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驻留时间离差限制参数对三维后装计划的影响分析
引用本文:纪天龙,赵晶,李权,李光.驻留时间离差限制参数对三维后装计划的影响分析[J].中国医学物理学杂志,2018,0(8):900-904.
作者姓名:纪天龙  赵晶  李权  李光
作者单位:中国医科大学附属第一医院放疗科, 辽宁 沈阳 110001
摘    要:目的:研究驻留时间离差限制(DTDC)参数对三维后装计划的影响。 方法:选取在中国医科大学附属第一医院治疗的30例妇科肿瘤患者计划,施源器为Fletcher单独宫腔管、全部三管和阴道施源器,每例患者治疗前扫描CT,并由医生勾画靶区和危及器官,以0.1步进修改DTDC参数,由DTDC=0到DTDC=1共制定11个计划,归一至DTDC=0时计划下相应的数值。比较CTV的V150、V200,膀胱、直肠的D2cc,驻留时间总和,计划调制指数,分析DTDC参数的修改对三维后装计划的影响。 结果:随着DTDC的增加,阴道施源器,Fletcher施源器单独宫腔管和全部三管使用时,CTV的V150和V200分别升高至105%和109%、102%和104%以及115%和120%,直肠和膀胱的D2cc分别至101%和102%、99%和99%以及115%和101%;总驻留时间分别达到DTDC=0时的96%、97%和104%。 结论:宫颈癌三维后装计划的制定针对不同的施源器应该选用合适的DTDC参数,给予患者更加合理治疗计划。

关 键 词:宫颈癌  近距离治疗  模拟退火  驻留时间离差限制参数  三维后装

 Effects of dwell time deviation constraint parameters on three-dimensional afterloading plan
JI Tianlong,ZHAO Jing,LI Quan,LI Guang. Effects of dwell time deviation constraint parameters on three-dimensional afterloading plan[J].Chinese Journal of Medical Physics,2018,0(8):900-904.
Authors:JI Tianlong  ZHAO Jing  LI Quan  LI Guang
Affiliation:Department of Radiation Oncology, the First Hospital of China Medical University, Shenyang 110001, China
Abstract:Objective To study the effects of dwell time deviation constraint (DTDC) parameters on three-dimensional (3D) afterloading plan. Methods Fifteen patients with gynecologic tumors who were treated in the First Hospital of China Medical University were enrolled in this study. The source device was a single intrauterine tube of Fletcher applicator, all 3 tubes of Fletcher applicator and vaginal applicator. Each patient was scanned by CT before treatment, and the target areas and organs-at-risk were delineated by doctors. DTDC parameters were modified in the step of 0.1. A total of 11 plans were developed from DTDC=0 to DTDC=1, and the plans were normalized to DTDC=0 plan to obtain the corresponding values. The V150, V200 of CTV, D2cc of bladder and rectum, total dwell time, planned modulation indexes were compared, and the effects of DTDC parameter modification on 3D afterloading plan were analyzed. Results When using vaginal applicator, a single intrauterine tube of Fletcher applicator, all 3 tubes of Fletcher applicator, with the increase of DTDC, the V150 and V200 of CTV were increased to 105% and 109%, 102% and 104%, 115% and 120%, respectively; and the D2cc in rectum and bladder were increased/decreased to 101% and 102%, 99% and 99% , 115% and 101%, respectively. The total dwell time of DTDC=1 plan using vaginal applicator, a single intrauterine tube of Fletcher applicator and 3 tubes of Fletcher applicator reached 96%, 97% and 104% of that in DTDC=0 plan, respectively. Conclusion To provide a more reasonable treatment plans for patients, the optimal DTDC parameters should be selected based on different source devices used in 3D afterloading plan for cervical cancer.
Keywords:cervical cancer  brachytherapy  simulated annealing  dwell time deviation constraint parameters  three-dimensional afterloading
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