TomoDirect和螺旋断层治疗在全身照射中的剂量学比较

Q4 Medicine

中华放射医学与防护杂志 Pub Date : 2019-09-25 DOI:10.3760/CMA.J.ISSN.0254-5098.2019.09.004

Haiyang Wang, Y. Pi

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引用次数: 0

摘要

目的探讨TomoDirect (TD)和Helical Tomotherapy (HT)在全身照射(TBI)中的剂量学差异，评价TBI的计划质量和递送效率。方法回顾性分析郑州大学第一附属医院8例平均身高约120cm的急性白血病脑外伤患者，采用TD和HT技术进行剂量学比较。两种技术都配置了相同的规划参数，除了TD平面设计为2-12个等间距的奇数油田，初始角度为180度或0度。比较两种治疗方案在靶体积平均剂量(PTVDmean)、均匀性指数(HI)、危及器官剂量(OARs)、给药时间等方面的剂量学差异。结果9场及以上的TD方案PTVDmean和HI与HT方案相似，小于9场的TD方案PTVDmean(t=-3.12， -5.41， -20.33， -4.56， -7.22， -11.27, P<0.05)和HI与HT方案差异有统计学意义(t=-2.94， -5.18， -15.66， -4.31， -5.51， - 9.13, P<0.05)。在OARs方面，7场及以上的TD方案与HT方案相比，左右肺平均剂量无显著差异。与HT方案相比，3个视野的TD方案最大剂量左侧晶状体风险体积(PRV)(2.14±0.60)Gy、右侧晶状体风险体积(PRV)(3.05±0.10)Gy差异有统计学意义(t=0.77、0.63,P<0.05)。分娩时间无显著差异。投石计划的初始角度对PTVDmean、HI、OAR剂量学和投石时间没有影响。结论9场及以上的TD方案在靶区覆盖、OAR节约和递送时间等方面均可达到相同的方案质量，但在晶状体PRV最大剂量方面优于HT方案。关键词:全身辐照;TomoDirect;螺旋tomotherapy

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Dosimetric comparison between TomoDirect and Helical Tomotherapy in total body irradiation

Objective To investigate the dosimetric differences between TomoDirect (TD) and Helical Tomotherapy (HT) in total body irradiation (TBI), as well to evaluate the plan quality and delivery efficiency of TD. Methods Eight patients with acute leukemia at an average height of about 120 cm who had undergone TBI in the first affiliated hospital of Zhengzhou university were retrospectively reviewed and replanned with the TD and HT techniques for dosimetric comparison. Identical planning parameters were configured for both techniques except that TD plans were designed with 2-12 equally spaced odd number fields and with an initial angle of 180 or 0 degree. Dosimetric differences in mean dose of plan target volume (PTVDmean), homogeneity index (HI), dose of organs at risk (OARs), as well as delivery time were compared between the TD and HT plans. Results The TD plans with 9 fields or more had similar PTVDmeanand HI compared with HT plans, while TD plans with less than 9 fields had a significant different PTVDmean(t=-3.12, -5.41, -20.33, -4.56, -7.22, -11.27, P<0.05) and HI (t=-2.94, -5.18, -15.66, -4.31, -5.51, - 9.13, P<0.05) compared with those of HT. In terms of OARs, the TD plans with 7 fields or more had no significant dosimetric differences in the mean dose of left and right lung compared with the HT plans. The TD plans with 3 fields had significant different maximum dose in the left lens plan risk volume(PRV) (2.14±0.60) Gy and the right lens PRV (3.05±0.10) Gy (t=0.77, 0.63, P<0.05) compared with the HT plans. No significant difference in delivery time was observed. The initial angle of the TD plans had no effects on PTVDmean, HI, OAR dosimetry and delivery time. Conclusions The TD plans with 9 fields or more can achieve similar plan quality in terms of target coverage, OAR sparing and delivery time, but have an advantage in the maximum dose to lens PRV compared with the HT plans. Key words: Total body irradiation; TomoDirect; Helical tomotherapy

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来源期刊

中华放射医学与防护杂志 Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

0.60

自引率

0.00%

发文量

6377

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