乳腺癌保乳术后瘤床补量放疗的研究.docVIP

精品论文 参考文献 乳腺癌保乳术后瘤床补量放疗的研究 司马义力?买买提尼牙孜 艾秀清 贺春钰 木克代斯?拜克提亚尔 朱相露 　　木妮热?木沙江（通讯作者） 　　（新疆医科大学附属肿瘤医院乳腺放疗科 新疆 乌鲁木齐 830011） 　　【摘要】 目的：比较乳腺癌保乳术后瘤床电子线补量放疗(SBT)和同步推量调强放疗(SIB)靶区剂量，评价两种不同的放疗方式对靶区、危及器官受照射体积及剂量的影响。方法：选择我院接受乳腺癌保乳手术的早期乳腺癌（Tis-2N0M0）患者10例，在术中瘤床放置银夹标记，将银夹所标记的范围外扩1.0～1.5㎝定义为瘤床靶区（CTVTb），胸壁和全乳腺定义为临床靶区（CTV）。通过三维治疗计划系统(TPS)，为每例患者设计了电子线补量计划和瘤床调强同步推量计划。用剂量体积直方图（DVH）评价靶区剂量适形度、均匀性和正常组织所受剂量以及体积。结果：两种不同的放??方式计划中CTV和CTVTb适形度和均匀性差异有统计学意义(P=0.000)；肺V20、肺V10照射体积差异无统计学意义；心脏V30和心脏V10照射体积差异均无统计学意义；对侧乳腺最大照射剂量和平均照射剂量均无统计学意义。结论：在正常组织器官照射体积上相差不明显。但瘤床调强同步推量放疗在瘤床靶区适形度和均匀性方面优于瘤床电子线补量放疗，瘤床调强同步推量放疗可以缩短治疗次数。 　　【关键词】 乳腺癌；放射疗法；同步推量调强放疗；电子线补量放疗；剂量学 　　【中图分类号】R737.9 【文献标识码】A 【文章编号】2095-1752（2016）15-0120-03 　　The analysis of simultaneously integrated boost(SIB) technique for breast-conserving radiotherapy Simayili Maimaitiniyazi,AI Xiuqing, He Chunyu, Mukedaisi Baiketiyaer, ZHU Xiang-lu,Munire Mushajiang.Department of Radiation Oncology, Affiliated Cancer Hospital, Xinjiang Medical University, Urumqi 830011,China. 　　【Abstract】Objective In order to compare the dose of the sequential boost(SBT) and the simultaneously integrated boost (SIB) technique in breast cancer treated with conservative surgery, evaluating the effects of target coverage,the doses and volume of normal tissues by the two different radiation types. Methods Ten patients with early stage breast cancer (Tis-2N0M0) treated with conservative surgery were selected, the region marked by silver clips, the region with extended margin of 1.5～2.0㎝ was defined as gross target volume (CTVTb), the chest wall and whole breast were defined as the clinical target volume ( CTV). The SBT planning and SIB planning of each patient were designed by three-dimensional treatment planning system. Evaluating the conformality and uniformity of target coverage dose, the dose and volume of normal tissues by dose-volume histogram(DVH). Results There were significant differences between the dose uniformity, conform