV. The average dose for total lung of the supine patients was 8.36 Gy, and V20, V10 and V5 for total lung were 12.6%, 24.60% and 37.40%, respectively. The average dose for total lung of the prone patients was 8.57 Gy, and V20, V10 and V5 were 12.67%, 25.10% and 40.40%, respectively. Conclusion As to physical dosage, OUR-QGD whole body γ rays radiotherapy is safe and feasible for patients with multiple pulmonary metastatic tumor.
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Key words:
- Pulmonary metastatic tumor /
- Body γ rays /
- Dose volume histogram（DVH）
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