宫颈癌螺旋断层与容积旋转调强治疗剂量学研究.docVIP

宫颈癌螺旋断层与容积旋转调强治疗剂量学研究 　　[摘要] 目的 评估螺旋断层放射治疗（TOMO）和容积旋转调强（VMAT）对于宫颈癌剂量学的影响。 方法 选取2015年5月～2016年2月在浙江省肿瘤医院治疗的20例宫颈癌患者，分别应用TOMO和VMAT两种照射技术，比较两种照射技术之间的靶区和危及器官之间的剂量学参数、有效治疗时间以及治疗跳数。 结果 应用TOMO治疗技术患者，肿瘤靶区的适形指数为（0.895±0.013），均匀性指数为（0.051±0.010），均优于应用VMAT[（0.860±0.021）、（0.079±0.010）]（P 0.01）。对于正常组织，TOMO同样具有剂量学优势，但是TOMO所需要的平均治疗时间为（548±44）s，远大于VMAT所需要的平均时间[（136±5）s]（P 0.01）；同时，TOMO需要更多的治疗跳数（7862±647），而应用VMAT的平均治疗跳数为（533±27），差异有高度统计学意义（P 0.01）。 结论 TOMO技术能获得更好的靶区适形性和均匀性以及对正常组织的保护，但是实施TOMO技术的有效治疗时间和治疗跳数多于VMAT技术。 　　[关键词] 宫颈癌；螺旋断层放射治疗；容积旋转调强；剂量学 　　[中图分类号] R737.31 [文献标识码] A [文章编号] 1673-7210（2017）04（b）-0095-04 　　[Abstract] Objective To investigate the influence of helical tomotherapy （TOMO） and volumetric modulated arc therapy （VMAT） on the dosimetry of cervical cancer. Methods Twenty cases of patients with cervical cancer treated in Zhejiang Cancer Hospital from May 2015 to February 2016 were selected， they were taken radiotherapy techniques of TOMO and VMAT respectively. The dosimetry parameters， effective deliver time and monitor unit of target region and organ at risk between two radiotherapy techniques were compared. Results For the patients applying TOMO technique， the conformity index was （0.895±0.013）， homogeneity index was （0.051±0.010）， which were all better than those applying VMAT [（0.860±0.021）， （0.079±0.010）] （P 0.01）. For normal tissue， TOMO also has dosimetry advantage. However， the average delivery time of TOMO was （548±44） s， which was significantly longer than that of VMAT [（136±5） s] （P 0.01）； at the same time， TOMO needed more monitor unit （7862±647）， while the average monitor unit of VMAT was （533±27）， the difference was highly statistically significant （P 0.01）. Conclusion TOMO technique can obtain better conformity and homogeneity of target region and protection for the normal tissue， but the effective deliver time and monitor unit of performing TOMO are more than those of VMAT. 　　[Key words] Cervical cancer； Helical tomotherapy； Volumetric modulated