本文關鍵詞：腮腺癌術后兩種放療計劃的劑量學研究　出處：《吉林大學》2017年碩士論文　論文類型：學位論文

  更多相關文章： 腮腺癌 放射治療計劃 劑量學

【摘要】：目的:通過比較腮腺癌術后容積弧形調強放療(VMAT)和調強放射治療(IMRT)兩種放療技術各自的的優(yōu)劣,為腮腺癌術后患者臨床放射治療方案選擇上提供相應的理論支持,以期選擇最優(yōu)治療方案。材料和方法:自2013年7月至2017年3月在我院放療科接受放療的腮腺癌術后患者中選取10例分別制定VMAT及IMRT兩種放療計劃進行比較。具體放療范圍包括:術后瘤床區(qū)(GTVtb)、同側頸部淋巴引流區(qū)Ib、II區(qū)和III區(qū);以下情況需包括同側IV區(qū)和V區(qū):局部病灶T3和T4;淋巴結陽性;腫瘤病理類型為低分化。放療劑量為瘤床區(qū)(PGTVtb):5936c Gy/212c Gy/28F;預防區(qū)(PTV):5040c Gy/180c Gy/28F。通過對比兩種放療技術靶區(qū)劑量分布情況及劑量體積直方圖(DVH),比較兩種放療技術的靶區(qū)適形度指數(shù)(CI)、均勻性指數(shù)(HI)、D95、D5和平均劑量(Dmean);危及器官(包括顳頜關節(jié)、脊髓、內耳、對側腮腺及腦干)最大劑量(Dmax)和平均劑量(Dmean)。結果:(1)放療靶區(qū)劑量分布情況:VMAT計劃的Dmean、D95和D5均低于IMRT計劃,三項差異均無統(tǒng)計學意義。(2)CI方面:VMAT和IMRT二者的PGTVtb分別為0.71±0.09和0.57±0.04(P=0.018),P0.05,差異有統(tǒng)計學意義;PTV分別為0.82±0.04和0.72±0.03(P=0.003),P0.05,差異有統(tǒng)計學意義。HI方面:VMAT和IMRT二者的PGTVtb分別為1.06±0.02和1.14±0.05(P=0.017),P0.05,差異有統(tǒng)計學意義;PTV分別為1.15±0.04和1.23±0.04(P=0.028),P0.05,差異有統(tǒng)計學意義。(3)危及器官保護方面:VMAT和IMRT相比,對側腮腺Dmax、脊髓Dmax、腦干Dmax VMAT明顯低于IMRT,其中P0.05,差異有統(tǒng)計學意義;內耳Dmean高于IMRT,其中P0.05,差異有統(tǒng)計學意義;脊髓Dmean、顳頜關節(jié)Dmean VMAT均小于IMRT,其中P0.05,該差異無統(tǒng)計學意義;對側腮腺Dmean、腦干Dmean、內耳Dmax、顳頜關節(jié)Dmax均略高于IMRT,其中P0.05,結果不具有統(tǒng)計學意義。(4)治療時間和機器跳數(shù)方面:容積弧形調強治療技術與調強放療技術相比,治療時間和機器跳數(shù)都明顯減少,差異有統(tǒng)計學意義。結論:VMAT和IMRT均能滿足臨床劑量學需求,VMAT有更優(yōu)良的靶區(qū)CI和HI;二者均能很好保護危及器官,并且VMAT優(yōu)于IMRT;在治療時間及機器跳數(shù)方面VMAT明顯優(yōu)于IMRT,縮短治療時間,使治療更加精確。
[Abstract]:Objective: through the parotid carcinoma were compared after volumetric arc intensity-modulated radiotherapy (VMAT) and intensity-modulated radiotherapy (IMRT) for two types of radiation technology to their advantages and disadvantages, provide corresponding theoretical support for the selection of clinical treatment options for patients with parotid carcinoma after operation, in order to select the optimal treatment program. Materials and methods: from from July 2013 to March 2017 in patients receiving radiotherapy in radiotherapy department in our hospital after parotid carcinoma were selected from 10 cases were developed VMAT and IMRT two kinds of radiotherapy were compared. The specific scope includes: postoperative radiotherapy of tumor bed area (GTVtb), ipsilateral cervical lymph drainage area Ib, II area and III area; the following conditions should include the ipsilateral IV and V area: T3 and T4 positive lesion; lymph node; tumor pathological type was low differentiation. The radiation dose to the tumor bed area (PGTVtb): 5936c Gy/212c Gy/28F (PTV); prevention area: 5040c Gy/180c Gy/28F. by comparing the two kinds of technology of target dose distribution 鎯呭喌鍙婂墏閲忎綋縐洿鏂瑰浘(DVH),姣旇緝涓ょ鏀劇枟鎶，

本文編號：1395100