SBRT治疗周围型非小细胞肺癌的布野剂量方案选择

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目的探讨立体定向体部放射治疗(SBRT)治疗周围型非小细胞肺癌(NSCLC)的布野剂量方案选择。方法对5例Ⅰ期周围型NSCLC患者设计三野、五野、七野和九野SBRT计划方案。所有计划均遵循放疗布野原则,予以同样的处方剂量,采用剂量体积直方图评估各计划靶区剂量分布均匀性指数(HI)、靶区适形指数(CI)和双肺不同照射剂量肺体积百分比。结果四种布野计划的靶区覆盖度均能达到要求,HI相仿(P>0.05),五野、七野和九野的CI均高于三野靶区(0.810±0.044、0.819±0.018和0.847±0.013vs.0.774±0.077)(P<0.05)。四种布野方案的肺组织受照射剂量均无统计学差异(P>0.05)。结论在周围型NSCLC的SBRT计划设计中,三野靶区适形性差,五野、七野和九野比较并未显示剂量学上的优势。 OBJECTIVE: To investigate the dosage regimen of stereotactic body radiation therapy (SBRT) in the treatment of peripheral non-small cell lung cancer (NSCLC). Methods Five plans of SBRT for Sanye, Wuye, Qiye and Jiunu were designed in 5 patients with stage Ⅰ NSCLC. All the plans followed the principle of radiotherapy cloth, and the same prescription dose was used. The dose volume histogram was used to evaluate the dose distribution uniformity index (HI), target conformal index (CI) and lung volume percentage . Results The coverage of target area of ​​the four kinds of field programs met the requirements of HI (P> 0.05). The CIs of Wuye, Qiye and Jiunu were higher than those of the three fields (0.810 ± 0.044,0.819 ± 0.018 and 0.847 ± 0.013 vs. 0.0747 ± 0.077) (P <0.05). There was no significant difference in the radiation dose of lung tissue between the four kinds of cloth-field programs (P> 0.05). Conclusion In the design of SBRT plan of peripheral NSCLC, the conformality of the three-field target area is poor, and the comparison of Wuye, Seven-field and Jiunu areas does not show the advantage of dosimetry.
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