鼻咽癌处理的调强放疗

摘要

This paper presents, from the physics perspective, the practical aspects of clinical implementation of intensity modulated radiotherapy (IMRT) in the treatment of nasopharyngeal carcinoma(NPC). The pre-requisites and challenges of the treatment technique and the workflow involved in routine implementation of the treatment, particularly the means of ensuring the geometrical and dosimetrical precision are discussed. The techniques and strategies adopted for planning and dose optimization, evaluation of treatment plans, dosimetry verification, and patient immobilization are discussed to gether with treatment quality assurance and monitoring. The principle and advantages of using virtual dosimetry verifi cation of IMRT treatment will be introduced and described. Our initial results with 35 NPC patients treated with the technique indicate that the technique can improve treatment complications that are normally associated with convention al radiotherapy techniques.%本文从物理学的观点介绍鼻咽癌处理中调强放疗临床实践的有关概况.文中对于处理过程中挑战性的问题以及临床处理流程,尤其是保证几何和计量计算的精度问题进行了讨论.对那些用于治疗计划和剂量优化计算的技术和策略、处理计划的评价、剂量验证和病人的移动等问题和处理的质量保证和检测问题一起进行了讨论.对调强放疗虚拟剂量验证的原理和邮电进行了介绍和描述.我们用35个鼻咽癌病人处理的初步结果表明:和常规的放疗技术相比,这里介绍的调强技术能够改进处理时的复杂性.