剂量体积联合等效均匀剂量优化在鼻咽癌调强放疗危及器官优化中的应用

庞皓文; 孙小杨; 杨波

doi:10.3971/j.issn.1000-8578.2018.17.0804

剂量体积联合等效均匀剂量优化在鼻咽癌调强放疗危及器官优化中的应用

Application of Dose-volume Combined with Equivalent Uniform Dose Optimization in Optimization of OAR in IMRT on Nasopharyngeal Carcinoma

摘要

摘要:
目的研究剂量体积优化（dose-volume, DV）联合等效均匀剂量（equivalent uniform dose, EUD）优化在鼻咽癌调强放疗危及器官优化中的应用。
方法选取西南医科大学附属医院肿瘤科放疗室鼻咽癌患者调强放疗计划55例，制作调强计划时优化方法分为常规DV优化法和DV与EUD联合优化法两种，比较两种优化方法优化后靶区与危及器官的受量。
结果常规DV优化和DV与EUD联合优化后肿瘤靶区处方剂量、均匀性指数与适形度指数之间差异均无统计学意义（均P > 0.05），危及器官平均剂量差异均有统计学意义，DV与EUD联合优化得到的危及器官平均剂量低于常规DV优化（均P < 0.001）。
结论本研究将DV优化与EUD联合优化法成功应用于鼻咽癌调强放疗危及器官的优化中，并在此基础上提出一种调强计划危及器官受量的验收方法，减少调强放疗计划中人为主观因素对危及器官受量的影响。

Abstract:
Objective To investigate the application of dose-volume (DV) combined with equivalent uniform dose (EUD) in the optimization of organ at risk (OAR) in IMRT on nasopharyngeal carcinoma.
Methods We selected 55 patients with nasopharyngeal carcinoma who received IMRT planning in the Department of Oncology, The Affiliated Hospital of Southwest Medical University. The optimization methods were divided into conventional DV optimization and DV and EUD combined optimization. The dosages of the target and OAR after two optimization methods were evaluated.
Results There was no significant difference in the prescription dose, homogeneity index or conformity index between the two groups (all P > 0.05). We found that the mean OAR doses for DV and EUD combined optimization were significantly lower than those for conventional DV optimization (all P < 0.001).
Conclusion DV and EUD combined optimization is successfully applied to the optimization of OAR in IMRT on nasopharyngeal carcinoma, and we give an evaluation methods for the dosimetry of organs at risk in IMRT, in order to reduce the influence of subjective factors.

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