论文部分内容阅读
目的比较不同放疗技术治疗脊柱转移性肿瘤的剂量学差异。方法 10例脊柱转移性肿瘤患者,利用三维治疗计划系统制定普通外照射及适形、调强放疗计划,处方剂量均为40 Gy/20 f,比较三种放疗计划的剂量学差别。结果适形、调强放疗计划相比普通放疗计划,能显著提高靶区的适形度(P<0.01);而适形和调强计划对靶区的适形度之间的差异无统计学意义(P>0.05)。适形放疗计划较普通外照射及调强放疗计划能明显提高靶区剂量的均匀性(P<0.01),调强放疗计划对提高靶区剂量的均匀性较普通外照射并没有优势(P>0.05)。脊髓所受的剂量在调强放疗计划中最低,普通外照射计划其次,适形放疗计划较高(P<0.01)。结论对于部分椎体转移性肿瘤、预计生存时间较长者可以选用调强放疗计划来提高椎体局部剂量以加强镇痛效果和控制肿瘤。
Objective To compare the dosimetry differences of radiotherapy for spinal metastases. Methods Ten patients with metastatic tumors of the spine were enrolled in this study. The common external radiation and the plan of intensity-modulated radiofrequency ablation were developed by using the three-dimensional treatment planning system. The prescription dose was 40 Gy / 20 f. The difference in dosimetry between the three radiotherapy plans was compared. Results The conformality and intensity-modulated radiotherapy plan significantly improved the conformality of the target area compared with the conventional radiotherapy (P <0.01). However, there was no significant difference in conformality between the conformal and intensity-modulated programs Significance (P> 0.05). Compared with normal external beam radiation and intensity modulated radiotherapy, conformal radiotherapy plans can significantly improve the uniformity of target dose (P <0.01). The intensity modulated radiation therapy plan has no advantage over ordinary external radiotherapy in improving the uniformity of target dose (P> 0.05). The dose of spinal cord was the lowest in IMRT plan, followed by the general external radiation plan and followed by the plan of conformal radiotherapy (P <0.01). Conclusions For some patients with metastatic tumors of vertebral body, IMRT may be selected to improve the local dose of vertebral body to enhance the analgesic effect and control the tumor.