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CMS XIO子野权重优化对鼻咽癌调强放疗计划的影响
邓娟,赵雷,范习刚,刘高元
0
(德阳市人民医院肿瘤科;德阳市人民医院放射科)
摘要:
【摘要】 目的 探讨CMS XIO计划系统子野权重优化(SWO,segment weight optimization)技术在鼻咽癌调强放疗(IMRT)计划中的影响。 方法 选取德阳市人民医院肿瘤科30例鼻咽癌确诊病例,应用CMS XIO 4.64计划系统,每例设计2个计划:S-IMRT(SIMRT组)和SWOIMRT(SWO-IMRT组),均采用7野均分入射方向(153,102,51,0,309,258,207)和相同的优化参数,首先利用静态调强方式(step&shoot)进行计划优化,S-IMRT计划组将通量图转换成子野序列生成调强治疗计划SIMRT;SWO-IMRT组在S-IMRT计划基础上使用子野权重优化工具(SWO)生成SWO-IMRT计划。比较使用子野权重优化前后机器总子野数、总跳数(MU)的变化,同时通过DVH图评价靶区均匀性指数(HI)、适形指数(CI)及靶区和危及器官(OAR)的剂量分布。〖HTH〗结果〖HTK〗〓两组靶区及危及器官的DVH图比较,SWO-IMRT组的靶区剂量高于S-IMRT组(P<0.05)。SWO-IMRT计划组靶区PGTVnx、PGTVnd、PCTV1及PCTV2的D98、D95、D50、适形度指数(CI)均优于S-IMRT组(P<0.05),D2与均匀性指数(HI)差异无统计学意义(P>0.05)。危及器官剂量两组差异无统计学意义(P<0.05)。SWOIMRT组子野个数较S-IMRT组减少17%( P=0.001),机器总跳数较S-IMRT组略有减少(P>0.05)。 结论 SWO技术在鼻咽癌调强计划中,有助于提高靶区剂量,同时明显降低子野个数,从而减少机器磨损和患者治疗时间。
关键词:  鼻咽癌  调强放疗  子野权重优化(SWO)  靶区剂量  子野个数
DOI:
基金项目:德阳市2017年度第二批应用技术研究与开发项目
Influence of CMS XIO subfield weight optimization on intensity modulated radiotherapy for nasopharyngeal carcinoma
DENG Juan,ZHAO Lei,FAN Xigang,LIU Gaoyuan
(Department of Oncology, The People′s Hospital of Deyang;Department of Radiology, The People’s Hospital of Deyang)
Abstract:
【Abstract】 Objective The aim of this study was to compare IMRT optimization for Nasopharyngeal carcinoma in the CMS XIO radiotherapy treatment planning system, with and without segment weight optimization. Methods 30 patients with pathologically confirmed nasopharyngeal carcinoma were enrolled. Two IMRT plans were made(S-IMRT and SWO-IMRT) for each case, and which had the same gantry directions(153,102,51,0,309,258,207)and optimization parameters. Firstly, S-IMRT plans were optimized with the way of the static intensitymodulated method (step & shoot), transformed the intensity distribution into MLC sequence by the CMS XIO 464 planning system. Then, SWO-IMRT plans were generated based on S-IMRT plans using segment weight optimization tool (SWO). Comparing the difference of the number of segments, MU between the S-IMRT and SWO-IMRT plans. By the dosevolume histogram(DVH), and the target homogeneity index (HI),conformal index(CI), dose distribution in the volume of targets and OARs were analyzed. Results For the target areas (PGTVnx, PGTVnd, PCTV1 and PCTV2) D98, D95, D50 and conformal index (CI) in SWO-IMRT group were superior to S-IMRT group(P<0.05), while no statistically significant differences were found in D2, homogeneity index (HI), PCTVnd and the OAR. The study showed a statistically significant reduction in the total number of segments (mean: 17%) with SWO-IMRT as compared to S-IMRT (P=0.000). And slightly reduction of in the total MU was observed with SWO-IMRT (P>0.05). Conclusion This study shows that the segment weight optimization method significantly improve the target areas dose and reduce the total number of segments for IMRT nasopharyngeal carcinoma, thus reducing machine wear and patient treatment time.
Key words:  Nasopharyngeal carcinoma  Emphasize radiotherapy  Segment weighted optimization  Target dose  Number of ziye

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