摘要
目的:探讨I期乳腺癌保乳术后三种常见的放射治疗方式在剂量学上的优劣。方法:选择33例接受保乳手术的T1N0M0 I期乳腺癌病例,其中左侧乳腺癌25例,右侧乳腺癌8例,应用三维治疗计划系统(TPS)为每例患者设计常规切线野(CR),三维适形放射治疗野(3D-CRT)以及三维适形调强放射治疗野(IMRT)三种全乳放射治疗计划,处方剂量均为DT50 Gy/25次。用剂量体积直方图(dose volume histograms,DVH)来比较3种计划中计划靶体积(planning targetvolume,PTV)、危及器官(organs at risks,OARs)的剂量学差异。结果:在三种计划靶区覆盖度的比较中,CR计划的PTV接受处方剂量的95%的体积要明显小于3D-CRT和IMRT,三者之间存在统计学差异;在三种计划剂量均匀性的统计中,IMRT明显优于CR和3D-CRT,三者之间存在统计学差异。结论:三维适形调强放射治疗(IMRT)作为一种目前较为先进的放射治疗技术,其在Ⅰ期乳腺癌保乳术后的辅助放射治疗中在靶区覆盖率以及靶区内剂量的均匀性上均体现出了剂量学的优势,并且对于同侧肺以及心脏的照射体积也显著低于常规的放射治疗和三维适形放疗治疗,但是由于其显著增加患侧肺低剂量受照射区域,因此有可能产生增加肺部第二原发肿瘤的隐患。
Objective: To compare dosimetrically three different techniques in patients with Stage I breast cancer after Breast-conserving surgery.Materials and Methods: Thirty three patients with Stage I(T1N0M0) breast cancer after Breast-conserving surgery,25 patients with left-sided breast cancer and 8 patients with right-sided breast cancer,based on three-dimensional treatment planning system(TPS),every patient planned with three techniques: conventional tangential field radiotherapy(CR),three-dimensional conformal radiotherapy(3D-CRT),intensity-modulated radiation therapy(IMRT),the prescribed dose in all cases is 50 Gy /25 fractions,dose volume histograms(DVH) were used to compare the planning target volume(PTV) and organs at risks(OARs).Results: In the PTV coverage comparison among the three techniques,the percentage of PTV receiving 95% in CR is less than 3D-CRT and IMRT,and there is statistically difference among the three techniques.In the dose uniformity comparison,IMRT is much better than CR and 3D-CRT,also there is statistical difference among the three techniques.Conclusions: In the adjuvant radiotherapy of stage I breast cancer after Breast-conserving surgery.IMRT,as an advanced radiation therapy technology,has dosimitric advantages over CR and 3D-CRT not only in The PTV coverage and dose uniformity,but also in the Volumes of ipsilateral lung and heart irradiated.But IMRT increases the low dose volume of ipsilateral lung irradiated,it may increase the possibility of secondery lung tumor
出处
《中国医学物理学杂志》
CSCD
2011年第4期2725-2728,共4页
Chinese Journal of Medical Physics
关键词
乳腺肿瘤
调强放射治疗
剂量学
剂量体积直方图
breast neoplasms
intensity-modulated radiation therapy(IMRT)
dosiology
dose volume histograms(DVH)
