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不同放疗技术在胃癌术后放疗中的剂量学研究[J]. 肿瘤防治研究, 2011, 38(05): 571-574. DOI: 10.3971/j.issn.1000-8578.2011.05.025
引用本文: 不同放疗技术在胃癌术后放疗中的剂量学研究[J]. 肿瘤防治研究, 2011, 38(05): 571-574. DOI: 10.3971/j.issn.1000-8578.2011.05.025
Dosimetry Studies of Different Radiation Technique for Postoperative Gastric Cancer[J]. Cancer Research on Prevention and Treatment, 2011, 38(05): 571-574. DOI: 10.3971/j.issn.1000-8578.2011.05.025
Citation: Dosimetry Studies of Different Radiation Technique for Postoperative Gastric Cancer[J]. Cancer Research on Prevention and Treatment, 2011, 38(05): 571-574. DOI: 10.3971/j.issn.1000-8578.2011.05.025

不同放疗技术在胃癌术后放疗中的剂量学研究

Dosimetry Studies of Different Radiation Technique for Postoperative Gastric Cancer

  • 摘要: 目的比较胃癌三维适形放疗(3DCRT)、7野分野放疗(7FRT)与调强放射治疗(IMRT)三种技术的剂量学差异,为临床应用提供参考。 方法选取5名在本院行胃癌根治术后的胃癌患者。每名患者制定上述三种放疗计划,给予95%PTV 45Gy的处方剂量,用等剂量曲线和剂量体积直方图(DVH)评价治疗计划,评价 参数包括V95%、V110%、适形指数(CI)、不均匀性指数(HI)、外部体积指数(EI)及正常组织受照剂 量。结果靶区适形性IMRT优于3DCRT及7FRT(P<0.05),3DCRT与7FRT差异无统计学意义(P>0.05);靶 区剂量分布均匀性,IMRT优于3DCRT及7FRT(P<0.05),3DCRT优于7FRT(P<0.05);外部体积指数IMRT 优于3DCRT及7FRT(P<0.05),3DCRT与7FRT无明显统计学差异(P>0.05);IMRT对肝脏的保护优于优于3DCRT及7FRT(P<0.05),7FRT的肝脏D1/3优于3DCRT(P<0.05),3DCRT与7FRT在肝脏受到的平均剂量 (Dmean)上差异无统计学意义(P>0.05);脊髓的最高受量(Dmax):3DCRT优于7FRT及IMRT(P<0.05),7FRT优于IMRT(P<0.05);3DCRT、7FRT及IMRT在肾脏的受量上差异无统计学意义。结论IMRT优于3DCRT及7FRT;3DCRT的HI、脊髓Dmax优于7FRT。7FRT的肝脏D1/3优于3DCRT。IMRT对于胃癌放疗具有放射物理的优势。

     

    Abstract: ObjectiveTo compare the dose distributions and dose-volume histograms (DVHs) in critical organs of three-dimensional conformal radiotherapy(3DCRT),7 fields radiotherapy(7FRT) and intensity modulated radiation therapy(IMRT) through the analysis of planning target volume(PTV) in gastric cancer treatment. MethodsFive patients with pathologically confirmed stage T3,T4 N0M0 gastric carcinoma who underwent radical gastrectomy were enrolled in our study. Dosimetry studies were carried out by three different treatment planning, such as 3DCRT, 7FRT or IMRT, in which each patient was prescribed a dose of 45Gy to 95% of PTV.The parameters of isodose distributions line, dose-volume histogram(DVH), V95%, V110%,CI, HI, EI of target volume and the dose of related critical organs were investigated. ResultsIMRT showed best dose uniformity and conformity, EI than 3DCRT and 7FRT(P<0..05), and there was no statistical difference between 3DCRT and 7FRT in CI and EI(P>0.05). 3DCRT was superior to 7FRT in CI(P<0.05).IMRT had advantage at sparing liver compared with 3DCRT and 7FRT(P<0.05),7FRT showed better D1/3 of liver than 3DCRT(P<0.05),but no difference between 3DCRT and 7FRT in Dmean of liver(P>0.05) was observed. 3DCRT had more increased Dmax of spinal cord than IMRT or 7FRT(P<0.05), and 7FRT was superior to IMRT(P<0.05).The dose exposed by the both kidneys was not significantly different among 3DCRT, 7FRT or IMRT. ConclusionPlans of IMRT were superior to 3DCRT and 7FRT,and 3DCRT plans were superior to 7FRT in CI and Dmax of spinal cord. 7FRT showed better D1/3 of liver than 3DCRT.IMRT would appear to be the favored technique for gastric cancer radiation for clinical therapy.

     

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