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1、·742·中華放射醫(yī)學(xué)與防護(hù)雜志2017年10月第37卷第10期ChinJRadiolMedProt,October2017,Vol.37,No.10·放射治療·基于四分位距值的調(diào)強放療計劃劑量體積直方圖分析李成強盧潔陶城朱健段敬豪尹勇250117濟(jì)南,山東大學(xué)附屬山東省腫瘤醫(yī)院放射治療物理科通信作者:尹勇,Email:yongyinsd@163.comDOI:10?3760/cma.j.issn.0254?5098?2017?10?004【摘要】目的提出一種基于四分位距值的調(diào)強放射治療(IMRT)計劃靶區(qū)及危及器官
2、劑量體積直方圖(DVH)差異分析方法。方法回顧分析22例宮頸癌IMRT計劃,將靶區(qū)和危及器官(膀3胱、直腸和左右股骨頭)5組DVH曲線從Pinnacle計劃系統(tǒng)中導(dǎo)出,對每組DVH曲線求出平均DVH曲線和四分位距值曲線。結(jié)果計劃靶區(qū)DVH在54?03Gy處差異最大,四分位距值為6?95%,處方劑量包繞的靶區(qū)體積為(96?43±1?63)%。膀胱DVH在17?24Gy處差異最大,四分位距值為14?62%,V和V分別為(32?79±7?06)%和(56?47±9?94)%。直腸DVH在35?92Gy處4030差異最大,四
3、分位距值為19?94%,V和V分別為(30?17±10?80)%和(58?16±11?99)%。膀胱與4030直腸的四分位距值差異有統(tǒng)計學(xué)意義(z=-6?59,P<0?05)。左側(cè)股骨頭DVH在16?06Gy處差異最大,四分位距值為31?47%。右側(cè)股骨頭DVH在17?47Gy處差異最大,四分位距值為32?82%,左右股骨頭間的四分位距值間差異無統(tǒng)計學(xué)意義(P>0?05)。結(jié)論四分位距值曲線可以分析靶區(qū)和危及器官DVH曲線的變化趨勢,為自動計劃優(yōu)化參數(shù)設(shè)置提供指導(dǎo)?!娟P(guān)鍵詞】調(diào)強放射治療;體積四分位距值;劑量體積直方
4、圖基金項目:國家自然科學(xué)基金(81472811,81671785);中國博士后科學(xué)基金(2016T90412);山東省科技發(fā)展計劃項目(2014GSF118011)AnalysisofDVHvariationsbasedoninterquartilerangeamongIMRTplansLiChengqiang,LuJie,TaoCheng,ZhuJian,DuanJinghao,YinYongDepartmentofRadiationOncologyPhysics,ShandongCancerHospitalAff
5、iliatedtoShandongUniversity,Jinan250117,ChinaCorrespondingauthor:YinYong,Email:yongyinsd@163.com【Abstract】ObjectiveTostudythedosevolumehistogram(DVH)differenceoftargetandorgansatriskinintensity?modulatedradiationtherapy(IMRT)planningofcervicalcancerbasedonthein
6、terquartilerange.MethodsAtotalof22cervicalcancerpatients′IMRTplanswereretrospectivelyanalyzed.FivegroupsofDVHcurvesofPTVandOARs(bladder,rectum,leftandrightfemoralheads)3werederivedfromthePinnacleplanningsystem.ThemeanDVHcurvesandinterquartilerangeofvolumevol(IQ
7、R)asafunctionofdosewerecalculatedfromeachgroup′sDVHcurve.ResultsThemaximumvolvolumevariationforPTVreachedatIQR(54?03Gy)=6?95%,thevolumeofthetargetreachedbythevolprescriptiondosewas(96?43±1?63)%.ThemaximumvolumevariationforbladderreachedatIQR(17?24Gy)=14?62%.Van
8、dVforbladderwere(32?79±7?06)%and(56?47±9?94)%,4030respectively.RectalDVHshowedthelargestdifferenceat35?92Gy,withthequartileof19?94%,theV40andVforrectumwere(30?17±10?80)%and(