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不同部位食管癌实施直线加速器调强适形放射治疗的临床剂量学评价
陆冬云  羊剑  孙锦意  周建军  杨军▲
江苏省海安市中医院肿瘤科,江苏海安   226600
Clinical dosimetry evaluation of linear accelerator intensity-modulated radiation therapy for esophageal cancer at different sites
LU Dongyun YANG Jian SUN Jinyi ZHOU Jianjun YANG Jun▲
Department of Oncology, Haian Traditional Chinese Medicine Hospital, Jiangsu Province, Haian   226600, China
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摘要 目的 评价不同病变部位食管癌实施直线加速器调强适形放射治疗(IMRT)的临床剂量学特点。 方法 回顾性分析2019年11月至2021年10月江苏省海安市中医院收治的132例食管癌患者的临床资料,其中颈段及胸上、中、下段食管癌患者各33例。比较不同病变部位食管癌患者实施直线加速器IMRT的计划靶区剂量、勾画危及器官剂量学指标、机器跳数、剂量验证通过率及治疗时间的差异。 结果 胸上、中段食管癌患者2%的靶区体积受照剂量(D2)、D50、D98及平均剂量(Dmean)均高于颈段患者,治疗时间长于颈段患者;胸中段食管癌患者靶区剂量均匀性指数(HI)高于颈段患者;胸上、中、下段食管癌患者心脏接受25 Gy放射剂量的体积(V25)、Dmean及双肺V5、V20、V30均高于颈段患者;胸上、下段食管癌患者剂量验证通过率高于颈段患者(P<0.05)。胸中段食管癌患D2、HI、心脏V25、心脏Dmean及双肺V5、V20、V30高于胸上段患者,剂量验证通过率低于胸上段患者;胸下段食管癌患者机器跳数低于胸上段患者,治疗时间短于胸上段患者(P<0.05)。胸下段食管癌患者D2、D50、D98、Dmean、HI、机器跳数均低于胸中段患者,心脏V25、Dmean及剂量验证通过率均高于胸中段患者,治疗时间短于胸中段患者(P<0.05)。结论 不同病变部位食管癌实施直线加速器IMRT的临床剂量有一定的差别,临床中应予以关注。
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陆冬云  羊剑  孙锦意  周建军  杨军▲
关键词 食管癌颈段胸段直线加速器调强适形放射治疗剂量学
    
Abstract:Objective To evaluate the clinical dosimetry characteristics of linear accelerator intensity-modulated radiation therapy (IMRT) for esophageal cancer at different pathological sites. Methods The clinical data of 132 patients with esophageal cancer admitted to Haian Traditional Chinese Medicine Hospital of Jiangsu Province from November 2019 to October 2021 were retrospectively analyzed, including 33 patients with cervical and upper, middle, and lower thoracic esophageal cancer. The difference of planned target dose, the dosimetric index of sketched organs at risk, machine hops, dose-validation pass rate, and treatment time of linear accelerator IMRT in patients with esophageal cancer at different sites was compared. Results The 2% of target volume exposure dose (D2), D50, D98, and mean dose (Dmean) in patients with upper and middle thoracic esophageal cancer were higher than those in cervical patients, and the treatment time was longer than that in cervical patients; target dose homogeneity index (HI) in patients with middle thoracic esophageal cancer was higher than that in cervical patients; the volume receiving a radiation dose of 25 Gy (V25), Dmean of the heart and V5, V20, V30 of both lungs in patients with upper, middle, and lower thoracic esophageal cancer were higher than those in cervical patients; the dose-validation pass rate in patients with upper and lower thoracic esophageal cancer were higher than those of cervical patients (P<0.05). D2, HI, V25 of heart, Dmean of heart, and V5, V20, V30 of both lungs in patients middle thoracic esophageal cancer were higher than those in upper thoracic patients, and the dose-validation pass rate was lower than that in upper thoracic patients; the machine hops in patients with lower thoracic esophageal cancer were lower than those in upper thoracic patients, the treatment time was shorter than that in upper thoracic patients (P<0.05). D2, D50, D98, Dmean, HI, and machine hops in patients with lower thoracic esophageal cancer were lower than those in middle thoracic patients, and V25, Dmean of heart, and dose-validation pass rate were higher than those in middle thoracic patients, and the treatment time was shorter than that in middle thoracic patients (P<0.05). Conclusion The clinical dose of linear accelerator IMRT in different pathological sites of esophageal cancer is different, which should be paid attention to in clinic.
Key wordsEsophageal cancer    Cervical segment    Thoracic segment    Linear accelerator    Intensity-modulated radiation therapy    Dosimetry
    
基金资助:江苏省自然科学基金面上项目(BK201903021)。
通讯作者: ▲通讯作者   
作者简介: 陆冬云(1974.12-),女,副主任技师;研究方向:肿瘤放疗。
引用本文:   
陆冬云  羊剑  孙锦意  周建军  杨军▲. 不同部位食管癌实施直线加速器调强适形放射治疗的临床剂量学评价[J]. 中国医药导报, 2023, 20(20): 125-128.
LU Dongyun YANG Jian SUN Jinyi ZHOU Jianjun YANG Jun▲. Clinical dosimetry evaluation of linear accelerator intensity-modulated radiation therapy for esophageal cancer at different sites. 中国医药导报, 2023, 20(20): 125-128.
链接本文:  
https://www.yiyaodaobao.com.cn/CN/10.20047/j.issn1673-7210.2023.20.27     或     https://www.yiyaodaobao.com.cn/CN/Y2023/V20/I20/125

 

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