| Guangjin Yuan,Qianwen Li,Shixian Chen,Chengwei Zheng,Jiang Tang,Jian Hu,Ximing Xu. Selective partial salivary glands sparing during intensity-modulated radiation therapy for nasopharyngeal carcinoma. Oncol Transl Med, 2017, 3: 65-70. |
| 选择性部分唾液腺保护在鼻咽癌调强放疗中的应用 |
| Selective partial salivary glands sparing during intensity-modulated radiation therapy for nasopharyngeal carcinoma |
| Received:January 03, 2017 Revised:April 19, 2017 |
| DOI：10.1007/s10330-017-0219-9 |
| 中文关键词: 鼻咽癌，调强放疗，选择性部分唾液腺保护 |
| 英文关键词: nasopharyngeal carcinoma; intensity-modulated radiotherapy; selective partial salivary gland sparing |
| 基金项目:重庆市黔江区科技计划资助项目2014046 |
| Author Name | Affiliation | E-mail | | Guangjin Yuan | Nationality Hospital of Qianjiang | yuantod@aliyun.com | | Qianwen Li | the 82nd Hospital of the Chinese People’s Liberation Army, Huai’an | | | Shixian Chen | Nationality Hospital of Qianjiang, Chongqing | | | Chengwei Zheng | Nationality Hospital of Qianjiang, Chongqing | | | Jiang Tang | the 82nd Hospital of the Chinese People’s Liberation Army, Huai’an | | | Jian Hu | Renmin Hospital of Wuhan University, Wuhan | | | Ximing Xu* | Renmin Hospital of Wuhan University, Wuhan | doxtorxu120@aliyun.com |
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| 中文摘要: |
| 目的：
研究选择性部分唾液腺保护技术在鼻咽癌（NPC）调强放疗（IMRT）中的剂量变化。
方法：
10例NPC患者纳入研究。每个患者作两个调强计划：常规计划（对照计划）：以全腮腺的限制条件作计划；治疗计划：以选择性部分唾液腺包括双侧腮腺及颌下腺的限制条件作计划。选择性部分唾液腺的勾画如下：包括双侧腮腺及颌下腺，根据计划靶区（PTV）进行勾画，勾画的部分唾液腺至少与PTV相距0.5cm以上。然后对两个计划的剂量参数如：PTV的V110%, V100%, V95%，Dmin，HI、CI，以及腮腺、颌下腺的平均剂量、V30等进行比较；尚对危器如脑干、脊髓、晶体等的受量进行比较。
结果
治疗计划的全腮腺与部分腮腺的平均剂量、V30与对照计划相比，均明显下降。治疗计划的部分颌下腺的平均剂量亦较对照计划明显下降。PTV剂量覆盖情况两计划相当，表现为两计划PTV的V110%, V100%, V95%，Dmin，HI、CI无明显差别。治疗计划中的危器受量如脊髓、脑干较对照计划稍升高，但无统计学意义。
结论：
选择性部分唾液腺保护技术可降低鼻咽癌患者腮腺与颌下腺的剂量，从而有利于减轻患者放疗后口干的症状，但不影响靶区剂量覆盖。 |
| 英文摘要: |
| Objective This study evaluated the dosimetric consequences of selective partial salivary gland sparing
during intensity-modulated radiotherapy (IMRT) for patients with nasopharyngeal carcinoma (NPC).
Methods Ten patients with NPC were enrolled in the study. Two IMRT plans were produced for each
patient: conventional (control) and partial salivary glands-sparing (treatment), with dose constraints to the
entire parotid glands or partial salivary glands (including the parotid and submandibular glands, delineated
with the adjacent distance of at least 0.5 cm between the glands and PTV, the planning target volume) in
planning, respectively. Dosimetric parameters were compared between the two plans, including the V110%,
V100%, V95% (the volume covered by more than 110%, 100%, or 95% of the prescribed dose), Dmin (the
minimum dose) of PTV, homogeneity index (HI), conformity index (CI), and the mean dose and percentage
of the volume receiving 30 Gy or more (V30) for the parotid glands and submandibular glands.
Results Treatment plans had significantly lower mean doses and V30 to both the entire parotid glands
and partial parotid glands than those in control plans. The mean doses to the partial submandibular glands
were also significantly lower in treatment plans than in control plans. The PTV coverage was comparable
between the two plans, as indicated by V100%, V95%, Dmin, CI, and HI. The doses to critical structures, including
brainstem and spinal cord, were slightly but not significantly higher in treatment plans than in control plans.
Conclusion A selective partial salivary gland-sparing approach reduces the doses to parotid and
submandibular glands during IMRT, which may decrease the risk of post-radiation xerostomia while not
compromising target dose coverage in patients with NPC. |
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