首页|海马保护全脑质子治疗的剂量研究

海马保护全脑质子治疗的剂量研究

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目的 基于迈胜S250i质子治疗系统配套的治疗计划系统,研究海马保护全脑质子治疗的剂量分布。方法 选取20例行海马保护全脑放疗的患者,在相同处方条件下为每位患者分别设计双弧VMAT计划和固定射野角度的不使用自适应光栅、使用静态自适应光栅和使用动态自适应光栅IMPT计划,比较不同方案靶区的靶区均匀性、适形度、剂量梯度以及海马、晶状体、视神经、耳蜗的受量。结果 与传统光子VMAT计划相比,不使用自适应光栅的IMPT计划将靶区均匀性指数从(0。45±0。15)提高到了(0。60±0。08),靶区内高剂量D2从(3368。22+65。94)cGy下降到(3270。67±104。78)cGy,海马体、晶状体和耳蜗的受量都显著减少(均P<0。05);使用静态自适应光栅进行优化,可以提升IMPT计划的靶区梯度,进一步降低晶状体受量(P<0。05);使用动态自适应光栅进行优化,则显著改善了IMPT计划的靶区梯度和适形度,更进一步降低了视神经、晶状体和耳蜗受量(均P<0。05)。结论 质子IMPT较传统光子VMAT在海马保护全脑治疗上更具剂量学优势。使用迈胜自适应多叶光栅不仅能进一步优化靶区剂量,更能最大程度降低靶区周围正常组织的照射剂量,具有良好的临床应用前景。
Study on Dose of Hippocampal Sparing Whole-brain Proton Therapy
Objective To evaluate the dose distribution of hippocampal sparing whole-brain proton therapy based on the treatment planning system of Mevion S250i proton therapy system.Methods Twenty patients undergoing hippocampal sparing whole-brain radiotherapy were selected.Under the same optimal conditions,plans using VMAT,fixed-angle IMPT without a-daptive aperture,IMPT with static adaptive aperture and IMPT with dynamic adaptive aperture were designed for each pa-tient.HI,CI,GI and the dose of hippocampus,lens,optic nerve,cochlea in different groups were compared.Results Compared with the VMAT plans,the IMPT plans without the adaptive aperture improved the target homogeneity index from(0.45±0.15)to(0.60±0.08),and the high-dose D2 in the targets decreased from(3368.22±65.94)cGy to(3270.67±104.78)cGy,and the irradiation doses of the hippocampus,lens and cochlea were significantly reduced(P<0.05).The target gradient of IM-PT plans could be improved using static adaptive aperture,and the dose of lens could be further reduced(P<0.05).The target gradient and conformal degree of the IMPT plans were significantly improved using dynamic adaptive aperture,and the dose of the optic nerves,lens and cochleae were further reduced(P<0.05).Conclusion IMPT has a dosimetric advantage over VMAT in hippocampal sparing whole-brain radiotherapy.The use of Mevion adaptive aperture can not only further optimize the dose to the target area,but also minimize the radiation doses to the normal tissue around the target area,which has a good clinical appli-cation prospect.

hippocampal sparingwhole-brainproton therapydose

郑仁超、吴韦清、卢晓光、张莉、胡广原、袁响林、郑言宏、李定宇

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华中科技大学同济医学院附属同济医院肿瘤科,武汉 430030

深圳清华大学研究院精准放射诊疗技术研发中心,深圳 518057

海马保护 全脑 质子治疗 剂量

2024

华中科技大学学报(医学版)
华中科技大学

华中科技大学学报(医学版)

CSTPCD北大核心
影响因子:1.443
ISSN:1672-0741
年,卷(期):2024.53(6)