發(fā)布時(shí)間：2018-01-16 19:43

  本文關(guān)鍵詞：有無均整器模式下高危神經(jīng)母細(xì)胞瘤容積弧形調(diào)強(qiáng)放療計(jì)劃的劑量學(xué)比較　出處：《吉林大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 神經(jīng)母細(xì)胞瘤 容積弧形調(diào)強(qiáng)放療技術(shù) 劑量學(xué) 非均整模式

【摘要】：目的:比較6 MV X射線非均整模式(FFF)和均整模式(FF)下容積調(diào)強(qiáng)弧形放射治療(Rapid Arc)在高危神經(jīng)母細(xì)胞瘤術(shù)后放療中的劑量學(xué)差異,為臨床高危神經(jīng)母細(xì)胞瘤術(shù)后患者選擇最佳放療技術(shù)提供參考。材料和方法:選擇高危神經(jīng)母細(xì)胞瘤術(shù)后患者10例,行CT模擬定位,并勾畫靶區(qū)及危及器官。分別對(duì)每例患者設(shè)計(jì)FFF和FF Rapid Arc計(jì)劃,比較兩種計(jì)劃靶區(qū)的最大劑量(Dmax)、平均劑量(Dmean)、靶區(qū)適形指數(shù)(CI)、均勻性指數(shù)(HI)、危及器官的受量、機(jī)器跳數(shù)和治療時(shí)間。結(jié)果:(1)與FF Rapid Arc治療計(jì)劃相比,FFF Rapid Arc治療計(jì)劃的PTV的Dmax和Dmean均明顯增高,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。FF和FFF Rapid Arc治療計(jì)劃的CI分別為0.85±0.03和0.84±0.04(P0.05),HI分別為1.057±0.01和1.062±0.01(P0.05)。(2)FFF Rapid Arc計(jì)劃顯著降低了小腸V10和Dmean(P0.05);FFF Rapid Arc計(jì)劃顯著降低了腎臟V10明顯降低(P0.05)。(3)FFF Rapid Arc計(jì)劃的機(jī)器跳數(shù)是(474.92±69.37)MU,FF計(jì)劃的機(jī)器跳數(shù)是(450.92±61.90)MU。兩種計(jì)劃治療時(shí)間均約2 min,無統(tǒng)計(jì)學(xué)差異。結(jié)論:兩種計(jì)劃均能滿足臨床治療需求,FF計(jì)劃較FFF Rapid Arc計(jì)劃提供了更好的靶區(qū)劑量分布,FFF Rapid Arc計(jì)劃更利于保護(hù)射野邊緣危及器官,如腎臟和小腸。雖然FFF Rapid Arc計(jì)劃的機(jī)器跳數(shù)高于FF Rapid Arc治療計(jì)劃,大分割照射時(shí),FFF模式能明顯減少治療時(shí)間,縮短治療時(shí)間,減少治療中體位移動(dòng)誤差,達(dá)到精準(zhǔn)治療。但由于本研究是常規(guī)劑量照射,兩者的治療時(shí)間無明顯差別。
[Abstract]:Objective: to compare the effect of Volumetric intensity modulated arc radiotherapy (VIMRT) on rapid Arc under 6 MV X ray nonuniform mode FFFFFFFFFFFFFFFFFFFFF). Dosimetric differences in postoperative radiotherapy for high-risk neuroblastoma. Materials and methods: 10 patients with high risk neuroblastoma were selected for CT simulation localization. FFF and FF Rapid Arc plans were designed for each patient, and the maximum dose of Dmaxin the two target areas was compared. The mean dose was Dmean, the conformal index of target area was CI, the index of homogeneity was high, and the organ acceptance was endangered. Number of machine jumps and duration of treatment. Results: 1) compared with FF Rapid Arc treatment plan. Both Dmax and Dmean of PTV in FFF Rapid Arc treatment plan were significantly increased. The CI of FFF Rapid Arc was 0.85 鹵0.03 and 0.84 鹵0.04, respectively. The HI values of 1.057 鹵0. 01 and 1. 062 鹵0. 01 P0. 05 Rapid Arc significantly decreased the intestinal V10 and Dmean (P < 0. 05). P0.05; The FFF Rapid Arc program significantly reduced kidney V10, significantly reduced the number of machine hops in the P0. 05 Rapid Arc program. 474.92 鹵69.37 MU. The number of machine hops in FF plan was 450.92 鹵61.90 mu. There was no statistical difference in the time of treatment between the two plans. Conclusion: the two plans can meet the needs of clinical treatment. Compared with the FFF Rapid Arc program, FF program provides better target dose distribution. FFF Rapid Arc program is more helpful to protect the organ at the edge of the field. For example, kidney and small intestine. Although the number of machine hops in the FFF Rapid Arc program is higher than that in the FF Rapid Arc treatment plan, the treatment time can be significantly reduced by using the FFF mode during large segment irradiation. The treatment time was shortened, the position movement error was reduced, and the accurate treatment was achieved. However, there was no significant difference in the treatment time between the two groups because of the conventional dose irradiation in this study.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R739.4;R730.55

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