摘要:目的:探讨不同多叶准直器(mul-tileaf collimator,MLC)叶片宽度对调强放疗(intensity-modulated radiotherapy,IMRT)治疗计划的影响.方法:用ADAC Pinnacle 3型计划系统,对实施IMRT的11例鼻咽癌患者,分别用叶片等中心宽度5 mm和10mm的MLC制定放疗计划,依照剂量体积直方图(dose volume histogram,DVH)对靶区剂量进行综合分析评价,并比较适形指数(radiation conformal index,CI)和剂量均匀指数(homogeneity index,HI).结果:两种治疗计划的靶区剂量配对t检验显示,靶区和腮腺之间差异有统计学意义,P<0.05(P值分别为0.036、0.002和0.001);脑干及脊髓之间差异无统计学意义,P>0.05(P值分别为0.327和0.545).5 mm MLC计划的靶区平均剂量略高于10 mm MLC计划,而两侧腮腺、脑干、脊髓的剂量降低.5 mm MLC计划的CI值明显高于10 mm计划的CI值,t=9.779,P=0.000.两种计划的HI值差异无统计学意义,t=1.257,P=0.237.结论:5 mm MLC与10 mm MLC比较,前者适形度好,靶区剂量更均匀,更适合于形状不规则而且邻近危险器官的病灶IMRT.
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