中国癌症防治杂志Issue(3)：275-279,5.DOI:10.3969/j.issn.1674-5671.2014.03.12
食管癌静态调强放疗与容积调强弧形放疗计划的剂量学比较
Comparison of dosimetry achieved using volumetric modulated arc therapy or static intensity-modulated radiotherapy to treat esophageal neoplasm
摘要
Abstract
Objective To compare the feasibility of using volumetric modulated arc therapy (VMAT)or static intensity-modulated radiotherapy (IMRT)to treat advanced esophageal neoplasm. Methods A consecutive series of 37 patients newly diagnosed with esophageal neoplasm was analyzed by computed tomography,and the resulting images were input into the oncentra planning system to generate protocols for IMRT and VMAT. All 37 patients received both types of treatment. Dose-volume histograms were generated to compare gross tumor volume (GTV),planning target volume (PTV) and exposure of at-risk organs. Different results for each method were assessed for statistical significance using the paired t-test. Results VMAT gave slightly but not significantly higher values than IMRT for PTV-D98 (58.39±1.03 vs 58.51±0.57,P=0.314)and PTV-D2 (65.92±1.57 vs 66.17±1.25,P=0.230). VMAT was associated with significantly lower GTV D98 (60.03±1.23 vs 62.46±1.03,P<0.001),D2 (64.83±0.91 vs 66.08±1.01,P=0.001), and Dmean(63.62±1.28 vs 64.07±1.08,P=0.021). VMAT also gave significantly lower PTV-V105 coverage(t=-8.216,P<0.001). The two methods were associated with similar conformity index(t=-0.147,P=0.884),homogeneity index(t=2.56,P=0.89),spinal dose (P=0.743)and heart dose (P=0.519). VMAT was associated with lower lung V20 than IMRT (t=-12.690,P<0.001),as well as lower lung V30(t=-2.870,P=0.007)and lower mean lung dose(t=-3.659,P=0.001). Mean MU was 24% lower with VMAT than with IMRT (572.33 vs 754.95). Conclusion In patients with esophageal neoplasms,VMAT can provide equivalent or superior dose distributions compared to IMRT,and it can generate more and better GTV hotspots. VMAT is also associated with lower lung V20 and V30,lower MU,and higher delivery efficiency. These findings suggest that VMAT has strong potential for treating esophageal cancer.关键词
食管肿瘤/放疗/静态调强放疗/容积调强弧形放疗/剂量学Key words
Esophageal neoplasm/Radiotherapy/Static intensity modulate radiotherapy/Volumetric modulated arc therapy/Dosimetry分类
医药卫生引用本文复制引用
何志杰,王晓敏,赵一电,孙秀珂,王慧涛,张强,陈龙..食管癌静态调强放疗与容积调强弧形放疗计划的剂量学比较[J].中国癌症防治杂志,2014,(3):275-279,5.基金项目
广西自然科学基金资助项目 （）
