| 赵 玲,卜明伟,杨筑春.VMAT应用于局部晚期直肠癌术前同步放化疗的剂量学研究[J].中国肿瘤,2016,25(7):575-578. |
| VMAT应用于局部晚期直肠癌术前同步放化疗的剂量学研究 |
| A Dosimetric Study on the Application of VMAT in Preoperative Concurrent Chemoradiotherapy for Locally Advanced Rectal Cancer |
| 投稿时间：2015-10-21 |
| DOI：10.11735/j.issn.1004-0242.2016.07.A014 |
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| 中文关键词: 动态容积调强 静态调强 直肠癌 术前 |
| 英文关键词:VMAT IMRT rectal neoplasms preoperative |
| 基金项目:吉林省卫生厅科研项目（2012Z093） |
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| 中文摘要: |
| 摘 要：［目的］ 比较局部晚期直肠癌术前静态调强放疗(IMRT)与动态容积调强放疗(VMAT) 计划的剂量学差异。［方法］ 应用Pinnacle 9.0治疗计划系统分别对10例术前同步放化疗的直肠癌患者行IMRT和VMAT放疗计划设计，比较两种放疗技术的靶区剂量分布特点以及小肠、膀胱、双侧股骨头等危及器官的受照射剂量及体积。［结果］ 10例患者的靶区中位体积为2321.25cm3(2021.19cm3~2741.65cm3)。IMRT和VMAT计划均能满足计划设计要求。VMAT与IMRT计划靶区的Dmax、Dmin、Dmean、V95%、V100%和V105%均无统计学差异，适形指数（CI）和均匀指数（HI）亦均无统计学差异（P＝0.522，P＝0.452）。VMAT计划对小肠的保护较好，VMAT计划中小肠受量的Dmax、Dmean、V40及V50较IMRT计划均有明显下降（P＝0.014，0.044，0.018和0.043）。两组计划中膀胱及双侧股骨头受量的指标Dmax、Dmean、V50均未见统计学差异。VMAT计划的平均加速器跳数（MU）为507.220，IMRT计划为528.060（P＝0.003）。IMRT计划平均治疗时间390s，VMAT计划为157s（P<0.001）。［结论］ VMAT计划具有降低总MU，缩短治疗时间及减少小肠受照射剂量的优势，但仍需要多中心、大样本的临床研究进一步证实。 |
| 英文摘要: |
| Abstract：［Purpose］ To compare the dosimetric differences between preoperative static intensity-modulated radiotherapy (IMRT) and volumetric-modulated arc therapy (VMAT) in locally advanced rectal cancer. ［Methods］ IMRT and VMAT planning were conducted respectively in 10 rectal cancer patients underwent preoperative concurrent chemoradiotherapy by using the Pinnacle treatment planning system 9.0. Target dose distribution as well as exposure dose and volume to the organs at risk including small intestine，bladder，bilateral femoral heads，etc. of IMRT and VMAT were compared. ［Results］ The median target volume of the 10 patients was 2321.25cm3 (2021.19~2741.65cm3). Both IMRT and VMAT planning could meet planning design requirements. No statistical differences in Dmax，Dmin，Dmean，V95%，V100% or V105% in the target area between IMRT and VMAT planning were detected. Also，no statistical differences in HI or CI were observed (P=0.522 and P=0.452，respectively). VMAT planning was superior to IMRT planning in protecting small intestine，with Dmax，Dmin，V40 and V50 of small intestine in VMAT planning all obviously decreased as compared with IMRT planning(P=0.014，P=0.044，P=0.018 and P=0.043，respectively). However，there were no statistical differences in Dmax，Dmean or V50 of bladder and bilateral femoral heads between IMRT and VMAT planning. The average MU in VMAT planning was 507.220，while the average MU in IMRT planning was 528.060(P=0.003). The average treatment duration of IMRT and VMAT planning was 390 seconds and 157 seconds，respectively，revealing that VMAT planning evidently shortened the treatment duration(P=0.000). ［Conclusion］ VMAT planning has advantages of reducing overall MU，shortening treatment duration and decreasing exposure dose to the small intestine. Thus it is worthy of clinical promotion. Nevertheless，more multi-center and large-sample clinical studies are needed for further confirmation. |
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