对偶弧功能在宫颈癌VMAT计划中的应用

冯永富,龙雨松,谭军文,贺先桃,李钢,王占宇

中国医疗设备 ›› 2023, Vol. 38 ›› Issue (2) : 47-51.

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中国医疗设备 ›› 2023, Vol. 38 ›› Issue (2) : 47-51. DOI: 10.3969/j.issn.1674-1633.2023.02.009
研究论著

对偶弧功能在宫颈癌VMAT计划中的应用

  • 冯永富,龙雨松,谭军文,贺先桃,李钢,王占宇
作者信息 +

Application of Dual Arc Function in VMAT Plan for Cervical Cancer

  • FENG Yongfu, LONG Yusong, TAN Junwen, HE Xiantao, LI Gang, WANG Zhanyu
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摘要

目的 利用Raystation计划系统的对偶弧功能,比较双弧与对偶弧计划对宫颈癌放疗患者危及器官的保护作用。方法 选取 2020年12月至2021年5月于柳州市工人医院肿瘤科接受放疗的宫颈癌术后患者20例作为研究对象,设计双弧与对偶弧计划,比 较2种计划的靶区剂量分布、适形度指数(Conformity Index,CI)、均匀性指数(Homogeneity Index,HI)、子野形状以及危 及器官受照剂量。结果 2种治疗方案均符合临床治疗要求,对偶弧计划的计划靶体积(Planning Target Volume,PTV)D50% 高于双弧计划,而V50.4,Body(处方剂量为50.4 Gy时覆盖正常组织的体积)低于双弧计划,差异均有统计学意义(P<0.05)。 对偶弧计划的CI优于双弧计划,总跳数(Monitor Units,MU)高于双弧计划,差异均有统计学意义(P<0.05),而2种 计划的PTV D2%、D98%和HI无统计学差异(P>0.05)。在危及器官方面,对偶弧计划的直肠、膀胱和小肠的Dmean、V30和 V40均低于双弧计划,股骨头的V30和V40低于双弧计划,差异均有统计学意义(P<0.05)。双弧计划A1与A2子野之间形 状相似;对偶弧计划的A1子野开口偏X1侧,A2子野开口偏X2侧,A1与A2之间呈左右互补的形状。结论 对于宫颈 癌容积旋转强调放疗计划设计,双弧计划和对偶弧计划均能实现较好的靶区覆盖,对偶弧计划适形度更优,且使用对偶 弧功能可以进一步降低多数危及器官的受照剂量,在临床设计宫颈癌容积旋转强调放疗计划时可优先使用对偶弧功能。

Abstract

Objective To compare the protection of the organs at risk between two arc and dual arc plans for patients during radiotherapy for cervical cancer by using dual arc function of Raystation treatment planning system. Methods A total of 20 patients with cervical cancer who received radiotherapy in the Department of Oncology, Liuzhou Worker’s Hospital from December 2020 to May 2021 were selected as the research subjects. The two arc plan and dual arc plan were designed to compare the target dose distribution, conformity index (CI), homogeneity index (HI), subfield shape and exposure dose of organs at risk. Results Both treatment plans met the requirements of clinical treatments. The planning target volume (PTV ) D50% of dual arc plan was higher than those of two arc plan, while the V50.4,Body(the volume of normal tissue was covered when the prescription dose was 50.4 Gy) was lower than of two arc plan, the difference was statistically significant (P<0.05). The CI of dual arc plan was better than that of two arc plan, and the total number of monitor units (MU) increased compared with two arc plans, the difference was statistically significant (P<0.05). There was no statistically difference in PTV D2%, D98% and HI between the two plans (P>0.05). As to organs at risk, the Dmean, V30 and V40 of rectum, bladder and small intestine in dual arc plan were all lower than those of two arc plan, the femoral head V30 and V40 of dual arc plan were lower than those of two arc plan, the difference was statistically significant (P<0.05). The shapes of A1 and A2 segments in two arc plan were similar. The opening of A1 segments of dual arc plans was biased to the X1 side, while the opening of A2 segments was biased to X2 side, A1 and A2 were complementary to each other. Conclusion For the volumetric intensity modulated arc therapy plan design of cervical cancer, both the dual arc plan and the two arc plan can achieve better target coverage, and the dual arc plan has better conformality, and the use of dual arc function can further reduce the radiation dose of most organs at risk,so the dual arc function can be given priority in the clinical design of volumetric intensity modulated arc therapy plan for cervical cancer

关键词

双弧 / 对偶弧 / 宫颈癌 / 容积旋转调强 / 剂量学

Key words

two arc / dual arc / cervical cancer / volumetric intensity modulated arc therapy / dosimetry

引用本文

导出引用
冯永富, 龙雨松, 谭军文, . 对偶弧功能在宫颈癌VMAT计划中的应用[J]. 中国医疗设备, 2023, 38(2): 47-51 https://doi.org/10.3969/j.issn.1674-1633.2023.02.009
FENG Yongfu, LONG Yusong, TAN Junwen, et al. Application of Dual Arc Function in VMAT Plan for Cervical Cancer[J]. China Medical Devices, 2023, 38(2): 47-51 https://doi.org/10.3969/j.issn.1674-1633.2023.02.009
中图分类号: R144    R815.6   

参考文献

[1] 周解平, 王鹏, 钱立庭, 等. 宫颈癌术后静态调强放疗与单个 和2个全弧容积调强弧形治疗的剂量学比较[J]. 吉林大学学 报(医学版), 2016, 42(1): 120-124. Zhou JP, Wang PP, Qian LT, et al. Dosimetric comparison between IMRT and a single full arc, two full arc VMAT for postoperative cervical cancer patients[J]. J Jilin Univ (Med Ed), 2016, 42(1): 120-124.

基金

广西壮族自治区卫生健康委员会自筹经费科研课题(Z20200966;Z20200421)。

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