摘要
目的对乳腺癌保乳术后患者设计野中野调强放射治疗(FIF-IMRT)、混合调强放射治疗(Hy-IMRT)、静态调强放射治疗(S-IMRT)、容积旋转调强放射治疗(VMAT)四种不同放疗计划,比较四种不同放疗计划模式下的剂量学差异。方法纳入于2019年1月至6月在广西医科大学第一附属医院确诊为乳腺癌且行保乳术后的22例患者,左、右侧各11例,分别设计FIF-IMRT、Hy-IMRT、S-IMRT、VMAT四种放疗计划,处方剂量均为50 Gy/25次。通过剂量体积直方图(DVH)采用非参数检验方法比较靶区剂量及危及器官受照剂量分布的差异。结果四种放疗计划在PTV的D_(2%)、D_(98%)、D_(50%)、均匀性指数(HI)、适形度指数(CI)、V105、V110方面比较,差异均有统计学意义(P<0.05)。四种放疗计划患侧肺V_(5)、V_(10),健侧肺D_(max)、Dmean,健侧乳腺D_(max)、Dmean,脊髓D_(max)、Dmean比较,差异均有统计学意义(P<0.05)。左侧乳腺癌四种放疗计划的心脏V_(5)、V_(10)、V_(40)、Dmean、D_(max),右侧乳腺癌四种放疗计划的心脏V_(5)、V_(10)、V_(20)、Dmean、D_(max)比较,差异均有统计学意义(P<0.05)。结论在乳腺癌保乳术后的放疗计划设计中,优先考虑Hy-IMRT,其次当靶区的HI和CI以及靶区内高剂量体积在可接受的情况下可以考虑FIF-IMRT,而当心、肺、肝的低剂量区在可接受的范围内可以适当考虑S-IMRT和VMAT。
Objective To design four different radiotherapy plans of field-in-field intensity-modulated radiation therapy(FIF-IMRT),hybrid intensity-modulated radiation therapy(Hy-IMRT),static intensity-modulated radiation therapy(S-IMRT)and volumetric modulated arc therapy(VMAT)for breast cancer patients after breast-conserving surgery,and to compare the dosimetry differences of the four different radiotherapy plans.Methods A total of 22 patients who were diagnosed with breast cancer and underwent breast-conserving surgery in the first affiliated hospital of Guangxi medical university from January to June 2019 were included,including 11 patients on the left and 11 on the right,respectively.Four radiotherapy plans of FIF-IMRT,HY-IMRT,S-IMRT and VMAT were designed respectively,and the prescribed dose was 50 Gy/25 times.The dose volume histogram(DVH)was used to compare the differences of target dose and dose distribution of endangered organs by nonparametric test.Results There were statistically significant differences in D_(2%),D_(98%),D_(50%),homogeneity index(HI),conformosity index(CI),V105 and V110 of PTV among the four radiotherapy plans(P<0.05).There were statistically significant differences in V_(5)and V_(10)of affected lung,D_(max)and Dmean of healthy lung,D_(max)and Dmean of healthy breast,D_(max)and Dmean of spinal cord of the four radiotherapy plans(P<0.05).There were statistically significant differences in V_(5),V_(10),V_(40),Dmean and D_(max)of the hearts of the four radiotherapy plans for left breast cancer and V_(5),V_(10),V_(20),Dmean and D_(max)of the hearts of the four radiotherapy plans for right breast cancer(P<0.05).Conclusion In the design of radiotherapy plans for breast cancer after breast-conserving surgery,the priority should be given to HY-IMRT.Then,when the HI and CI of the target region and the high-dose volume of the target region are acceptable,the FIF-IMRT can be considered,while the S-IMRT and VMAT can be considered in the low-dose region of the heart,lung and liver within the acceptable rang
作者
谢金莲
覃文
李博
王仁生
XIE Jinlian;QIN Wen;LI Bo;WANG Rensheng(Radiation Oncology Department,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China)
出处
《临床医学研究与实践》
2022年第3期56-61,共6页
Clinical Research and Practice
关键词
乳腺癌
剂量学
野中野调强放射治疗
混合调强放射治疗
静态调强放射治疗
容积旋转调强放射治疗
breast cancer
dosimetry
field-in-field intensity-modulated radiation therapy
hybrid intensity-modulated radiation therapy
static intensity-modulated radiation therapy
volumetric modulated arc therapy
