Tian Wei, Zhou Pixiao, Guo Fen, Wen Yu, Dong Wen, Wang Hongming, Wu Zhijun, Du Yangfeng, Xiao Zemin
Department of Oncology, Xiangya School of Medicine, Changde Hospital, Central South University (The First People's Hospital of Changde City), Changde, Hunan Province, China.
Department of Hematology/Oncology, Changde First Hospital of Traditional Chinese Medicine, Changde, Hunan Province, China.
Medicine (Baltimore). 2025 Feb 28;104(9):e41738. doi: 10.1097/MD.0000000000041738.
To evaluate the feasibility of multi-parameters combined simplified intensity-modulated radiation therapy (sIMRT) planning in thoracic tumors and provide guidance for clinical practice. A total of 34 patients with thoracic tumors who underwent radiotherapy during 2019 to 2020 in our hospital were retrospectively analyzed. The same experienced medical physicist designed the sIMRT planning. The sIMRT planning limited the maximum number of segments per beam-field, the minimum segment area, and the minimum number of segment monitor units (MU), remaining consistent with the conventional intensity-modulated radiation therapy (IMRT). Comparative analysis of the difference in the irradiation dose to the tumor target area, and organs at risk, and delivery validate between 2 groups. The sIMRT slightly increased the tumor target area irradiation dose, but the homogeneity index was similar when compared with IMRT (P > .05). The sIMRT planning significantly reduced the low dose-volume area of the lungs (left lung, V5: 2.5%; right lung, V5: 3.1%; V10: 1.8%; lungs, V5: 3.2%; V10: 1.5%, P < .05) and significantly increased the high dose-volume area of the lungs, heart, and esophagus, while meeting the clinical dose-restriction requirements. Moreover, the planning delivery validation showed that significantly reduced the treatment time (6.5 ± 1.9 minutes vs 8.8 ± 2.0 minutes, P < .0001) and total MU (386.3 ± 109.4 MU vs 406.3 ± 107.9 MU, P < .05). This simplified sIMRT method can meet the requirements of thoracic tumors radiotherapy planning, and has higher time effectiveness. In the future, it needs to be further explored in clinical practice.
评估多参数联合简化调强放射治疗（sIMRT）计划在胸部肿瘤中的可行性，并为临床实践提供指导。回顾性分析2019年至2020年在我院接受放疗的34例胸部肿瘤患者。由同一位经验丰富的医学物理师设计sIMRT计划。sIMRT计划限制了每个射野的最大子野数、最小子野面积和最小子野监测单位（MU）数，其余与传统调强放射治疗（IMRT）一致。比较分析两组在肿瘤靶区、危及器官照射剂量及计划执行验证方面的差异。sIMRT使肿瘤靶区照射剂量略有增加，但与IMRT相比，均匀性指数相似（P>0.05）。sIMRT计划显著降低了肺的低剂量体积区域（左肺，V5：2.5%；右肺，V5：3.1%；V10：1.8%；双肺，V5：3.2%；V10：1.5%，P<0.05），并显著增加了肺、心脏和食管的高剂量体积区域，同时满足临床剂量限制要求。此外，计划执行验证显示，治疗时间显著缩短（6.5±1.9分钟对8.8±2.0分钟，P<0.0001），总MU数减少（386.3±109.4 MU对406.3±107.9 MU，P<0.05）。这种简化的sIMRT方法能够满足胸部肿瘤放疗计划的要求，且具有更高的时间效率。未来，需要在临床实践中进一步探索。
