摘要
目的:利用三维治疗计划系统(3DTPS),比较乳腺癌保乳术后常规放疗(CRT)与调强放疗(IMRT)剂量学分布的优劣,为乳腺癌保乳术后IMRT的临床推广应用提供依据。方法:对10例乳腺癌保乳术后患者,利用3DTPS分别设计CRT计划和IMRT计划。处方剂量均为50Gy/25F。用剂量体积、剂量分布图及靶区剂量分布均匀性指数评估CRT与IMRT计划的优劣。结果:CRT和IMRT两种放疗计划PTV的V95%、V105%、V110%、V115%分别为(98.3±1.9)%、(42.7±15.1)%、(8.2±8.7)%、(2.2±5.3)%和(98.5±1.0)%、(8.6±4.5)%、(0±0.4)%、0,V95%无统计学差异(P>0.05),V105%、V110%有统计学差异(P<0.05);CRT与IMRT的剂量分布均匀性指数分别为1.30±0.14与1.12±0.03,有统计学意义(P<0.05);IMRT与CRT比较,心脏V30、V40分别降低了70.69%、93.33%,肺V20、V30分别降低了17.96%、14.86%,均有统计学差异(P<0.05)。结论:对乳腺癌保乳术后的PTV,CRT和IMRT计划均有较好覆盖,但IMRT较CRT适形度好,剂量分布均匀。IMRT有效降低了心、肺等正常组织的照射剂量。
Objective： To compare the dose distribution of conventional radiotherapy （CRT） with that of the intensity modulation radiation therapy （IMRT） in breast cancer patients after breast-conserving surgery （BCR）, and to provide evidence for the application of IMRT in the treatment of the patients. Methods： The 3-dimensional treatment planning system was used to design CRT and IMRT plans for 10 post-BCR patients, with the prescribed dosage as 50Gy/25f. CRT and IMRT were compared by evaluation of the dose volume, dose profile and dose distribution homogeneity indices. Results： The V95%, V105% , V110% and V115% of PTV for CRT were （98.3 ±1.9）%, （42.7 ±15.1）%, （8.2 ±8.7）% and （2.2±5.3）%, and those for IMRT were （98.5±1.0）%, （8.6±4.5）%, （0±0.4）% and 0, respectively. Statistically significant differences were observed in V105^ and V110^ （P 〈 0.05 ） but not in V95^ （P 〉 0.05）. Dose distribution homogeneity indices of CRT and IMRT were 1.30 ± 0. 14 and 1.12 ± 0.03, respectively, with statistically significant differences （P 〈 0.05）. Comparing with CRT, IMRT reduced the V30 and V40 of the heart by 70.69% and 93.33% , and the V20 and V30 of the lungs by 22.27% and 40.35%, respectively, both with statistically significant differences （P 〈 0.05）. Conclusion ： For PTV after breast-conserving surgery, both CRT and IMRT plans had a satisfactory coverage, but the latter was more conformal and had a more uniform dose distribution than the former, and it could effectively reduce the radiation dose for normal organs such as the heart and lungs.
出处
《医学研究生学报》
CAS
2009年第2期161-164,I0004,共5页
Journal of Medical Postgraduates
基金
江苏省中医药局科研基金资助项目(批准号:HL07024)
关键词
乳腺癌
常规放射治疗
调强放射治疗
剂量学
Breast cancer
Conventional radiotherapy
Intensity modulation radiation therapy
Dosiology
