摘要
目的:对比分析容积旋转调强放射治疗(VMAT)和螺旋断层治疗(HT)两种技术在宫颈癌患者行盆腔骨保护计划中的剂量学差异。方法:选取2023年1月至2024年2月在蚌埠医科大学第一附属医院进行放射治疗的40例宫颈癌患者,采集患者的CT定位图像信息后勾画靶区与危及器官(OAR),并将盆腔骨作为OAR单独勾画。利用放射治疗计划系统(TPS)对每例患者分别设计共面双弧VMAT和HT两种骨髓剂量限定的放射治疗计划,并对两种计划的靶区剂量参数、适形度、均匀性与OAR剂量体积、平均剂量、点最大剂量等参数进行统计学分析。结果:VMAT、HT两种计划均能满足靶区与OAR剂量要求。常规OAR上,HT计划在膀胱40Gy剂量体积百分比(V_(40Gy))、平均剂量(D_(mean))、直肠V_(40Gy)和小肠点最大剂量(Dmax)分别为(38.97±2.29)%、(38.06±0.45)Gy、(61.50±2.51)%和(50.82±0.36)Gy,均低于VMAT计划,与VMAT计划比较差异有统计学意义(t=25.46、13.99、1.56、10.93,P<0.05)。骨盆VMAT计划的V_(10Gy)、V_(20Gy)、V_(30Gy)和D_(mean)分别为(70.76±2.51)%、(60.84±3.29)%、(52.40±2.56)%和(32.02±4.33)Gy,均显著低于HT计划,差异有统计学意义(t=-20.68、-13.23、-7.73、-10.26,P<0.05)。结论:HT计划在宫颈癌患者放射治疗中靶区剂量分布最优,能够更好地保护靠近靶区的OAR。VMAT计划在保护骨盆低剂量区上有明显优势,临床治疗中可根据患者情况进行个体化计划设计。
Objective:To compare the dosimetric differences between volumetric modulated arc therapy(VMAT)and helical tomotherapy(HT)in undergoing protective plan for pelvic bones of patients with cervical cancer.Methods:A total of 40 patients with cervical cancer,who underwent radiotherapy at the First Affiliated Hospital of Bengbu Medical University from January 2023 to February 2024,were selected for this study.The target volumes and organs at risk(OARs)were delineated after the information of computed tomography(CT)simulation images were acquired from each patient.The pelvic bone was alone delineated as OAR.Two kinds of bone marrow dose-limiting radiotherapy plans,coplanar dual-arc VMAT and HT,were respectively designed for each patient by using the treatment planning system(TPS)of radiotherapy.A statistical analysis was conducted to compare the dose parameters of target volume,conformity,homogeneity,OAR dose-volume,mean dose,and maximum dose of point between the two kinds of plans.Results:Both the VMAT and HT plans could meet the requirements of target volume and OARs for dose.For general OARs,the dose-volume percentage(V_(40Gy))of V_(40Gy) at bladder,mean dose(D_(mean)),rectal V_(40Gy),maximum dose(Dmax)at small intestine point of HT plan were respectively(38.97±2.29)%,(38.06±0.45)Gy,(61.50±2.51)%and(50.82±0.36)Gy.The differences of them between HT plan and VMAT plan were statistically significant(t=25.46,13.99,1.56,10.93,P<0.05).The V_(10Gy),V_(20Gy),V_(30Gy) and D_(mean) of VMAT plan were respectively(70.76±2.51)%,(60.84±3.29)%,(52.40±2.56)%and(32.02±4.33)Gy for pelvic bones,which were significantly lower than those of HT plan,and the differences of them between two kinds of plans were also statistically significant(t=-20.68,-13.23,-7.73,-10.26,P<0.05).Conclusion:The HT plan can provide the optimal dose distribution for target region in radiotherapy for patients with cervical cancer,which can better protect OAR nearby target region.VMAT plan has a significant advantage in low-dose regions of protecting pelvis.Thus,individualized treatment design should be conducted according to the conditions of each patient in clinical treatment.
作者
仇好
张菲菲
毕春
唐天红
李文静
石善成
王佳佳
施前进
Qiu Hao;Zhang Feifei;Bi Chun;Tang Tianhong;Li Wenjing;Shi Shancheng;Wang Jiajia;Shi Qianjin(Center of Radiotherapy,Siyang Hospital,Suqian 223700,China;Department of Radiation Oncology,The First Affiliated Hospital of Bengbu Medical University,Bengbu 233030,China)
出处
《中国医学装备》
2025年第3期22-28,共7页
China Medical Equipment
基金
泗阳医院与江苏大学附属医院第一届院内科技计划(2024SY007)。
