中国医学装备2017，Vol.14Issue(7)：13-18,6.DOI:10.3969/J.ISSN.1672-8270.2017.07.004
Avoidance Sectors在中段食管癌VMAT放射治疗计划设计中的应用
Application of the avoidance sectors in the design of VMAT plan for midpiece esophageal carcinoma
摘要
Abstract
Objective: To explore the application of Avoidance Sectors in the design of volumetric modulated arc therapy (VMAT) plan for midpiece esophageal carcinoma. Methods: 8 patients with midpiece esophageal carcinoma were selected. VMAT plans of 4 groups were designed by using the Eclipse planning system. According to four avoidance angle on the left and right sides of horizontal axis of double arc, the plans were divided into 4 groups (P0 group, P30 group, P60 group and P90 group) and the P0 group didn't receive avoidance. A series of indicators, such as V95, V110, conformal index (CI), homogeneity index (HI) and dosage volume parameter of every organ at risk (OAR) of 4 planning target region groups, were compared, and then their implement efficiencies were evaluated through monitor unit (MU). Results: All of the 4 groups achieved appreciating cover for target region as prescription dosage, while HI and CI appeared decrease in different degree after angle was avoided, and the decrease of CI was obviously with the increase of avoided angle. The low dosage volume of double lung, especial the V5, were obviously decrease with the increase of avoided angle, while the high dosage volume (V30, V40) have obviously increased trend. All of the differences of pairwise comparisons (P0 and P60, P0 and P90, P30 and P60, P30 and P90, P60 and P90) were statistically significant except for the comparison between P0 and P30. While the difference of the Dmean of double lunge among different groups was small and only the difference between P30 and P90 was statistically significant (t=2.945, P<0.05). Dmax of spinal cord among the 4 groups were no significant. Only V40 and Dmean of heart of P30 group were smaller than that of P0 group, while the difference was no significant. And V40 and Dmean of heart of other planning groups were increase with the increase of avoidance angle. On the implement efficiency, the MU of P60 was minimum (532.17±118.23), the difference of MU between P60 group and P0 group was statistically significant (t=4.265, P<0.05). Conclusion: The application of Avoidance Sectors procedure to avoid proper angle in VMAT planning design of using two arc for midpiece esophageal carcinoma can significantly reduce the low dose volume for two lungs, while this application is not optimal in high dosage volume. Therefore, this method should be chosen according to the specific circumstances.关键词
容积旋转调强放射治疗/Eclipse计划系统/食管癌/剂量学/放射治疗/治疗计划系统Key words
VMAT/Eclipse/Esophageal carcinoma/Dosimetry/Radiotherapy/Therapy planning sysytem分类
医药卫生引用本文复制引用
王严兴,解传滨,徐寿平,丛小虎,戴相昆,陈高翔,王金媛..Avoidance Sectors在中段食管癌VMAT放射治疗计划设计中的应用[J].中国医学装备,2017,14(7):13-18,6.基金项目
国家重点研发计划(2016YFC0904600)"以生物组学特征与多模态功能影像为基础的多线束精准放疗方案研究" （2016YFC0904600）
解放军总医院临床科研扶持基金(2017FC-WJFWZX-04)"基于旋转调强全中枢照射的临床研究" （2017FC-WJFWZX-04）
