| 螺旋断层动态钨门技术在宫颈癌术后放疗中的应用 |
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| 引用本文： | 吴骏翔,刘敏,康盛伟,王培,黎杰,唐斌,吴凡.螺旋断层动态钨门技术在宫颈癌术后放疗中的应用[J].中国医学物理学杂志,2020,37(11):1356-1359. |
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| 作者姓名： | 吴骏翔 刘敏 康盛伟 王培 黎杰 唐斌 吴凡 |
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| 作者单位： | 四川省肿瘤医院·研究所/四川省癌症防治中心/电子科技大学医学院/放射肿瘤学四川省重点实验室， 四川 成都 610041 |
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| 摘 要： | 目的:通过评估动态钨门技术的计划质量和执行效率，探讨能否在螺旋断层调强放疗中使用射野宽度5.0 cm的动态钨门代替2.5 cm的固定钨门应用于宫颈癌术后放疗。方法:选取25例宫颈癌术后患者，相同优化条件下分别使用射野宽度2.5 cm的固定钨门（2.5F）、2.5 cm的动态钨门（2.5D）和5.0 cm的动态钨门（5.0D）进行计划设计和评估。比较3组计划靶区的D95、Dmean、均匀性指数（HI）、适形度指数（CI）、危及器官的受照剂量、机器跳数和照射时间。结果:2.5D组得到的靶区CI和HI优于其他两组（P<0.05），其他剂量学参数的差异无统计学意义（P>0.05）。2.5F组与2.5D和5.0D组相比，直肠和膀胱的V20、V40、Dmean，以及小肠的V20均增加（P<0.05）；2.5F组与5.0D组相比，骨、股骨头和小肠的Dmean均降低（P<0.05）。与2.5D组相比，5.0D组的直肠、膀胱和小肠的V20、骨和小肠的Dmean均增加（P<0.05）。5.0D组的机器跳数和照射时间与2.5D和2.5F组相比分别减少了46.1%、45.1%、45.0%、44.1%（t=17.703、-40.698、17.654、-40.414, P<0.05）。结论:综合考虑计划质量和照射效率，建议采用5.0D组应用于宫颈癌术后螺旋断层调强放疗，在满足临床要求的同时可以显著缩短照射时间。若只考虑计划质量则选择2.5D组。
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| 关 键 词： | 螺旋断层调强放疗 动态钨门技术 宫颈癌术后 剂量学 |
Application of dynamic jaw technique in helical tomotherapy for postoperative cervical cancer |
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| WU Junxiang,LIU Min,KANG Shengwei,WANG Pei,LI Jie,TANG Bin,WU Fan.Application of dynamic jaw technique in helical tomotherapy for postoperative cervical cancer[J].Chinese Journal of Medical Physics,2020,37(11):1356-1359. |
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| Authors: | WU Junxiang LIU Min KANG Shengwei WANG Pei LI Jie TANG Bin WU Fan |
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| Affiliation: | Sichuan Cancer Hospital & Research Institute/Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China/Sichuan Provincial Key Laboratory of Radiation Oncology, Chengdu 610041, China |
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| Abstract: | Abstract: Objective To evaluate the plan quality and execution efficiency of dynamic jaw techniques and investigate the feasibility of replacing the fixed jaw 2.5 cm with dynamic jaw 5.0 cm in helical tomotherapy for postoperative cervical cancer. Methods A total of 25 cases of postoperative cervical cancer were sampled and divided into three groups and were applied fixed jaw 2.5 cm (2.5F), dynamic jaw 2.5 cm (2.5D) and dynamic jaw 5.0 cm (5.0D) separately in helical tomotherapy.The differences of D95, Dmean, Homogeneity Index (HI), Conformity Index (CI), dose to organs at risk (OARs), monitor unit and beam-on time were compared among these 3 groups. Results 2.5D plan was better in the aspects of the CI and HIin target area (P<0.05), but there were no statistically significant differences in other parameters (P>0.05). 2.5F plan was higher than 2.5D and 5.0D plans in the aspects of the V20, V40 and Dmean in the rectum and bladder and V20 in the intestine (P<0.05). As for the Dmean in the bone, femoral head and intestine, 2.5F plan was lower (P<0.05) than 5.0 D plan When it comes to the V20 in rectum, bladder and intestine and Dmean inintestine, 5.0D plan was higher (P<0.05) than 2.5D plan. The monitor unit and beam-on time in 5.0D plan was significantly reduced by 46.1%, 45.1%, 45.0%, 44.1% respectively,compared with those in 2.5D and 2.5F plans respectively (t=17.703, -40.698, 17.654, -40.414, P<0.05). Conclusion 5.0D plan could meet clinical requirements and its beam-on time was significantly reduced. 5.0D plan is recommended for treatment of postoperative cervical cancer when both plan quality and radiation efficiency are considered, but the 2.5D plan is recommended, if only plan quality is concerned. |
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| Keywords: | Keywords: helical tomotherapy postoperative cervical cancer dynamic jaw dosimetry |
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