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中华放射肿瘤学杂志
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中华放射肿瘤学杂志  2016, Vol. 25 Issue (5): 508-512    DOI: 10.3760/cma.j.issn.1004-4221.2016.05.019
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呼吸运动幅度对静态IMRT剂量分布的影响研究
刘苓苓, 费振乐, 李兵兵, 王宏志
230031 合肥,中国科学院合肥物质科学研究院肿瘤医院(刘苓苓、李兵兵、王宏志);230031合肥,中国人民解放军第一零五医院肿瘤诊疗中心(费振乐)
Effect of amplitude of respiratory movements on dose distribution of static intensity-modulated radiotherapy
Liu Lingling,Fei Zhenle,Li Bingbing,Wang Hongzhi
Cancer Hospital,Hefei Institutes of Physical Science,Chinese Academy of Sciences,Hefei 230031,China (Liu LL,Li BB,Wang HZH);Center of Radiotherapy,105th Hospital of Liberation Army,Hefei 230031,China (Fei ZL)
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摘要  目的 研究呼吸运动幅度对静态IMRT剂量分布的影响,为受其影响的剂量修正提供指导。方法 采用QUASAR程控呼吸运动仪带动二维矩阵模拟人体上下方向呼吸运动,采集不同呼吸运动幅度等中心层面剂量分布。通过Verisoft软件及绝对剂量分析,分析采集数据与计划剂量分布、绝对剂量百分误差、射野通过率。结果 呼吸运动对靶区内剂量分布影响较小,主要使运动方向边缘靶区外剂量偏高;当呼吸运动幅度<6 mm时γ通过率能满足临床剂量验证需求,>8 mm时随着呼吸幅度的增加γ通过率变小,不能满足临床需求。结论 呼吸运动对静态IMRT技术的影响主要是模糊效应,可通过适当补偿方法确定静态IMRT周期性呼吸运动肿瘤的可行性。呼吸运动方向靶区边缘正常组织实际受量高于计划评价,制定放疗计划时应尽可能降低周围正常组织受量。对呼吸运动幅度较大者,应采取措施减小呼吸幅度提高靶区受照。
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刘苓苓
费振乐
李兵兵
王宏志
关键词 呼吸运动幅度 静态IMRT 剂量分布 QUASAR程控呼吸运动仪    
AbstractObjective To study the effect of amplitude of respiratory movements on dose distribution of static intensity-modulated radiotherapy (IMRT), and to provide a basis for dose correction against respiratory movements. Methods A two-dimensional matrix driven by the QUASAR program-controlled respiratory movement instrument was used to simulate human respiratory movements in the head/foot direction. The dose distribution was evaluated on the isocenter plane with different amplitudes of respiratory movements. The Verisoft software and absolute dose analysis were used to analyze dose distribution, percentage errors of absolute dose, and passing rates of radiation field for both collected data and planned dose distribution. Results In spite of little effect on dose distribution in target volume, respiratory movements increased the dose outside the marginal target volume along the movement direction. When the respiratory amplitude was lower than 6 mm, the passing rate of γ distribution met the requirement of clinical dose verification;when the respiratory amplitude was larger than 8 mm, the passing rate of γ distribution was reduced with the increasing respiratory amplitude and fell below the clinical standard. Conclusions Respiratory movements have a blurring effect on static IMRT. It is possible to introduce some compensation methods to static IMRT in the treatment of tumor with periodic respiratory movements. The normal tissue at the edge of target volume along the respiratory movement direction is exposed to a higher radiation dose than expected. Therefore, the radiation dose for the normal tissue around target volume should be made as low as possible in the radiotherapy plan. For the patients with relatively large respiratory amplitude, action should be taken to lower respiratory amplitude and elevate the radiation dose in target volume.
Key wordsrespiratory movement amplitude    static intensity modulated radiotherapy    dose distribution    QUASAR program-controlled respiratory movement instrument   
收稿日期: 2015-07-15     
基金资助:中国科学院合肥物质科学研究院院长基金(YZJJ201325)
通讯作者: 费振乐,Email:feizhenle@21cn.com;王宏志,Email:wanghz@hfcas.ac.cn   
引用本文:   
刘苓苓,费振乐,李兵兵等. 呼吸运动幅度对静态IMRT剂量分布的影响研究[J]. 中华放射肿瘤学杂志, 2016, 25(5): 508-512.
Liu Lingling,Fei Zhenle,Li Bingbing et al. Effect of amplitude of respiratory movements on dose distribution of static intensity-modulated radiotherapy[J]. Chinese Journal of Radiation Oncology, 2016, 25(5): 508-512.
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http://journal12.magtechjournal.com/Jweb_fszlx/CN/10.3760/cma.j.issn.1004-4221.2016.05.019     或     http://journal12.magtechjournal.com/Jweb_fszlx/CN/Y2016/V25/I5/508
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