乳腺癌保乳术后全乳放疗三种计划剂量学比较剖析.docVIP

乳腺癌保乳术后全乳放疗三种计划剂量学比较剖析 　　[摘要] 目的 比较左乳腺癌保乳术后采用常规（RT）、三维适形放射治疗（3DCRT）和调强放疗（IMRT）三种不同照射方法的剂量学差异。 方法 选择10例接受保乳手术的左侧早期乳腺癌患者，应用Eclipse 7.3计划系统为每例患者分别设计常规、3DCRT和5野逆向IMRT三套放疗计划，均给予50 Gy/25次，比较靶区、正常组织的受照剂量差异。 结果 IMRT计划的剂量分布以及靶区适形性和均匀性均显著优于常规和3DCRT计划。RT、3DCRT、IMRT计划中患侧肺的V20分别为（29.4±4.6）%、（26.7±4.6）%、（22.6±1.8）%；患侧肺的V30分别为（26.4±5.2）%、（23.4±4.5）%、（16.2±1.6）%；心脏V30分别为（21.9±6.0）%、（14.6±3.5）%、（8.0±3.8）%，差异均具有统计学意义。 结论 与常规（RT）、3DCRT切线野计划相比，5野IMRT计划可以显著改善靶区的剂量分布，降低危及器官OARs（肺及心脏）高剂量受照体积，更好地保护心、肺组织，但同时增大了正常组织低剂量区受照体积。 　　[关键词] 乳腺肿瘤；放射疗法；三维适形放射治疗；调强放射治疗；剂量学 　　[中图分类号] R737.9 [文献标识码] A [文章编号] 1674-4721（2012）02（a）-0007-03 　　 　　Comparison and analysis of dosimetry in three kind of plan of whole breast radiation therapy after breast-conservation treatment in breast cancer 　　HAN Baoshan1 ZHANG Li2 QIAO Li1 CHEN Ming2 　　1. Radiation Center, Yantai Tumor Hospital of Yantai City in Shandong Province, Yantai 264025, China; 2. Tumor Hospital Affiliated Sun Yat-Sen University in Guangdong Province, Guangzhou 510060, China 　　[Abstract] Objective To compare the dosimetric distribution between conventional radiotherapy (RT), three-dimensional cnformal radiotherapy (3DCRT), and intensity-modulated radiotherapy (IMRT) for left-sided whole breast treatment. Methods Ten patients with left-sided breast-conserving surgery and whole breast irradiation were selected. For each patient, the RT, 3DCRT and IMRT with 5 fields were prepared using Eclipse 7.3 treatment planning system. Prescription dose was set to 50 Gy to planning target volume (PTV) in 25 fractions. PTV dose coverage and dose to normal tissues were evaluated. Results Compared with RT and 3DCRT plans, IMRT provided a significant improvement in PTV dose coverage, conformity and homogeneity. The V20 of ipsilateral lung was (29.4±4.6)% (RT), (26.7±4.6)% (3DCRT), and (22.6±1.8)% (IMRT), respectively. The V30 of ipsilateral lung was (26.4±5.2)% for RT (23.4±4.5)% for 3DCRT, and (16.2±1.6)% for IMRT. The V30 of heat was as follows: (21.9±6.0)% f