三维适形和调强放疗技术在肝癌放射治疗中的剂量学研究

【目的】探讨三维适形（3DCRT）和静态调强（sIMRT）在肝癌放射性治疗中的剂量学差异。【方法】选择原发性肝右叶癌患者38例，所有患者均进行3DCRT和 sIMRT放疗，剂量均为50 Gy，分25次照射。比较不同放疗的靶区及危险器官剂量学参数、加速器跳数（MU）和有效治疗时间参数等。【结果】sIMRT放疗的Dmax、Dmin、V95％靶区剂量学分别为（52．9±0．3）Gy、（49．0±0．2）Gy、（99．5±0．2）％，与3DCRT （53．1±0．4）Gy、（46．2±0．6）Gy、（97．4±1．5）％比较剂量明显减少，比较有统计学意义（P＜0．05）；sIMRT的肝平均剂量（20．1±4．3）Gy与3DCRT的（21．3±3．4）Gy比较无显著性差异（P ＞0．05）；3DCRT的 MU为（403±97）与 sIMRT（391±82）比较无显著性差异（P＞0．05）；3DCRT有效治疗时间为（2．0±0．1）min少于 sIMRT（4．9±0．6）min，差异有显著性（P＜0．05）。【结论】sIMRT与3DCRT比较，可显著性提高疗效，改善肝癌靶区的剂量覆盖，因此 sIMRT放疗技术是治疗肝癌的更有效手段。

Dosiology Study of Three-dimensional Conformal and Intensity-modulated Radiotherapy in Ra- diation Therapy of Liver Cancer

Objective]To explore the difference of dosiology of three-dimensional conformal（3DCRT）and static intensity-modulated radiology（sIMRT）in radiation therapy for liver cancer.Methods]Totally 38 pa-tients with primary right lobe cancer of liver were chosen.All patients received 3DCRT and sIMRT.The dose was 50Gy for 25 fractions of radiation.The dosiology parameters of different radiotherapy target area and dan-gerous organ,accelerator hops（MU）and effective treatment time parameters were compared.Results]The Dmax/Gy,Dmin/Gy and V95% target region dosiology in sIMRT were （52.9±0.3）,（49.0±0.2）and （99.5±0.2）respectively which were lower than those in 3DCRT（53.1±0.4）,（46.2±0.6）and （97.4± 1.5）,respectively],and there were significant differences（P〈0.05）.There was no significant difference in mean liver dose between sIMRT and sDCRT（20.1± 4.3）Gy vs.（21.3±3.4）Gy]（P〉0.05）.There was no significant difference in MU between 3DCRT and sIMRT（403 ± 97）vs.（391±82）]（P〉0.05）.The effective treatment time of 3DCRT was （2.0±0.1）min which was less than that in sIMRT（4.9± 0.6）min] （P〈0.05）.Conclusion]Both sIMRT and 3DCRT can markedly increase the curative effect and improve liv-er target dose coverage.Therefore,sIMRT technology is more effective means of treating liver cancer.