| IMRT、sIMRT及3DCRT在胸中段食管癌放疗中的应用比较 |
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| 引用本文： | 傅博,吴建语,沈佳鹏,阮必顺,许锦慧,龙泉先,何玉凤,彭志刚.IMRT、sIMRT及3DCRT在胸中段食管癌放疗中的应用比较[J].中国医学物理学杂志,2022,0(10):1208-1212. |
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| 作者姓名： | 傅博 吴建语 沈佳鹏 阮必顺 许锦慧 龙泉先 何玉凤 彭志刚 |
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| 作者单位： | 1.钦州市第二人民医院肿瘤科， 广西 钦州 535000； 2.广西医科大学第一附属医院肿瘤内科， 广西 南宁 530021 |
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| 摘 要： | 目的:探讨调强放疗（IMRT）、简化调强放疗（sIMRT）及三维适形放疗（3DCRT）在胸中段食管癌放疗中的应用比较。方法:回顾性选取胸中段食管癌患者105例，根据患者所接受的放疗方式分为IMRT组（n=33）、sIMRT组（n=40）及3DCRT组（n=32），比较各组靶区2%体积的器官所受照射剂量（D2）、D50、D98、均匀性指数（HI）和适形度指数（CI）差异，双肺接受5 Gy剂量照射的肺体积占全肺总体积的百分比（V5）、V10、V20、脊髓最大剂量（Dmax）和心脏平均剂量（Dmean）等。结果:IMRT组和sIMRT组D2、D50、D98和HI分别为（6 659.43±161.15） cGy和（6 603.55±145.54） cGy、（6 312.26±132.20） cGy和（6 289.94±121.17） cGy、（5 815.43±114.41） cGy和（5 801.16±120.03） cGy、（1.09±0.04）和（1.08±0.03），显著高于3DCRT组（P<0.05），CI分别为（0.71±0.02）和（0.72±0.03），显著低于3DCRT组（P<0.05）；IMRT组、sIMRT组和3DCRT组双肺V5、V10、V20和脊髓Dmax比较差异无统计学意义（P>0.05）；IMRT组和sIMRT组心脏Dmean分别为（784.69±101.16） cGy和（796.79±112.28） cGy，显著低于3DCRT组（P<0.05）；sIMRT组机器跳数和子野数目分别为（432.24±71.19） MU和（18.03±5.56），显著低于IMRT组和3DCRT组（P<0.05）；IMRT组机器跳数和子野数目分别为（501.16±78.98） MU和26.65±7.140，显著低于3DCRT组（P<0.05）；IMRT组、sIMRT组和3DCRT组骨髓抑制、放射性肺炎、放射性食管炎和肺纤维化发生率比较差异无统计学意义（P>0.05）；IMRT组、sIMRT组和3DCRT组放疗疗效比较差异无统计学意义（P>0.05）。结论:3DCRT、IMRT和sIMRT靶区剂量参数均可满足临床要求，其中sIMRT心脏受照剂量、机器跳数低，临床上可优先选择sIMRT计划。
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| 关 键 词： | 调强放疗 简化调强放疗 三维适形放疗 胸中段 食管癌 |
Comparison among IMRT,sIMRT and 3DCRT in radiotherapy for middle thoracic esophageal cancer |
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| FU Bo,WU Jianyu,SHEN Jiapeng,RUAN Bishun,XU Jinhui,LONG Quanxian,HE Yufeng,PENG Zhigang.Comparison among IMRT,sIMRT and 3DCRT in radiotherapy for middle thoracic esophageal cancer[J].Chinese Journal of Medical Physics,2022,0(10):1208-1212. |
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| Authors: | FU Bo WU Jianyu SHEN Jiapeng RUAN Bishun XU Jinhui LONG Quanxian HE Yufeng PENG Zhigang |
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| Affiliation: | 1. Department of Oncology, The Second Peoples Hospital of Qinzhou, Qinzhou 535000, China 2. Department of Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China |
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| Abstract: | Abstract: Objective To compare the dosimetric differences among intensity-modulated radiotherapy (IMRT), simplified intensity-modulated radiotherapy (sIMRT) and three-dimensional conformal radiotherapy (3DCRT) for middle thoracic esophageal cancer. Methods According to the radiotherapy techniques, 105 patients with middle thoracic esophageal cancer were divided into IMRT group (n=33), sIMRT group (n=40) and 3DCRT group (n=32). The D2, D50, D98, homogeneity index (HI) and conformity index (CI) of target areas, the V5, V10, V20 of both lungs, the maximum dose (Dmax) to spinal cord and the mean dose (Dmean) to heart were compared among different groups. Results The D2, D50, D98 and HI in IMRT group and sIMRT group were (6 659.43±161.15) cGy and (6 603.55±145.54) cGy, (6 312.26±132.20) cGy and (6 289.94±121.17) cGy, (5 815.43±114.41) cGy and (5 801.16±120.03) CGy, (1.09±0.04) and (1.08±0.03), respectively, which were significantly higher than those in 3DCRT group (P<0.05). The CI was (0.71±0.02) in IMRT group and (0.72±0.03) in sIMRT group, significantly lower than that in 3DCRT group (P<0.05). There were no significant differences in the V5, V10, V20 of both lungs and the Dmax to spinal cord among IMRT group, sIMRT group and 3DCRT group (P>0.05). The Dmean to heart was (784.69±101.16) cGy in IMRT group and (796.79±112.28) cGy in sIMRT group, significantly lower than that in 3DCRT group (P<0.05). The monitor units and number of subfields in sIMRT group were (432.24±71.19) MU and (18.03±5.56), which were significantly lower than those in IMRT group and 3DCRT group (P<0.05). The monitor units and number of subfields in IMRT group were (501.16±78.98) MU and (26.65±7.140), respectively, which were significantly lower than those in 3DCRT group (P<0.05). The differences in the incidences of bone marrow transplantation, radiation pneumonia, radiation esophagetis, pulmonary fibrosis among IMRT group, sIMRT group and 3DCRT group were trivial (P>0.05), and there was no significant difference in radiotherapy efficacy among IMRT group, sIMRT group and 3DCRT group (P>0.05). Conclusion 3DCRT, IMRT and sIMRT can all meet the clinical requirements for dosimetric parameters, and among them, sIMRT is preferred in clinical practice because of the low cardiac radiation dose and monitor units. |
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| Keywords: | Keywords: intensity-modulated radiotherapy simplified intensity-modulated radiotherapy three-dimensional conformal radiotherapy middle thoracic esophageal cancer |
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