摘要
目的比较左侧乳腺癌保乳术后野中野正向调强放疗（FIF-F-IMRT）与逆向调强放疗（I-IMRT）两种放疗技术的剂量学分布。方法选择山西省人民医院2015年1月至7月18例左侧乳腺癌保乳术后患者，分别设计FIF-F-IMRT和I-IMRT计划。比较两组计划靶区剂量分布及危及器官受量差异。结果两种方法均能达到处方剂量要求。两组靶区最大剂量（Dmax）、平均剂量（Dmean）、接受100%处方剂量百分体积（V100）、接受105%处方剂量的百分体积（V105）、接受110%处方剂量百分体积（V110）比较，差异均无统计学意义（均P〉0.05）。心脏接受5 Gy照射的百分体积（V5）、接受20 Gy照射的百分体积（V20）、接受30 Gy照射的百分体积（V30）、Dmean在FIF-F-IMRT组[（11±4）%、（7±4）%、（8±3）%、（15±3）Gy]低于I-IMRT组[（42±8）%、（14±10）%、（14±4）%、（18±7）Gy]（t值分别为29.457、5.542、5.064、4.165，均P=0.000）；左肺V5在FIF-F-IMRT组[（26±6）%]低于I-IMRT组[（47±12）%]（t=6.708，P=0.000），左肺V20、V30、接受40 Gy照射的百分体积（V40）、Dmean两组比较差异均无统计学意义（均P≥0.05）；右肺、右乳V5、右肺Dmean在FIF-F-IMRT组[（7±4）%、（26±5）%、（60±19）Gy]低于I-IMRT组[（31±9）%、（48±11）%、（489±67）Gy]（t值分别为12.304、6.708、42.489，均P=0.000）；FIF-F-IMRT组较I-IMRT组机器跳数少，优化时间短（t=12.214、29.899，均P=0.000）。结论FIF-F-IMRT有很好的靶区剂量分布，可减少危及器官剂量，特别是减少不必要的低剂量照射，并耗费较少的计划时间，减少设备耗损。
ObjectiveTo compare the dosimetric differences in forward intensity-modulated radiotherapy using field-in-field （FIF-F-IMRT） and inverse intensity-modulated radiotherapy （I-IMRT） for the left-sided breast cancer.MethodsA total of 18 patients with left-sided breast cancer undergoing breast-conserving surgery in Shanxi Provincial People＇s Hospital from January to July 2015 were enrolled. For each patient, two treatment plans were designed. The plans were compared by means of target dose distribution and dose for organ at risk.ResultsThe two methods met the requirements of the prescribed doses. There were no differences for maximal dose （Dmax）, mean dose （Dmean）, and 100%, 105%, 110% prescription dose percent volume （V100, V105, V110） of the target （all P 〉 0.05）. The percentage volume of heart receiving 5 Gy （V5）, 20 Gy （V20）, 30 Gy （V30）, Dmean of heart of FIF-F-IMRT [（11±4）%, （7±4）%, （8±3）%, （15±3） Gy] were lower than those of I-IMRT [（42±8）%, （14±10）%, （14±4）%, （18±7） Gy] （t values were 29.457, 5.542, 5.064, 4.165, all P = 0.000）. V5 of left-sided lung of FIF-F-IMRT [（26±6）%] was lower than that of I-IMRT [（47±12）%] （t = 6.708, P = 0.000）, but there was no significant difference between the two groups in V20, V30, V40, Dmean of left-sided lung （all P≥0.05）. V5 of right-sided lung and right-sided breast, Dmean of right-sided lung of FIF-F-IMRT [（7±4）%, （26±5）%, （60±19） Gy] were lower than those of I-IMRT [（31±9）%, （48±11）%, （489±67） Gy] （t values were 12.304, 6.708, 42.489, all P = 0.000）. The number of the monitor units and spending time of FIF-F-IMRT were lower than those of I-IMRT （t values were 12.214 and 29.899, both P = 0.000）.ConclusionFIF-F-IMRT has a good dose distribution in the target volume, and could reduce the dose for organ at risk, especially reduce the unnecessary low dose irradiation, and consume less planning time and equipment consumption.
作者
戚秀荣
张树平
宋睿宁
李欣悦
Qi Xiurong;Zhang Shuping;Song Ruining;Li Xinyue(Department of Radiation Oncology,Shanxi Provincial People＇ s Hospital,Taiyuan 030012,China)
出处
《肿瘤研究与临床》
CAS
2018年第8期541-544,共4页
Cancer Research and Clinic
关键词
乳腺肿瘤
放射治疗剂量
放射疗法
凋强适形
Breast neoplasms
Radiotherapy dosage
Radiotherapy
intensity-modulated
