脑胶质瘤旋转调强放疗与固定野调强放疗的临床应用及剂量学研究.docVIP

精品论文 参考文献 脑胶质瘤旋转调强放疗与固定野调强放疗的临床应用及剂量学研究 余芳 袁君 　　（中南大学湘雅医学院肿瘤科 410013） 　　【摘 要】目的：比较固定野调强（Intensity Modulated Radiation Therapy，IMRT）与旋转调强（Volumetric Modulated Arc Therapy，VMAT）在脑胶质瘤术后放射治疗中的临床应用及剂量学差异。方法：回顾性分析我院2013年1月-2015年2月期间收治的22例颅内肿瘤患者，采用Monaco治疗计划系统，将其分为观察组与对照组各11例，观察组采取VMAT计划，对照组采取IMRT计划。两组患者处方剂量全部为PTV:60 Gy/30f。比较两组计划的适形度指数（CI）、均匀指数（HI）、治疗时间、治疗跳数、危及器官受量。结果：观察组患者平均治疗时间和机器跳数分别为（2.16plusmn;0.78）min和（343plusmn;87）MU，明显优于对照组，组间差异存在统计学意义（P＜0.05），但在CI值、HI值两个指标比较上，差异不存在统计学差异（P＞0.05）。观察组患者在视神经、视网膜、晶体和周围正常脑组织的平均剂量明显低于对照组，有显著统计学差异（P＜0.05）。两组患者在脑干与视交叉的平均剂量比较上差异无显著统计学差异（P＞0.05）。结论：在脑胶质瘤术后的放射治疗中，VMAT与IMRT的靶区剂量分布相近，但在治疗时间、治疗跳数方面具有明显优势，同时减少了部分危及器官受量，提高了肿瘤控制率和降低正常组织损伤，减轻放疗副作用，提高了治愈率，值得在临床上广泛推广应用。 　　【关键词】脑胶质瘤；固定野调强；I旋转调强 　　【中图分类号】R739.41 【文献标识码】B 【文章编号】1003-5028（2015）8-0580-02 　　【Abstract】Objective: comparison of fixed field IMRT (intensity modulated radiation therapy, IMRT) and rotation of the adjusting strong volumetric modulated arc therapy (VMAT) in brain gliomas postoperative radiation therapy in clinical and dosimetric differences. Methods: retrospective analysis of 22 cases of intracranial tumor patients treated in our hospital from January February to 2013, the Monaco treatment planning system, which is divided into observation group and control group, 11 cases, the observation group to take the VMAT plan, the control group to take the IMRT plan. The two groups of patients were prescribed dose of Gy/30f PTV:60. The fitness index (CI), uniform index (HI), treatment time, number of treatment, and the risk of organ weight were compared between the two groups. Results: the average time of treatment and the number of hops in the observation group were (2.16 + 0.78) min and (343 + 87) MU, significantly better than the control group (P lt; 0.05), but the difference was not statistically significant (P gt; 0.05). The average dose of the patients in the observation group was significantly lower than that in the control group (P lt; 0.05). There was no significant diff