对SIB全脑放射治疗计划的剂量测量分析:共平面VMAT和断层治疗技术的比较
Eda Kaya Pepele1, Öztun Temelli2
1Yeşilyurt Vocational School, Department of Electronics and Automation, Biomedical Device Technology Program, Malatya Turgut Özal University, Malatya, Turkey.
Journal of applied clinical medical physics
|October 24, 2025
概括
与VMAT相比,螺旋式断层切割疗法在脑转移中表现出优异的剂量合规性和关键器官节省,与全脑放射疗法与同时集成增强 (WBRT + SIB) 相比,VMAT在脑转移中表现出优异的剂量合规性和关键器官节省. 仔细选择评估指数对于复杂的SIB计划至关重要.
科学领域:
- 辐射瘤学 辐射瘤学
- 医学物理 医学物理
背景情况:
- 先进的放射治疗技术,如全脑放射治疗与同时集成增强 (WBRT + SIB) 越来越多地用于有限的大脑转移.
- WBRT+SIB允许剂量升级到转移性病变,同时不影响周围的正常组织.
研究的目的:
- 为了回顾性地比较螺旋断层疗法和共平面体积调制弧线疗法 (VMAT) 对于WBRT+SIB在多重脑转移的患者.
- 评估不同评估指数对SIB申请治疗计划比较的影响.
主要方法:
- 对15名患有2-3个脑转移的患者进行了回顾性分析.
- 使用TomoHD进行断层治疗和使用Eclipse进行VMAT的治疗计划.
- 用剂量体积直方图来评估目标体积和处于危险的器官 (OAR),评估指标包括同质指数 (HI),合规指数 (CI) 和计划质量指数 (PQI).
主要成果:
- 与VMAT相比,断层疗法在规划目标体积 (PTV_WB和PTV_met) 中实现了显著更高的D98%,并且对镜头和眼睛的最大和平均剂量较低.
- 断层疗法显示出优越的PTV_WB CI和PTV_met HI和CI.
- 两种技术在计划质量指数 (PQI) 中没有发现显著差异.
结论:
- 断层疗法和VMAT都能实现WBRT+SIB的可接受的目标覆盖率和OAR剂量.
- 断层疗法在剂量一致性和节省眼睛和透镜等关键器官方面具有优势.
- 评估指数的选择对计划质量的解释产生重大影响,特别是在复杂的SIB治疗中.
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