TomoTherapy在全身放疗方面的应用

目的：本文报道一例TomoTherapy全身照射病例,介绍其调强计划方案,并分析其计划及验证结果。方法：由定位CT获取病人全身CT图像,在CMS医生工作站进行靶区和重要器官的勾画,传至TomoTherapy计划工作站进行计划设计。用ArcCheck三维半导体矩阵对计划实施验证,计划验证通过后在螺旋断层放疗设备上完成对病人的全身照射。结果：85%的靶区接受10Gy的处方剂量,靶区适形度CI和均匀指数HI分别为0.76和1.16。重要器官限制剂量达到临床要求,左晶体的最大剂量为3.4Gy,右晶体的最大剂量为4.3Gy,肺的平均剂量为5.5Gy,V5为45%,左肾的平均剂量为5Gy,右肾的平均剂量为5.7Gy。结论：TomoTherapy可以完成全身的照射,肺的剂量可以降得更低,减少毒副反应。为全身放疗提供了一种安全的方法。

The Application of Helical TomoTherapy in Total Body Irradiation

Objective:To present the TBI with helical TomoTherpay in one patient.CT–simulation,treatment planning,deliv- ery dose verification and toxicity were present.Methods:The planning CT images were acquired on Siemens CT,all the CT images were sent to CMS system for contouring.After contouring the targets and critical organs,the images and structure were sent to the TomoTherpay planning station.The treatment delivery was archived after the QDA was done.Results:85%of the target was covered by the prescription dose and the dose received by the organ at risk did not exceed the safety dose.The con- formity index of the CTV was 0.76 and the homogeneity index of the CTV was 1.16.The mean dose of lung was 5.5 Gy and the V5 of lung was 45%.The max dose of the R-lens and L-lens was 3.4 Gy and 4.3 Gy.Conclusions:It is feasible to use To- moTherpay to deliver clinical TBI.TomoTherapy provides a more elegant and convenient solution for TBI than conventional technique.