广义等效均匀剂量优化方法在鼻咽癌调强放射治疗计划中的应用研究

唐天赐; 翟周诗佳; 李省苇; 王孝深; 倪晓晨

doi:10.19401/j.cnki.1007-3639.2023.03.011

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广义等效均匀剂量优化方法在鼻咽癌调强放射治疗计划中的应用研究

论著 | 更新时间：2025-12-31

- 广义等效均匀剂量优化方法在鼻咽癌调强放射治疗计划中的应用研究
- Application of generalized equivalent uniform dose optimization in the treatment of nasopharyngeal carcinoma with intensity-modulated radiotherapy
- 中国癌症杂志 2023年33卷第3期页码：274-281
- 作者机构：
  
  复旦大学附属眼耳鼻喉科医院放疗科，上海 201100
- 作者简介：
  
  [ "唐天赐（ORCID: 0000-0001-9320-6574），学士，技师，剂量师。" ]
  倪晓晨（ORCID: 0000-0003-0935-9776），硕士，主管技师，复旦大学附属眼耳鼻喉科医院放疗科物理组副组长。
- 基金信息：
- DOI：10.19401/j.cnki.1007-3639.2023.03.011
  中图分类号： R739.62；R739.63
- 收稿：2022-06-16，
  
  修回：2022-08-25，
  
  纸质出版：2023-03-30
- 稿件说明：
移动端阅览
唐天赐, 翟周诗佳, 李省苇, 等. 广义等效均匀剂量优化方法在鼻咽癌调强放射治疗计划中的应用研究[J]. 中国癌症杂志, 2023,33(3):274-281.

Tianci TANG, Zhoushijia ZHAI, Shengwei LI, et al. Application of generalized equivalent uniform dose optimization in the treatment of nasopharyngeal carcinoma with intensity-modulated radiotherapy[J]. China Oncology, 2023, 33(3): 274-281.
唐天赐, 翟周诗佳, 李省苇, 等. 广义等效均匀剂量优化方法在鼻咽癌调强放射治疗计划中的应用研究[J]. 中国癌症杂志, 2023,33(3):274-281. DOI： 10.19401/j.cnki.1007-3639.2023.03.011.

Tianci TANG, Zhoushijia ZHAI, Shengwei LI, et al. Application of generalized equivalent uniform dose optimization in the treatment of nasopharyngeal carcinoma with intensity-modulated radiotherapy[J]. China Oncology, 2023, 33(3): 274-281. DOI： 10.19401/j.cnki.1007-3639.2023.03.011.

摘要

背景与目的：

在制订鼻咽癌的调强放射治疗（intensity-modulated radiotherapy，IMRT）计划时，通过比较传统的剂量-体积（dose-volume，DV）物理优化方法，与联合运用DV物理优化方法和广义等效均匀剂量（generalized equivalent uniform dose optimization，gEUD）优化方法的鼻咽癌放疗计划中的剂量学差异，探讨不同的优化方法对IMRT计划中危及器官（organ at risk，OAR）的保护作用。

方法：

随机选取2019—2021年复旦大学附属眼耳鼻喉科医院收治的鼻咽癌患者50例，将每例计划都同时采用两组优化方案进行优化计算：A组仅采用传统的DV物理优化方法；B组采用联合DV优化和gEUD优化方法，其中gEUD的

值分别选取1、2、5、10和20。通过分别观察采用不同的优化方案及不同的

值所获得的腮腺和口腔等OAR的剂量数据结果，从而评估两组优化方案的剂量学差异。

结果：

比较分析两组方案的计划数据，其中靶区的剂量学指标差异无统计学意义（

0.05）。但在腮腺和口腔的保护方面，B组优化方案的结果明显优于A组。对腮腺和口腔而言，gEUD的

值对腮腺和口腔平均剂量的影响比较明显。

结论：

鼻咽癌放疗计划中，联合使用物理优化和生物优化能在满足靶区剂量要求的同时，更好地保护腮腺和口腔等较大体积的并联性OAR。

Abstract

Background and purpose:

In the design of intensity-modulated radiotherapy (IMRT) for nasopharyngeal carcinoma

the traditional dose-volume (DV) physical optimization method is compared with the combined use of the DV physical optimization method and the generalized equivalent uniform dose (gEUD) optimization. This study aimed to investigate dosimetry differences in radiotherapy planning for nasopharyngeal carcinoma using gEUD method

to explore the effect of different optimization methods on the protection of organ at risk (OAR) in IMRT planning.

Methods:

Fifty patients with nasopharyngeal carcinoma in Eye

ENT Hospital of Fudan University from 2019 to 2021 were randomly selected

and two optimization plans were used for each case at the same time for optimization calculation. Group A used the traditional DV physical optimization method

while group B combined DV optimization and gEUD optimization methods adopted

in which gEUD was selected as

10 and 20. We evaluated the results of OAR dose data obtained by using different optimization schemes and different

values.

Results:

The planned data of the two plans were compared and analyzed

and there was no statistically significant difference in the dosimetry index of the target area between groups (

0.05). However

in terms of the protection of the parotid gland and oral cavity

the results of the optimization plan of group B

were significantly better compared with group A. The

value of gEUD had more obvious influence on the average dose of the parotid gland and the oral cavity.

Conclusion:

In the radiotherapy plan for nasopharyngeal carcinoma

the combined use of physical optimization and biological optimization can not only meet the target dose requirements but also better protect the parotid gland

oral cavity and other endangered OAR.

关键词

Keywords

references

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