胶质瘤离子放疗的剂量学研究

doi:10.3760/cma.j.cn113030-20190212-00048

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摘要目的研究胶质瘤患者接受质子+碳离子放疗(离子放疗)与光子放疗剂量学差异。方法选取 12例胶质瘤患者数据,给予相同总处方剂量60.00 Gy[RBE],分别基于离子射程不确定及摆位误差获得离子计划靶区和光子计划靶区;基于离子计划靶区制定质子及碳离子加量计划。基于两种计划靶区制定两类光子调强计划。实现靶区覆盖类似并对比危及器官受量。结果三类计划靶区覆盖相近(P>0.05)。离子计划正常脑组织积分剂量仅为两光子计划最优值的44.90%(P<0.001)。离子计划与光子计划最优值相比能降低脑干 Dmean{(6.83±6.22) Gy[RBE]∶(15.10±10.11) Gy[RBE],P=0.001)}和视交叉 Dmax{(47.76±20.8) Gy[RBE]∶(49.59±20.52) Gy[RBE],P=0.009}及健侧海马 Dmean{(0.26±9.08) Gy[RBE]∶(16.28±11.14) Gy[RBE],P=0.002}。结论质子+碳离子放疗能保持光子放疗类似靶区覆盖下显著降低危及器官受量;紧邻靶区危及器官受量受靶区外扩影响。

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	卢艳
	王巍伟
	邢影
	高晶
	孔琳
	陆嘉德

关键词 ：脑肿瘤/放射疗法, 放射疗法,离子, 放射疗法,光子, 剂量学

Abstract：Objective To investigate the dosimetric difference between glioma patients treated by particle (proton+carbon ion) and photon radiotherapy. Methods Twelve previously-treated glioma patients were selected, and given with the same total dose of 60.00 Gy [RBE]. Two types of planning target volumes (PTVs) including PTV-ion and PTV-photon were expended from clinical target volumes according to range uncertainty and patient setup errors. Based on PTV-ion, proton plans with sequential carbon ion boost (particle plan) were created. Following the same prescription, two types of photon intensity-modulated radiotherapy (IMRT) plans were established to achieve similar target coverage and compare the dose of organs at risk. Results Target coverages of three types of plans had no statistical difference (all P>0.05). The median integral dose of normal brain of all patients receiving particle plan was merely 44.90% of the minimum number from photon plans (P<0.001). Compared with the minimum number from photon plans, particle radiotherapy decreased the mean dose of brain stem[(6.83±6.22) Gy[RBE] vs. (15.10±10.11) Gy[RBE], P=0.001)], the maximum dose of chiasm[(47.76±20.80) Gy[RBE] vs. (49.59±20.52) Gy[RBE], P=0.009)] and the mean dose of contralateral hippocampus (0.26±9.08) Gy[RBE] vs. (16.28±11.14) Gy[RBE], P=0.002), respectively. Conclusions Particle radiotherapy can achieve similar target coverage while maintaining lower normal tissue doses to the photon radiotherapy. Photon planion can increase the doses to adjuvant normal tissues.

Key words： Brain neoplasm/radiotherapy Radiotherapy, particle Radiotherapy, photon Dosimetry

收稿日期: 2019-02-12

基金资助:市级医院新兴前沿技术联合攻关项目(SHDC12016120)

通讯作者: 王巍伟,Email:weiwei.wang@sphic.org.cn

引用本文:

卢艳,王巍伟,邢影等. 胶质瘤离子放疗的剂量学研究[J]. 中华放射肿瘤学杂志, 2020, 29(10): 866-871.

Lu Yan,Wang Weiwei,Xing Ying et al. Dosimetric study of particle radiotherapy for glioma patients[J]. Chinese Journal of Radiation Oncology, 2020, 29(10): 866-871.

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http://journal12.magtechjournal.com/Jweb_fszlx/CN/10.3760/cma.j.cn113030-20190212-00048 或 http://journal12.magtechjournal.com/Jweb_fszlx/CN/Y2020/V29/I10/866

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