- 期刊
非小細胞癌肺部放射治療計畫之探討
The Study of Different Radiotherapy Treatment Planning for Non-Small Cell Lung Cancer
摘要
非小細胞癌（non-small cell lung cancer，NSCLC）發生率占所有癌症的85%，放射治療計畫的目標即是提升局部腫瘤控制率和降低鄰近組織併發症之機率，故劑量分佈需要更能夠順著腫瘤的形狀，才有利達成計劃最適化目標。本文目的在於探討非小細胞癌三度空間順形治療與強度調控放射治療之劑量適宜性，評估靶與鄰近邊側組織之劑量。隨機收集5位已完成治療的非小細胞患者之電腦斷層影像，使用三度空間順形治療設置5個共平面之射束，而強度調控放射治療計畫設置5個共平面射束並配合50個組合照野（segments）執行計畫，在依據靶和各組織之劑量、靶劑量之順型指數（conformity index，CI）、劑量同質性指數（homogenate index，HI）、劑量分布圖和劑量體積直方圖（dose volume histogram，DVH），對兩者治療計畫做評估。結果顯示三度空間順形治療和強度調控放射治療患側肺V20分別為50.8%和47.9%，對側肺V20為13.3%和3.3%，CI為0.66和0.75，HI為0.89和0.95。使用強度調控放射治療施予肺之非小細胞癌確實能提升靶之劑量之順形程度和劑量同質性，且減少鄰近組織之劑量，更能保護對側肺，降低放射性肺炎之發生率。
並列摘要
This experiment compares three-dimensional conformal therapy (3D-CRT) and intensity modulated radiation therapy (IMRT) for non-small cell lung cancer (NSCLC) to assess the target and adjacent tissue dosage to determine the most suitable treatment. The computed tomography, three-dimensional conformal therapy, and IMRT for five patients with NSCLC and that have completed treatment were randomly collected. The two treatment plans were assessed according to the target and adjacent tissue dosage, conformity index (CI) of target dosage, homogenate index (HI) of dosage, dose distribution map, and dose volume histogram (DVH). Our research results have shown that V20 of lung lesions of three-dimensional conformal therapy and IMRT were 50.8 % and 47.9 %; the V20 of non-lesion were 13.3 % and 3.3 %;CI were 0.66 % and 0.75 %; and HI were 0.89 % and 0.95 %. Previous literature and our experiment results have indicated that NSCLC treated with IMRT has indeed enhanced the degree of conformity and homogeneity of target dosage, has reduced the dosage of adjacent tissue, and has further protected the non-lesion lungs and reduced incidences of radiation pneumonitis.
延伸閱讀
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