摘要
目的分析比较膀胱癌术后患者螺旋断层放射治疗(TOMO)与常规加速器容积旋转调强放射治疗(VMAT)剂量学差异,为该疾病放射治疗技术的选择提供参考。方法选取北京协和医院2019年1月至2019年12月收治的10例膀胱癌经尿道膀胱肿瘤电切术(TURBT)后接受放射治疗的患者。在其定位CT图像上勾画靶区(CTV)及危及器官(OAR),然后分别设计TOMO计划和VMAT计划。评价95%靶区体积所接受的剂量(D95%)、靶区平均剂量(Dmean)、靶区最大剂量(Dmax)、靶区最小剂量(Dmin)、靶区适形度指数(CI)、靶区均匀度指数(HI)以及直肠、小肠、骨盆骨髓、股骨头等OAR的V20、V30、V40、D5、D10、Dmean和Dmax。结果两种计划均满足临床剂量学要求,TOMO计划靶区的Dmean、Dmax、Dmin及HI均优于VMAT计划(均P<0.05)。OAR方面,小肠的V20、V30;右侧股骨头Dmax;直肠Dmax;骨盆骨髓Dmean和Dmax,TOMO计划均优于VMAT计划(均P<0.05)。结论对于膀胱癌TURBT术后行放射治疗的患者,TOMO计划和VMAT计划均能满足临床剂量学要求,但前者有更多的剂量学优势,具有较好的靶区适形度和均匀性以及较低的危及器官受量,可为膀胱癌放射治疗方案的选择提供参考。
Objective To analyze and compare the dosimetric difference between helical tomotherapy(TOMO)and volumetric modulated arc therapy(VMAT)in postoperative patients with bladder cancer,so to provide a reference for optimal radiotherapy technique for this disease.Methods Ten bladder cancer patients with who were received radiotherapy after transurethral bladder tumor resection(TURBT)from January 2019 to December 2019 in Peking Union Medical College Hospital were included.Clinical target volume(CTV)and organ at risk(OAR)were delineated on the CT images,and then the TOMO plans and the VMAT plans were designed,respectively.The difference was evaluated by D95%,Dmean,Dmax,Dmin,and CI,HI of the target volume,and V20,V30,V40,D5,D10,Dmean and Dmax of the rectum,small intestine,pelvic bone marrow,femoral head and other OARs.ResultsBoth TOMO and VAMT plans met the clinical dosimetry needs,and the Dmean,Dmax,Dmin and HI of the targetvolume of the TOMO plans were better than those of the VMAT plans(all P<0.05).In terms of OARs,TOMO plans were better than VMAT plans,as comparing to the V20 and V30 of small intestine,Dmax of the right femoral head,Dmax of the rectum,Dmean and Dmax of the pelvic bone marrow(P<0.05).Conclusions For bladder cancer patients who received radiotherapy after TURBT,both the TOMO plans and VMAT plans can achieve the clinical dosimetry needs,but the TOMO plans exhibit more dosimetry advantages,better target volume conformity and uniformity,and lower exposure of OARs.These results may function as a potential reference for the choice of radiotherapy plan for bladder cancer patients.
作者
李洪明
于浪
黎蕊
沈捷
张福泉
吴松
LI Hong-ming;YU Lang;LI Rui;SHEN Jie;ZHANG Fu-quan;WU Song(Mudanjiang Medical University,Mudanjiang 157000;Department of Radiotherapy,Peking Union Medical College Hospital,CAMS & PUMC, Beijing 100730;Department of Urology, the Third Affiliated Hospital of Shenzhen University,Institute Urology of Shenzhen University,Shenzhen 518000, China)
出处
《基础医学与临床》
CSCD
2020年第11期1529-1533,共5页
Basic and Clinical Medicine
基金
深圳市重点实验室资助项目(ZDSYS20190902092857146)
罗湖区医学重点学科建设项目(精准实验室)。
作者简介
通信作者:吴松,Doctor_wusong@126.com;通信作者:张福泉,zhangfuquan3@sina.com。
