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中国癌症防治杂志

中国癌症防治杂志 ›› 2016, Vol. 8 ›› Issue (4): 230-234.doi: 10.3969/j.issn.1674-5671.2016.04.07

• 临床研究 • 上一篇    下一篇

鼻咽癌螺旋断层调强与快速旋转调强放射治疗的剂量学比较

  

  1. 武警边防总医院放射治疗科 深圳武警医院放射治疗科；解放军总医院放射治疗科
  • 出版日期:2016-08-25 发布日期:2016-09-12
  • 通讯作者: 戴相昆 13520924521@163.com
  • 基金资助:

    解放军总医院临床扶持研究基金资助项目（2015FC-TSYS-1008）

Dosimetric comparison of helical tomotherapy and rapid arc therapy for patients with nasopharyngeal carcinoma

  • Online:2016-08-25 Published:2016-09-12

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被引次数

1

摘要：

目的 比较螺旋断层调强（helical tomotherapy，HT）与快速旋转调强（rapid arc，RA）在鼻咽癌放疗计划中的剂量学差异。方法 回顾性选取11例接受放疗的鼻咽癌患者，分别设计HT计划与RA计划。根据两组计划的剂量体积直方图（dose volume histogram，DVH）统计靶区剂量、危及器官（organs at risk，OARs）的受照射剂量，并计算计划靶区的适形度指数（conformity index，CI）与均匀性指数（homogeneity index，HI）。比较两种计划的机器跳数（monitor unit，MU）、治疗时间和Gamma通过率。结果 两组计划的靶区剂量分布以及OARs的受照射剂量均能满足临床治疗要求，HT计划和RA计划的Gamma通过率分别为（99.06±0.45）%和（98.7±0.46）%。但HT计划的靶区HI以及对脊髓、晶体和腮腺的保护优于RA计划。RA计划能够降低眼球、视神经、视交叉以及靶区外正常组织的受照射剂量，RA计划的出束时间和MU较HT计划分别降低了60%和85%。结论 两种技术均能满足鼻咽癌放疗的剂量学要求，但RA计划可以显著提高疗效。

关键词: 鼻咽肿瘤, 螺旋断层调强, 快速旋转调强, 放射疗法, 剂量学

Abstract:

Objective To compare dosing levels and exposure of organs at risk（OARs） after treating patients with nasopharyngeal carcinoma using helical tomotherapy （HT） or rapid arc therapy （RA）. Methods Eleven patients were subjected to HT and RA using simultaneously integrated boost，and examined by computed tomography. The two techniques were compared in terms of dose volume histograms（DVH），isodose distribution，dosing of OARs，monitor units （MU），treatment time and Gamma value. Results Both HT and RA showed good target coverage and acceptable OAR sparing. HT was superior to RA for dosing the HI and for sparing certain OARs；for example，HT was associated with lower maximum doses to the cord and lens and parotids. RA was superior to HT for protecting the chiasm and optic nerves and eyes，and it was associated with 60% shorter treatment time and 85% lower MU. Both techniques were associated with a similar Gamma result. Conclusion Both HT and RA are clinically useful for treating nasopharyngeal carcinoma，but RA may be more efficient.

Key words: Nasopharyngeal neoplasms, Helical tomotherapy, Rapid Arc, Radiotherapy, Dosimetry