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find Keyword "容积调强" 3 results
  • 摆位系统误差对乳腺癌调强放射治疗剂量分布的影响

    目的探究摆位系统误差对乳腺癌患者实施调强放射治疗的剂量学影响。 方法2012年10月对一典型乳腺癌改良根治术后患者分别设计常规三维适形切线野(CRT)、多野静态调强(s-IMRT)、旋转调强(VMAT)3种不同治疗技术的计划,在计划中将治疗中心点向患者左、右、腹、背、头、脚方向分别平移3、6 mm模拟2种不同程度的系统误差,共计39个计划与原计划进行比较,观察不同治疗技术间、不同平移距离,不同方向上的靶区及主要危及器官患侧肺和心脏的剂量变化。 结果对于3 mm摆位系统误差,靶区D95%于向背侧s-IMRT降低4.0%,VMAT降低3.5%,向右(患侧)s-IMRT降低3.0%,VMAT降低2.8%,其余均方向降低且<1.6%。对于主要危及器官,系统误差对s-IMRT技术的患侧肺接受20 Gy剂量的体积影响大,对VMAT技术的患侧肺接受10 Gy剂量的体积影响大。除此外,对主要危及器官患侧肺及其他剂量参数影响均小(3 mm<3%,6 mm<6%)。系统误差对3D-CRT技术的影响小(3 mm<3%,6 mm<6%)。6 mm的系统误差对靶区及危及器官的影响与3 mm趋势一致,仅变化程度更大,两种调强技术的靶区D95%降低>5%。 结论对乳腺癌改良根治术后的呈弧段状、位于胸廓表面的放射治疗靶区,s-IMRT和VMAT方式的调强治疗技术对治疗摆位系统误差的影响程度相当,但较CRT技术更敏感,其中以向患者背侧、健侧方向偏移影响最大。改良根治术后乳腺癌调强治疗的实施需要有较三维治疗更高的位置精度保证。

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  • Dosimetric Comparison among Volumetric-modulated Arc Therapy, Intensity-modulated Radiotherapy and Three-dimensional Conformal Radiotherapy as Adjuvant Radiotherapy for Cervical Cancer

    ObjectiveTo compare the dosimetric differences among the double-arc volumetric-modulated arc therapy (VMAT), 7 field intensity-modulated radiotherapy (IMRT) and 3-dimensional conformal radiotherapy (3D-CRT) techniques in treatment planning for cervical cancer as adjuvant radiotherapy. MethodFifteen patients who underwent adjuvant chemotherapy for cervical cancer between March 1st and September 30th, 2013 were chosen to be our study subjects through random sampling. Under Pinnacle 9.2 planning system, the same CT image was designed through three different techniques:VMAT, IMRT and 3D-CRT. We then compared target zone fitness index, evenness index, D98%, D2%, D50% among those different techniques. Monitor unit (MU) and treatment time were also analyzed. ResultsThree techniques showed similar target dose coverage. The IMRT and VMAT plans achieved better target dose conformity, which reduced the V20 of the pelvic, the V50 of the rectum and bladder, as well as the V40/50 of the small intestine (P<0.05). The VMAT technique showed few dosimetric advantages over the IMRT technique. VMAT technique had the advantages of less MU (P>0.05) and shorter overall treatment time (P<0.01) compared with IMRT technique. ConclusionsThe IMRT and VMAT plans achieve similar dose distribution to the target, and are superior to the 3D-CRT plans, in adjuvant radiotherapy for cervical cancer. VMAT technique has the advantages of less MU and shorter overall treatment time.

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  • Application of Liner-accelerator Two-degrade Collimator in the Treatment of Nasopharyngeal Carcinoma with Volumetric Modulated Arc Therapy

    ObjectiveCompare the two-degrade collimator (MLC) angle selection's impact on plan quality and operational efficiency for volumetric intensity-modulated radiotherapy (VMAT) in the treatment planning system, and to explore the scheme for treatment plan optimization. MethodsTwenty patients with nasopharyngeal carcinoma underwent the treatment between March and December 2013 were randomly selected and planned for SIBVMAT treatment with different parameters set in the range of 0-60°with 15°interval for collimator angles. Planned dose distribution to the target volumes, organs at risk, and monitor units were compared. ResultsAs the MLC angle increased, target conformal index and homogeneity index had a trend to became deteriorated. The optimal plans were 0°and 15°, while 45°and 60°plans gave poor protection for the organ at risk compare to other angle plans and the monitor units were significantly increased. ConclusionChange the MLC angle had visible impact on treatment plans,there was a trend to deteriorate with the MLC angle increased, but small changes in MLC angle range can theoretically reduce the influence from leakage radiation on the human body.

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