【摘要】 目的：探讨射线能量和调强计划对宫颈癌放疗计划质量的影响。方法：回顾性选取10例宫颈癌术后患者，每例患者在不同射线能量不同调强技术，使用6MV和10MV能量，动态调强技术（IMRT）和容积旋转调强技术（VMAT）,分别做6MV-IMRT、6MV-VMAT和10MV-IMRT、10MV-VMAT计划，用同样的处方和优化函数以及相同的布野方案和剂量体积约束，比较4种不同能量、不同调强技术的治疗计划在靶区适形指数（CI）、均匀指数（HI）以及危及器官限量和计划质量上的差异。结果：4种计划的肿瘤靶区的剂量参数D_2%、D_98%、D_50%、HI,以及危及器官膀胱、直肠的V_30Gy、V_40Gy、V_50Gy及D_mean,小肠的D_2%及D_mean、V_40Gy、V_45Gy,股骨头D_5%、D_mean、V_30Gy、V_20Gy均值无显著性差异，在同种能量不同调强计划PTV中，VMAT组的CI高于IMRT组，差异有统计学意义（P<0.05）。在盆腔骨受照射剂量中，VMAT组的V_10Gy高于IMRT组，差异有统计学意义（P<0.001）。VMAT组的机器跳数显著低于IMRT组，差异有统计学意义（P<0.001）。结论：射线能量的变化对宫颈癌的放疗计划质量影响无显著差异，IMRT和VMAT对计划靶区适形性指数和危及器官的盆腔骨，以及计划总机器跳数有显著差异。更多还原

【Abstract】 Objective: To investigate the impact of radiation energy and intensity-modulated radiotherapy plans on the quality of radiotherapy plans for cervical cancer. Methods: A retrospective study was conducted on 10 patients with cervical cancer after surgery. Each patient underwent radiotherapy plans using different radiation energies and IMRT techniques, specifically 6MV-IMRT, 6MV-VMAT, 10MV-IMRT, and 10MV-VMAT plans with 6MV and 10MV energies, dynamic intensity-modulated radiotherapy（IMRT）, and volumetric-modulated arc therapy（VMAT）. The same prescription and optimization functions, as well as identical field placement schemes and dose-volume constraints, were applied to compare the differences in target conformality index（CI）, homogeneity index（HI）, organ-at-risk constraints, and plan quality among the four plans with different energies and IMRT techniques. Results: There were no significant differences in the dose parameters of the tumor target region, including D_2%,D_98%,D_50%, and HI, as well as the V_30Gy,V_40Gy,V_50Gy, and D_mean for the bladder and rectum, D_2%,D_mean,V_40Gy,V_45Gy for the small intestine, D_5%, D_mean, V_30Gy, and V_20Gy for the femoral head among the four plans. Within the same energy level but different IMRT plans for PTV, the conformality index was higher in the VMAT group compared to the IMRT group, with statistically significant differences（P<0.05）. Additionally, in terms of pelvic bone irradiation dose, the V_10Gy in the VMAT group was higher compared to the IMRT group, with statistically significant differences（P<0.001）. Furthermore, the machine monitor units（MU） in the VMAT group were significantly lower than those in the IMRT group, with statistically significant differences（P<0.001）. Conclusion: Changes in radiation energy had no significant impact on the quality of radiotherapy plans for cervical cancer. However, there were statistically significant differences in the conformality index of the planned target volume, the irradiation dose to the pelvic bone as an organ-at-risk, and the total machine monitor units between different IMRT and VMAT.更多还原