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    李亮, 沙冠辰, 解昕, 张一擎, 徐钰梅, 范雪梅, 刘肖肖, 章龙珍. 基于RTOG 0813/0915剂量学指标比较不同技术对非小细胞肺癌立体定向放疗计划的影响[J]. 徐州医科大学学报, 2022, 42(12): 913-918. DOI: 10.3969/j.issn.2096-3882.2022.12.010
    引用本文: 李亮, 沙冠辰, 解昕, 张一擎, 徐钰梅, 范雪梅, 刘肖肖, 章龙珍. 基于RTOG 0813/0915剂量学指标比较不同技术对非小细胞肺癌立体定向放疗计划的影响[J]. 徐州医科大学学报, 2022, 42(12): 913-918. DOI: 10.3969/j.issn.2096-3882.2022.12.010
    shu
    Comparison of the effects of different plans using different techniques in stereotactic radiotherapy for non-small cell lung cancer ba＜x＞sed on RTOG 0813/0915 dosimetry index[J]. Journal of Xuzhou Medical University, 2022, 42(12): 913-918. DOI: 10.3969/j.issn.2096-3882.2022.12.010
    Citation: Comparison of the effects of different plans using different techniques in stereotactic radiotherapy for non-small cell lung cancer ba＜x＞sed on RTOG 0813/0915 dosimetry index[J]. Journal of Xuzhou Medical University, 2022, 42(12): 913-918. DOI: 10.3969/j.issn.2096-3882.2022.12.010
    shu

    基于RTOG 0813/0915剂量学指标比较不同技术对非小细胞肺癌立体定向放疗计划的影响

    Comparison of the effects of different plans using different techniques in stereotactic radiotherapy for non-small cell lung cancer ba＜x＞sed on RTOG 0813/0915 dosimetry index

      摘要
    • 摘要: 目的 针对CRT、DCAT、IMRT和VMAT等不同NSCLC-SBRT技术在RTOG 0813/0915剂量学指标（R100%、R50%、D2cm和V20）、其他全肺受量指标以及治疗效率等方面的差异进行系统评价，探讨合适的NSCLC-SBRT技术。方法 回顾分析2019年4月至2021年3月接受SBRT的17例非小细胞肺癌患者临床资料，分别设计7野CRT、7野IMRT、双弧DCAT和双弧VMAT，比较其靶区RTOG 0813/0915剂量学指标、其他全肺受量指标和治疗效率的差异。结果 4种技术中，靶区R100%、R50%和D2cm方面，VMAT组最优（P＜0.001），IMRT组次之（P＜0.001），CRT和DCAT组较差且两组间差异无统计学意义。VMAT与IMRT组全肺V5、V20及Dmean均相近（P=0.082,P=0.082,P=0.652），其中VMAT组全肺V20较CRT与DCAT组分别减少13.3%和9.3%（P＜0.001）。与IMRT组相比，VMAT组全肺V10、MU数和治疗时间分别减少6.9%、53.1%和18.1%（P＜0.001），DCAT组MU数和治疗时间分别减少65.4%和36.4%（P＜0.001）。与VMAT组相比，DCAT组MU数和治疗时间分别减少26.1%和22.3%（P＜0.001）。结论 基于医用加速器的NSCLC-SBRT，优先推荐VMAT技术，其既能保证RTOG协议的剂量限值要求又能减少全肺剂量。

       

      Abstract: ob＜x＞jective The differences in NSCLC-SBRT techniques such as CRT, DCAT, IMRT and VMAT were systematically evaluated by RTOG 0813/0915 dosimetric index (R 100%, R50%, D2cm and V 20), other whole-lung dose index and treatment efficiency, and to explore the appropriate NSCLC-SBRT technology. Methods The clinical data of 17 patients with NSCLC-SBRT were retrospectively analyzed.The plannings conclude 7-beam CRT, 7-beam IMRT, double arc DCAT and double arcs VMAT. The target dose distribution, total lung dose and therapeutic efficiency were compared. Results In terms of target volume R 100%, R50% and D 2cm in the four plans, the VMAT group was the best( P＜0.001), followed by the IMRT group(P＜0.001), the CRT and DCAT groups were worse and the difference between the two groups was without statistical significances. The total lung V 5, V20 and Dmean of the VMAT and IMRT groups were similar(P=0.082,P=0.082,P=0.652), and the total lung V 20 of the VMAT group was 13.3% and 9.3% lower than that of the CRT and DCAT groups, respectively (P＜0.001). Compared with the IMRT group,the total lung V 10, MUs and treatment time of the VMAT group were decreased by 6.9%, 53.1% and 18.1%, respectively (P＜0.001),and the total lung V10, MUs and treatment time of the CRT and DCAT group were decreased by 65.4% and 36.4%, respectively(P＜0.001).Compared with the VMAT group, the number of MUs and treatment time in the DCAT group were decreased by 26.1% and 22.3%, respectively(P＜0.001). Conclusion For NSCLC-SBRT ba＜x＞sed on medical accelerators, VMAT technology is preferred, which can not only ensure the dose limit requirements of the RTOG protocol but also reduce the total lung dose

       

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