摘要
目的胃癌放射治疗在胃癌术后辅助治疗中发挥重要作用,目前胃癌放疗主要应用静态调强和共面容积调强技术,随着非共面容积调强在其他肿瘤放疗中逐渐被应用,在胃癌中尚缺乏数据。本研究分析共面和非共面容积调强在胃癌放疗中的剂量学差异,为临床应用提供指导。方法随机选取2019-07-01-2017-12-01蕲春县人民医院肿瘤科10例中早期胃癌术后患者,分别设计共面和非共面容积旋转调强计划,并使用配对t检验比较两组计划靶区和危及器官的剂量分布差异。结果共面和非共面容积调强均可以达到靶区剂量覆盖的要求,但非共面容积调强在均匀性指数(t=5.547,P=0.013)和适形度指数(t=6.310,P=0.008)上优于共面容积调强;在脊髓Dmax(t=8.214,P=0.004),双肾V5和Dmean(左肾V5:t=3.334,P=0.041;Dmean:t=3.475,P=0.032;右肾V5:t=2.625,P=0.039;Dmean:t=5.462,P=0.020)以及肝脏V10(t=3.325,P=0.025)指标上,非共面容积调强优于共面容积调强;肝脏V30、V40和小肠Dmax上非共面容积调强和共面容积调强之间差异无统计学意义,均P>0.05。结论使用非共面容积调强可以在胃癌术后放疗中有助于提高靶区的适形度和均匀度,同时降低脊髓Dmax,双肾V5和Dmean以及肝脏V10,但在肝脏V30,V40和小肠Dmax上无明显改善。
OBJECTIVE Radiation therapy for gastric cancer plays an important role in postoperative adjuvant therapy.At present,static intensity modulation and coplanar volume intensity modulation are mainly used in gastric cancer radiotherapy.With the gradual application of non coplanar volume intensity modulation in other tumor radiotherapy,there is still a lack of data in gastric cancer.In order to provide guidance for clinical application,this study analyzed the dosimetric differences between coplanar and non coplanar volume intensifier in gastric cancer radiotherapy.METHODS From July 1 to December 1,2019,a total of 10 patients with early gastric cancer were randomly selected from the oncology department of Qichun People’s Hospital to design a coplanar and non coplanar volume rotation intensity modulation plan,and the paired t test was used to detect the dose distribution difference between the two groups in the planned target area and the organs at risk.RESULTS Both coplanar and non-coplanar volumetric modulated arc therapy(VMAT)can meet the requirements of target dose coverage,but non-coplanar VMAT was significantly better than coplanar VMAT on heterogeneity index(t=5.547,P=0.013)and conformity index(t=6.310,P=0.008);On the Dmaxof Spine,V5 and Dmeanof kidneys and V10of liver,the non-coplanar VMAT was significantly better than the coplanar VMAT(Spine Dmax:t=8.214,P=0.004;Left kidney V5:t=3.334,P=0.041;Dmean:t=3.475,P=0.032;Right kidney V5:t=2.625,P=0.039;Dmean:t=5.462,P=0.020;Liver V10:t=3.325,P=0.025);no statistical difference was found between the non-coplanar VMAT and coplanar VMAT on the V30,V40of liver and Dmaxof small intestine,all P>0.05.CONCLU-SION The use of non-coplanar VMAT can improve the conformality and uniformity of the target area in postoperative radiotherapy for gastric cancer,while reducing Dmaxof spinal cord,V5 and Dmeanof kidney and V10of liver,but on the V30,V40of liver and Dmaxof small intestine no significant improvement is found.
作者
明淑凤
童光武
童肖广
黄卫彬
吴志权
MING Shu-feng;TONG Guang-wu;TONG Xiao-guang;HUANG Wei-bin;WU Zhi-quan(Qichun People's Hospital,Qichun435300,P.R.China)
出处
《社区医学杂志》
2020年第16期1139-1142,共4页
Journal Of Community Medicine
关键词
胃癌
放射治疗
容积旋转调强
剂量学
gastric cancer
radiotherapy
volumetric modulated arc therapy
dosimetry
作者简介
第一作者:明淑凤,女,湖北鄂州人,主治医师,主要从事肿瘤放射治疗技术的临床研究工作。Tel:86-713-7308888,E-mail:hgmf91705@163.com;通信作者:童肖广,男,湖北蕲春人,主任医师,主要从事骨肿瘤放射治疗的临床研究工作。Tel:86-713-7232978,E-mail:jollens@163.com
