弧形治疗与调强治疗计划的比较(1)
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【摘要】 目的： 用等剂量分布和剂量体积直方图对弧形(Arc)治疗和调强治疗计划进行比较。方法： 11例颅内肿瘤的病人均采用传统的Arc治疗，其中4例用1个等中心，4例用2个等中心，3例用3个等中心；相同条件下用多叶准直器(MLC)的调强治疗计划软件重新设计计划，采用1个等中心多个共面野。结果： 对非球形的靶区来说，调强的治疗计划是直观的，并且可以减少工作量。结论： 调强的治疗计划不仅减少计划的时间，而且与传统的Arc治疗计划相比较，正常组织受到的剂量较低，在理论上减少并发症的危险。
【关键词】 调强放射治疗；多叶准直器；等剂量分布；剂量体积直方图
Comparison of arc-based stereotactic radiosurgery and intensity modulated radiation theraphy plans
Sun Lei, Ren Qian Wang Jing Feng.
Radiotheraphy Treatment Center, Zibo Wanjie Cancer Hospital, Zibo Shandong 255213
【Abstract】 Objective To compare intensity modulated radiation theraphy and arc-based stereotactic radiosurgery plans using isodose distributions and dose-volume histograms. Methods Of 11 patients who underwent convertional arc-based radiosurgery for intracranial m alignancies, four were treated with one isocenter, four were treated with two isocenters and three were treated with three isocenters .The same cases were re-planned using MLC-based intensity modulate radiation theraphy software for one isocenter with multiple static field. Results For non-spherical targets, intensity modulated radiation theraphy plan is relatively intuitive, reducing the amount of time required for planning. Conclusion The planning with intensity modulated radiation theraphy reduced the amount of time required for planning. Moreover, a lower dose of radiation is delivered to normal tissue with intensity modulated radiation theraphy than with arc-based radiosurgery, which theoretically should lead to a reduced risk of complications.
【Key words】 Intensity modulated radiation theraphy；Multileaf collimator；Isodose distributions； Dose-volume histograms
【中图分类号】R-1 【文献标识码】B 【文章编号】1007-8231(2011)11-1983-02
尽管脑转移瘤经常是球形的，但大多数放射外科的靶区不是球形的，这项研究的目的是在靶区为非球形时，用等剂量分布和剂量体积直方图比较MLC调强治疗计划和传统的Arc治疗计划的优劣。
1 材料和方法
1.1 靶区定位和勾画 11例脑转移瘤病人使用BrainLAB(博医来公司，德国)的头部面膜固定器进行固定后行CT(美国GE公司的Light Speed Ultra型)扫描整个头颅，扫描层厚3mm，层与层之间无间隔。定位CT和诊断MRI图像通过网络传送到治疗计划系统并进行三维重建。图像重建完成后进行CT和MRI的图像融合，然后在CT图像上层层勾画病灶。
1.2 治疗计划 使用BrainSCAN 5.0 (BrainLAB, GmbH, Munich, Germany)和Eclipse 8.6 (Varian USA) 治疗计划系统，每例病人分别做Arc和MLC调强两套计划。对传统的Arc治疗计划来说，有4个圆形准直器，可以在等中心处形成7.5, 10, 15, 20mm直径的圆形射野，11例中4例采用1个等中心，4例采用2个等中心，3例病人采用3个等中心。在单个等中心的情况下，用5个非共面弧进行设计，床角分别是20, 55, 90, 305和3400；对于多个等中心的情况，其中的1个等中心用3~4个非共面弧进行设计 ......
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