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目的探讨混合调强放疗在局部晚期和晚期肺癌放射治疗中的剂量学特点。方法对16例不适合做适形放疗的肺癌患者分别设计单纯调强计划和混合调强计划,比较两种计划的剂量学差异。结果两种计划均满足临床要求,而混合调强计划的靶区适形度(CI)和均匀性(HI)均优于调强计划(P<0.05)。混合调强计划中全肺受照5、10、13、15和20Gy剂量的体积V5、V10、V13、V15、V20和平均剂量(MLD)均明显小于调强计划(P<0.05)。结论混合调强明显减少了与放射性肺炎发生率相关的中低剂量照射体积,降低了脏器运动引起的剂量误差,减小了剂量计算误差,对局部晚期和晚期肺癌的放疗有一定的剂量学优势。
Objective To investigate the dosimetric characteristics of mixed intensity modulated radiation therapy in the treatment of locally advanced and advanced lung cancer. Methods Sixteen patients with lung cancer who were not suitable for conformal radiotherapy were designed for simple intensity-modulated and mixed-intensity-modulated plans, and the difference between the two plans was compared. Results Both of the two plans met the clinical requirements. However, the target area conformality (CI) and homogeneity (HI) of the hybrid intensity-modulated program were better than those of the intensity modulated program (P <0.05). The volumes of V5, V10, V13, V15, V20 and mean dose (MLD) at 5, 10, 13, 15 and 20 Gy doses for whole lung exposure in the MIP were significantly lower than those in the IMR (P <0.05). Conclusions Mixing intensity modulation can significantly reduce the volume of middle and low doses of radiation associated with the incidence of radiation pneumonitis, reduce the dose error caused by organ motion, reduce the error of dose calculation and have some dosimetry for the radiotherapy of locally advanced and advanced lung cancer Advantage.