非小细胞肺癌不同调强放疗方案剂量学对比研究

【作者】 季永领； 许亚萍； 马胜林； 孙晓江； 王健； 狄小云；

【机构】 浙江省肿瘤医院；

【摘要】 目的探讨非小细胞肺癌调强放疗计划设计的合理方案。方法对11例非小细胞肺癌患者分别制定两种放疗计划:"PTV60"计划的PTV为CTV(GTV+6～8mm)+呼吸动度+摆位误差,对PTV获得60 Gy处方剂量进行归一;"PTV70"计划PTV为GTV+呼吸动度+摆位误差,对PTV获得70 Gy处方剂量进行归一。通过剂量体积直方图分析两种治疗计划的靶区剂量分布和危及器官受量,并进行剂量学的对比研究。结果"PTV70计划"接受60 Gy剂量的靶区体积明显高于"PTV60计划",两组在靶区剂量均匀性方面相似。"PTV70计划"的肺V20较"PTV60计划"平均下降(1.69±0.42)%,两组相比有显著统计学差异(P=0.002);肺V5平均下降(1.29±1.09)%,两组相比差异无统计学意义(P=0.264)。结论以GTV+呼吸动度+摆位误差作为PTV、并以PTV获得70 Gy处方剂量进行归一的调强计划明显优于以CTV+呼吸动度+摆位误差作为PTV、并以PTV获得60 Gy处方剂量进行归一的调强计划。更多还原

【Abstract】 Objective To investigate the optimal treatment planning of intensity modulated radiotherapy(IMRT) for non-small cell lung cancer(NSCLC). Methods Two types of treatment plans were designed for 11 patients with inoperable NSCLC disease.In the first plan(PTV60 plan),60Gy was prescribed to the planning target volume(PTV) which was created using CTV(GTV+6～8 mm) plus the margin for organ motion and setup uncertainties.And in another plan(PTV70 plan),70Gy was prescribed to the PTV which was created using GTV plus the margin for organ motion and setup uncertainties.All plans were compared according to dose-volume histogram,the planning target volume coverage,and other dosimetric parameters of normal structures. Results Commpared with the PTV60 plan,the PTV70 plan significantly improved 60Gy volume with regard to PTV coverage,and without significant difference in the heterogeneity.The V20 of lung were reduced with a median reduction of(1.69±0.42)%,the difference was significant(P=0.002).And the V5 were reduced with a median reduction of(1.29±1.09)%,without significant difference(P=0.264). Conclusion The planning of 70Gy to the PTV using GTV plus the margin for organ motion and setup uncertainties were better than that of 60Gy to the PTV using CTV(GTV+6～8 mm) plus the margin for organ motion and setup uncertainties.更多还原