广义等效均匀剂量生物优化法在食管癌调强计划的应用

摘要/Abstract

摘要： 目的探讨食管癌调强计划中广义等效均匀剂量生物优化法的应用。方法选取承德医学院附属医院8例食管癌患者。每位患者使用三种方式进行运算,分别是对心脏和肺采用单目标物理优化法（PlanA）,多目标物理优化法（PlanB）以及广义等效均匀剂量生物优化法（PlanC）。脊髓及其外放的约束条件保持不变,对比3组计划的优劣。结果在靶区和脊髓以及脊髓外扩剂量没有发生明显变化时,用广义等效均匀剂量生物优化法设计的计划在肺和心脏的大部分均值都下降,PlanA与PlanC对比显示,肺的V5、V10、V20、V30及Dmean均有差异且具有统计学意义（P<0.05）,心脏的V5、V10、V20及Dmean均有差异且具有统计学意义（P<0.05）。PlanB与PlanC对比显示,肺的V5、V10、V20、V30、V40及Dmean均有差异且具有统计学意义（P<0.05）,心脏的V5、V20及Dmean均有差异且具有统计学意义（P<0.05）。在剂量体积直方图（DVH）的显示中,在计划靶区（PTV）曲线没有明显变化且脊髓及脊髓外扩也没有明显变化的情况下,肺和心脏的曲线均有不同程度的左移。并且肺的正常组织并发症概率（NTCP）下降且具有统计学意义（P<0.05）。结论采用广义等效均匀剂量生物优化法可以降低肺和心脏的照射剂量。广义等效剂量生物优化法要更优于多目标优化法和单目标优化法,可以更好的保护危及器官。

关键词: 广义等效均匀剂量生物优化法, 食管癌, 单目标优化法, 多目标优化法

Abstract: Objective To explore the application of generalized equivalent uniform dose biological optimization method in intensity-modulated planning of esophageal cancer. Methods Eight patients with esophageal cancer were selected from the Affiliated Hospital of Chengde Medical University. Each patient used three methods for calculation: single objective physical optimization (planA), multi-objective physical optimization (PlanB) and generalized equivalent uniform dose biological optimization (PlanC) for heart and lung. The constraints of spinal cord and its external radiation remained unchanged, and the advantages and disadvantages of the three groups were compared. Results When there were no significant changes in the target area, spinal cord and spinal cord external expansion dose, most of the mean values of the plan designed by the generalized equivalent uniform dose biological optimization method decreased in the lung and heart. The comparison between PlanA and PlanC showed that V5, V10, V20, V30 and dmean of the lung, there were significant differences in V5, V10, V20 and dmean (P<0.05). The comparison between PlanB and PlanC showed that V5, V10, V20, V30, V40 and dmean of lung were statistically significant (P<0.05), while V5, V20 and dmean of heart were statistically significant (P<0.05). In the display of dose volume histograms (DVH), when there is no significant change in the planning target volume (PTV) curve and there is no significant change in the spinal cord and spinal cord expansion, the curves of lung and heart move to the left in varying degrees. The normal tissue complication probability (NTCP) of lung decreased and was statistically significant (P<0.05). Conclusion The radiation dose of lung and heart can be reduced by using the generalized equivalent uniform dose biological optimization method. Generalized equivalent dose biological optimization method is better than multi-objective optimization method and single objective optimization method, and can better protect endangered organs.

Key words: generalized equivalent uniform dose biological optimization method, thoracic tumor, single objective optimization method, multi objective optimization method

中图分类号:

R735.1

葛佳林, 何瑞龙, 廖润超, 许士奇. 广义等效均匀剂量生物优化法在食管癌调强计划的应用[J]. 承德医学院学报, 2024, 41(1): 5-9.

GE Jia-lin, HE Rui-long, LIAO Run-chao, XU Shi-qi. Application of Generalized Equivalent Uniform Dose Biological Optimization Method in Intensity-Modulated Planning of Esophageal Cancer[J]. Journal of Chengde Medical University, 2024, 41(1): 5-9.

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