摘要
目的比较基于等效均匀剂量(Equivalent Uniform Dose,EUD)的生物函数与基于剂量体积(Dose Volume,DV)的物理函数在Ⅲ期非小细胞肺癌(NSCLC)调强放疗中的剂量学差异。方法15例Ⅲ期非小细胞(NSCLC)病例分别设计4组不同放疗计划:A组,靶区、危及器官均使用物理函数优化(DV+DV);B组,靶区在使用物理函数优化的基础上加入生物函数优化条件,危及器官使用物理函数优化(DV-EUD+DV);C组,靶区、危及器官均使用生物函数优化(EUD+EUD);D组,靶区在使用生物函数优化的基础上加入物理函数优化条件、危及器官使用生物函数优化(EUD-DV+EUD)。比较4组计划在剂量学参数方面的差异。结果靶区方面:PTV:B组与D组D_(2%)、D_(98%)、D_(50%)、D_(105%)及D_(max)数值相对较小(P<0.05);C组相对最高(P<0.05);均匀性指数:B组及D组结果优于其他两组(P<0.05);适形性指数:4组结果相近(P>0.05)。危及器官方面:肺组织平均剂量(MLD)、V_(5)、V_(10)、V_(20)、V_(30)及心脏V_(30)、V_(40)、D_(mean)剂量参数结果相近(P>0.05),脊髓:C组及D组D_(1%)优于其他两组(P<0.05);机器跳数(MU)方面,4组无差异(P>0.05)。结论靶区采用物理与生物函数优化相结合的优化方法在保证治疗的前提下可以提高靶区均匀性;脊髓采用生物函数优化或生物函数与物理函数优化相结合能显著降低脊髓受量。
Objective To compare the dosimetric difference between the biological function based on equivalent uniform dose(EUD)and the physical function based on dose volume(DV)in the intensity modulated radiotherapy for stageⅢnonsmall cell lung cancer.Methods Four different radiotherapy plans were designed for 15 stageⅢnon-small cell lung cancer patients:Group A,physical function optimization(DV+DV)was used for target area and organs at risk;GroupB,in the target region,biological function optimization conditions were added on the basis of physical function optimization,and physical function optimization of organs at risk(DV-EUD+DV)was added.Group C,biological function optimization(EUD+EUD)was used for target area and organs at risk.Group D,in the target area,physical function optimization conditions were added on the basis of biological function optimization,and biological function optimization of organs at risk(EUD-DV+DV)was added.The differences in dosimetric parameters of the four plans were compared.Results Target area:PTV:D_(2%),D_(98%),D_(50%),D_(105%) and Dmax values of group C(P<0.05)is the highest while group B and group D were relatively small(P>0.05);The homogeneity index:the results of the group B and the group D were better than those of the other two groups(P<0.05).conformity index:The results of the four groups were similar(P>0.05).Organ at risk:lung tissue mean dose(MLD),V_(5),V_(10),V_(20),V_(30) and heart V_(30),V_(40),D_(mean) dose parameters were similar(P>0.05).Spinalcord:Group C and group D D_(1%) were better than the other two groups(P<0.05).There was no statistical difference in the number ofmonitor unit(MU)among the four groups(P>0.05).Conclusion The optimization method combining physical and biological function optimization in the target area can improve the conformity of the target area on the premise of ensuring the treatment.The Spinalcord load would be significantly reduced when using biological function optimization or the combination of biological function and physical function optimization.
作者
李贞虎
任洪荣
殷海涛
周云
周冲
LI Zhenhu;REN Hongrong;YIN Haitao;ZHOU Yun;ZHOU Chong(Graduate School of Xuzhou Medical University,Xuzhou 221000 China;Department of Radiotherapy,Xuzhou Medical College of Xuzhou Medical University,Xuzhou 221000 China)
出处
《中国辐射卫生》
2021年第3期303-308,共6页
Chinese Journal of Radiological Health
关键词
等效均匀剂量
剂量体积
非小细胞肺癌
调强放疗
Equivalent Uniform Dose
Dose Volume
Non-small Cell Lung Cancer
Intensity-modulated Radiation Therapy
