利用肺部模体研究肺癌在螺旋断层放射治疗计划中靶区间空间关系对肺组织的剂量学影响

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英文篇名：Dosimetric Impact of Spatial Relationship of Radiation Targets in Tomotherapy on Lung Cancer by Using a Lung Phantom 作者：万斌 ; 康盛伟 ; 吴凡 ; 唐斌 ; 王培 英文作者：Wan Bin;Kang Shengwei;Wu Fan;Tang Bin;Wang Pei;Radiotherapy Center,Sichuan Cancer Hospital & Institute,Sichuan Cancer Center,School of Medicine,University of Electronic Science and Technology of China; 关键词：肺部体模 ; 螺旋断层放射治疗 ; 剂量学 ; 肺癌 英文关键词：Lung phantom;;Tomotherapy;;Eosimetry;;Lung cancer 中文刊名：SCZF 英文刊名：Journal of Cancer Control and Treatment 机构：四川省肿瘤医院·研究所四川省癌症防治中心电子科技大学医学院放疗中心; 出版日期：2019-03-25 出版单位：肿瘤预防与治疗 年：2019 期：v.32 基金：国家重点研发计划项目(编号:2017YFC 0113100);; 四川省科技重点研发项目(编号:2018GZ0197)~~ 语种：中文; 页：SCZF201903009 页数：5 CN：03 ISSN：51-1703/R 分类号：46-50

摘要

目的:通过螺旋断层放射治疗(tomotherapy,TOMO)计划系统及肺部模体模拟肺癌中两个靶区的多种相对空间位置关系,研究各种相对空间位置关系的靶区对肺组织剂量的影响。方法:模拟肺癌中两个靶区的情况,分别改变这两个靶区的相对空间位置关系及体积大小,并设计相应的TOMO治疗计划,统计肺组织被5Gy剂量辐照体积V_5,20Gy剂量辐照体积V_(20)及平均剂量辐照体积V_(mean),并利用matlab软件进行数学统计。结果:靶区大小与肺V_5、V_(20)及V_(mean)呈正相关关系,而靶区大小不变时,肺V_5、V_(20)及V_(mean)与靶区间距离呈正相关关系,但会在距离到达一定值时出现极大值且不再随距离变大而变大。结论:TOMO计划系统中肺组织的所受剂量不但与肺组织自身和肿瘤大小有关,还与肿瘤间的空间相对位置有关。
        Objective: To study the impact of several spatial relationships of two targets on absorbed dose received by lung Phantom in the tomotherapy(TOMO) treatment planning system. Methods: On a lung phantom, two targets were contoured in various targets sizes or spatial relationships. Then for each individual way a treatment plan was respectively optimized with relevant prescription dose in each TOMO treatment plan. At last, the V_5, V_(20) and V_(mean) of lung in each plan were collected and then analyzed by MATLAB. Results: A positive correlation was found between target size and V_5, V_(20), V_(mean). When the target size was constant, V_5, V_(20) and V_(mean) increased with the growth of the distance between two targets till the distance reached a certain threshold beyond which the V_5, V_(20) and V_(mean) would not increase anymore. Conclusion: The dose for lung is related to not only the size of lung and that of the tumor but also the relative position of between tumors.

引文

[1] Morias S, Marcu LG, Short M, et al. Do SABR-related toxicities for lung cancer depend on treatment delivery?[J]. Crit Rev Oncol Hemat, 2018,129:67-78.
    [2] Lin Y, Kong F, Li H , et al. Comparison of target volume and clinical effects of four radiotherapy plans for acute lymphoblastic leukemia prior to hematopoietic stem cell transplantation[J]. Mol Med Reports, 2018, 18(3):2762-2770.
    [3] Scrimger RA, Tomé WA, Olivera GH , et al. Reduction in radiation dose to lung and other normal tissues using helical tomotherapy to treat lung cancer, in comparison to conventional field arrangements[J]. Am J Clin Oncol-Canc, 2003, 26(1):70-78.
    [4] Santos JDL . Image Guided Radiation Therapy (IGRT) technologies for radiation therapy localization and delivery[J]. Int J Radiat Oncol Biol Phys, 2013, 87(1):33-45.
    [5] 刘苓苓, 费振乐, 李兵兵,等. 呼吸幅度对旋转容积调强剂量分布的影响研究[J]. 中华放射医学与防护杂志, 2016, 36(3):220-224.
    [6] 张富利,张勇乾,王雅棣.螺旋断层加速器与常规加速器在肺癌调强放疗中的剂量学评估初探[J].中国医学物理学杂志,2012,29(13005):3596-3598.
    [7] 戴相昆, 曲宝林, 杜乐辉, 等. 断层径照技术在非小细胞肺癌放疗中的应用[J]. 中国医学物理学杂志, 2017, 34(2):126-130.
    [8] 李四凤, 张鹏, 郎锦义. 非手术非小细胞肺癌的大分割放射治疗[J]. 肿瘤预防与治疗, 2017, 30(3):208-212.
    [9] Murshed H, Liu HH, Liao Z, et al. Dose and volume reduction for normal lung using intensity-modulated radiotherapy for advanced-stage non-small-cell lung cancer[J]. Int J Radiat Oncol, 2004, 58(4):1258-1267.
    [10] 解佳奇, 蒋俊, 任伟, 等. 非小细胞肺癌调强放疗与螺旋断层放疗剂量学的比较研究[J]. 实用癌症杂志, 2017, 32(3):479-483.
    [11] Leung SW, Lee TF. Treatment of nasopharyngeal carcinoma by tomotherapy: five-year experience[J]. Radiat Oncol, 2013, 8(1):1-6.
    [12] 宋威, 赵迪, 鹿红, 等. 放疗计划剂量学数据的自动提取分析[J]. 中国医疗器械杂志, 2016, 40(4):301-304.
    [13] 施振远, 许康康, 姜洁. 基于MATLAB的最小二乘法数据拟合[J]. 社会科学:全文版, 2016,8(1):00053.
    [14] Xu Y, Deng W, Yang S, et al. Dosimetric comparison of the helical tomotherapy, volumetric-modulated arc therapy and fixed-field intensity-modulated radiotherapy for stage IIB-IIIB non-small cell lung cancer[J]. Sci Rep, 2017, 7:14863.
    [15] 朱夫海, 吴伟章, 王勇, 等. 肺癌螺旋断层放疗计划设计的初步研究[J]. 中国医学物理学杂志, 2014, 31(4):4979-4983.
    [16] Li HQ, Wang YJ, Li J, et al. The application of gamma stereotactic body radiation therapy in stage I/II non-small-cell lung cancer. Promising and encouraging outcome[J]. Saudi Med J, 2013, 34(11):1139-1144.
    [17] 宋颖秋, 王天禄, 党军,等. Ⅳ期非小细胞肺癌预后因素分析及胸部放疗的潜在意义[J]. 现代肿瘤医学, 2018,26(8):1207-1211.
    [18] Li Y, Ma J, Chen X, et al. 4DCT and CBCT based PTV margin in Stereotactic Body Radiotherapy(SBRT) of non-small cell lung tumor adhered to chest wall or diaphragm[J]. Radiat Oncol,2016,11:152.