中国医学装备2025，Vol.22Issue(4)：13-17,5.DOI:10.3969/j.issn.1672-8270.2025.04.003
螺旋断层调强放射治疗系统对局部晚期非小细胞肺癌患者危及器官受照剂量参数的影响
Effect of TOMO therapy on the parameters of exposure dose of organs at risk in locally advanced NSCLC patients
摘要
Abstract
Objective:To analyze the effect of the TOMO therapy on the exposure dose and volume of organs at risk(OAR)in patients with locally advanced non-small cell lung cancer(NSCLC),so as to analyze the TOMO's advantages.Methods:A total of ninety-eight patients with locally advanced NSCLC who received TOMO treatment at the General Hospital of PLA Southern Theatre Command from January 2019 to March 2024 were selected.The TOMO plan was designed for 54 patients,and the volumetric modulated arc therapy(VMAT)plan was designed for 44 patients.The effect of the two plans on the parameters of exposure dose in OAR was compared and analyzed.Results:The conformity index(CI)values of planning target volume(PTV)and planning gross tumor volume-T(PGTV-T)in the TOMO plan were respectively(0.769±0.012)and(0.756±0.011),which were higher than those in the VMAT plan.The homogeneity index(HI)value of PTV in the TOMO plan was(0.138±0.014),which was lower than that in the VMAT plan.The differences of the above indicators between TOMO plan and VMAT plan were statistically significant(t=4.457,6.993,7.245,P<0.05).In all NSCLC patients,the exposure volume(V5 Gy)of receiving 5Gy dose on whole lung and the V30 Gy on heart in OAR in the TOMO plan were respectively(45.251±1.652)％ and(21.002±1.265)％,which were better than those in the VMAT plan,with statistically significant differences(t=3.931,6.169,P<0.05).However,the V20 Gy of the whole lung in the VMAT plan was better than that in the TOMO plan,with statistically significant difference(t=4.346,P<0.05).In the left lung of NSCLC patients,the V20 Gy of the whole lung and the V30 Gy of the heart of OAR in the TOMO plan were respectively(24.278±1.456)％and(21.365±1.687)％,which were better than those in the VMAT plan,with statistically significant differences(t=9.140,4.992,P<0.05).The V40Gy of the heart in the VMAT plan was better than that in the TOMO plan,with statistically significant difference(t=1.422,P<0.05).In the right lung of NSCLC patients,the V50 Gy of the whole lung and the V40 Gy of the heart of the OAR of the TOMO plan were better than those of the VMAT plan,with statistically significant differences(t=7.460,6.201,P<0.05).There were no significant differences in the V20 Gy of the whole lung,V30 Gy of the heart,V50 Gy of the esophagus,and the maximum dose(Dmax)of spinal cord between the two plans(P>0.05).Conclusion:The conformity of PTV radiation of TOMO plan is the best in patients with locally advanced NSCLC,which is more suitable for the locally advanced NSCLC in right and left lungs.关键词
螺旋断层放射治疗(TOMO)系统/非小细胞肺癌(NSCLC)/容积弧形调强放射治疗(VMAT)/危及器官(OAR)Key words
Tomotherapy system/Non-small cell lung cancer(NSCLC)/Volumetric modulated arc therapy(VMAT)/Organs at risk(OAR)分类
医药卫生引用本文复制引用
陈莹,黄文涛,徐志勇..螺旋断层调强放射治疗系统对局部晚期非小细胞肺癌患者危及器官受照剂量参数的影响[J].中国医学装备,2025,22(4):13-17,5.基金项目
广东省医学科研基金(C2022134) Guangdong Provincial Medical Research Fund Directive Project(C2022134) （C2022134）
