| 铱源驻留步长对宫颈癌三维近距离治疗计划的影响 |
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| 引用本文： | 吴爱林,姜潇,吴爱东,朱磊,刘云琴,钱立庭.铱源驻留步长对宫颈癌三维近距离治疗计划的影响[J].中国医学物理学杂志,2022,0(1):9-13. |
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| 作者姓名： | 吴爱林 姜潇 吴爱东 朱磊 刘云琴 钱立庭 |
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| 作者单位： | 1.中国科学技术大学附属第一医院（安徽省立医院）放疗科， 安徽 合肥 230031； 2.中国科学技术大学物理学院， 安徽 合肥 230026 |
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| 基金项目： | 国家自然科学基金(11805198,81671681);中国科学技术大学基本科研业务费创新团队培育基金(WK2030040089)。 |
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| 摘 要： | 目的:研究宫颈癌近距离治疗计划设计中，铱源驻留步长选择对计划评估及剂量稳定性的影响。方法:选取在安徽省肿瘤医院接受治疗的15例宫颈癌患者，均接受Fletcher型施源器植入的铱源高剂量率CT引导下近距离治疗。按照驻留步长大小分别为每位患者制定4组计划（Plan_1 mm、Plan_3 mm、Plan_5 mm和Plan_7 mm），对比治疗时长，靶区D100、D90和V100和危及器官D2 cc、SF系数等参数。模拟计算施源器发生脚向3 mm移位时剂量分布，分析施源器移位对不同驻留步长近距离治疗计划剂量学的参数影响。结果:不同驻留步长治疗计划的高危靶区（HRCTV）剂量学参数差异不明显（P>0.05），而Plan_1 mm、Plan_3 mm的中危靶区（IRCTV）的D100、D90、V100和治疗时长均大于Plan_5 mm，且差异有统计学意义（P<0.05）；Plan_5 mm计划中危及器官SF参数的平均值和中位值最小；Plan_5 mm在施源器移位后HRCTV和IRCTV的D90平均降幅最小，分别为2.88%和0.91%。结论:宫颈癌近距离治疗计划的制定应选择合适的铱源驻留步长，使得治疗计划不仅满足剂量评估要求，还具有一定的剂量传递稳定性。
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| 关 键 词： | 宫颈癌 铱源 驻留步长 三维近距离治疗 剂量 |
Effects of iridium source dwell step size on three-dimensional brachytherapy plan of cervical cancer |
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| WU Ailin,JIANG Xiao,WU Aidong,ZHU Lei,LIU Yunqin,QIAN Liting.Effects of iridium source dwell step size on three-dimensional brachytherapy plan of cervical cancer[J].Chinese Journal of Medical Physics,2022,0(1):9-13. |
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| Authors: | WU Ailin JIANG Xiao WU Aidong ZHU Lei LIU Yunqin QIAN Liting |
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| Affiliation: | 1. Department of Radiation Oncology, The First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital), Hefei 230001, China 2. School of Physical Sciences, University of Science and Technology of China, Hefei 230026, China |
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| Abstract: | Abstract: Objective To study the effect of iridium source dwell step size on plan evaluation and dose stability in the brachytherapy planning for cervical cancer. Methods Fifteen cervical cancer patients undergoing CT-guided high-dose-rate brachytherapy with iridium source applied by the Fletcher applicator in Anhui Provincial Cancer Hospital were enrolled in the study. Four kinds of plans with different dwell step sizes (Plan_1 mm, Plan_3 mm, Plan_5 mm and plan_7 mm) were created for each patient. The treatment duration as well as the parameters of target areas (D100, D90 and V100) and organs-at-risk (D2 cc and SF coefficient) were compared. The dose distribution with applicators shifting 3 mm to the feet was calculated, and the effects of the applicators shift on the dosimetric parameters of brachytherapy plans were analyzed under different dwell step sizes. Results There was no significant difference in dosimetric parameters of HRCTV among treatment plans with different step sizes (P>0.05). However, the D100, D90 and V100 of IRCTV and treatment duration of Plan_1 mm and Plan_3 mm were greater than those of Plan_5 mm, and the differences were statistically significant (P<0.05). The mean value and median value of SF coefficient of organs-at-risk in Plan_5 mm were smallest. After shifting applicators, the average decreases of the D90 of HRCTV and IRCTV in Plan_5 mm were minimum, which were 2.88% and 0.91%, respectively. Conclusion The appropriate iridium source dwell step size should be selected in the brachytherapy for cervical cancer, so that the treatment plan can not only fulfill the requirements of dose evaluation, but also has a certain dose delivery stability. |
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| Keywords: | cervical cancer iridium source dwell step size three-dimensional brachytherapy dose |
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