调强适形放射治疗与三维适形放射治疗技术治疗原发性肝癌的临床剂量学研究

目的:探讨调强适形放射治疗(IMRT)与三维适形放射治疗(3D-CRT)技术治疗原发性肝癌的临床剂量学。方法:选取入住本院的45例原发性肝癌患者,针对每例患者制定2套放射治疗计划,比较计划靶区(PTV)的平均剂量、最小剂量、最大剂量及最大剂量与处方剂量的百分比、靶区适形指数以及靶区均匀指数,分析危及器官的照射剂量。结果:统计分析显示,最小受照剂量(PTVD min)中,两者差异无统计学意义(t=0.037,P>0.05);平均受照剂量(PTVD mean)、最大受照剂量(PTVDmax)、靶区最大剂量与处方剂量的百分比(PTVDmax/%)、靶区剂量均匀度指数(HI)和适形度指数(CI)IMRT与3D-CRT差异均具有统计学意义(t=35.631,t=4.136,t=3.428,t=2.123,t=15.996;P<0.05)。危及器官的照射剂量分析中,IMRT在肾脏、胃、十二指肠和脊髓的剂量明显低于3D-CRT的照射剂量。结论:IMRT能有效地提高靶区的照射剂量,降低危及器官的损伤。

Clinical Dosimetric Research on IMRT and 3D-CRT for Hepatocellular Carcinoma Treatment

Objective： To explore the clinical dosimetry of intensity modulated radiation therapy（IMRT） and three dimensional conformal radiotherapy（3D-CRT） for hepatocellular carcinoma treatment. Methods： Firstly, making radiotherapy schemes of IMRT and 5D-CRT for each patient among 45 ones in our hospital. Secondly, comparing PTVDmean, PTVDmin, PTVDmax, PTVDmax% , CI and HI. Finally, analyzing the dosage which endangers patient＇s organs. Results： Comparation analysis results show that there is no statisiicai difference in PTVDmin （t=0.037, P 〉0.05）, but there is significant statistical difference in PTVDmean, PTVDmax, PTVDmax/%, HI and CI between IMRT and 3D-CRT （t=35.631, t=4. 136, t=3.428, t=2. 123, t= 15.996; P〈0.05）. Dosage analysis results show that IMRT remains in kidney, small intestine and spinal cord is remarkably less than the 3D-CRT. Conclusion： IMRT can effectively increase the radiation dose in target areas, reduce organ damage, and improve life quality of the patients.