摘要
目的:比较右乳癌保乳术有无银夹标记患者术后X线瘤床同步整合补量调强放疗的剂量学特点。方法:选取右乳癌保乳术中有无放置银夹标记患者各15例,给X线瘤床同步整合补量调强放疗,6MV-X CTV1 D_T55 Gy/25F,CTV D_T50 Gy/25F,PTV D_T50 Gy/25F,比较两组计划的剂量学差异。结果:瘤床靶区容积无银夹组比有银夹组明显增大,两者比较差异有统计学意义(P<0.05);全乳靶区容积两组比较差异无统计学意义(P>0.05);瘤床与全乳靶区容积的比值(VCTV1/VCTV)无银夹组比有银夹组明显增大,两组比较差异有统计学意义(P<0.05)。全乳靶区D_(max)两组比较差异无统计学意义(P>0.05),D_(mix)、D_(mean)、V_(95)、V_(105)、V_(110)两组比较差异有统计学意义(P<0.05);全乳和瘤床靶区的适形度、均匀性指数两组比较差异无统计学意义(P>0.05)。右肺V_5、V_(10)、V_(20)、D_(mean)、左肺D_(mean)、全肺V_(20)、心脏V_5、V_(15)、D_(mean),脊髓D_(max)、左乳腺D_(mean)两组比较差异均无统计学意义(P>0.05)。结论:无银夹组瘤床靶区容积过大,全乳和瘤床靶区适形度和均匀指数两组比较差异虽无统计学意义(P>0.05),但无银夹组全乳D_(mean)、V105、V110明显偏高,D_(mix)、V_(95)明显偏低,一定程度上影响了靶区的均匀性。建议保乳术时应规范放置标记物以明确瘤床的边界,使瘤床靶区勾画更准确,避免瘤床漏照或不必要的照射,同时让全乳靶区剂量更加均匀。
Objective The aim of this study was to compare the dosimetry characteristics of patients with or without silver clip marks when they finished simultaneous integrated boost intensity- modulated radiotherapy which used X- ray after the right breast cancer breast- conserving surgery. Method 15 patients were selected in each with or without silver clip marks who were performed breast- conserving surgery,and treating these patients with X- ray simultaneous integrated boost intensity- modulated radiotherapy,6MV- XCTV1DT55 Gy /25 F,CTVDT 50 Gy /25 F,PTVDT50Gy /25 F. Comparing differences on dosimetry between the two groups. Results On tumor bed target volume,the group without silver clip marks was larger than the group with silver clip marks,there was significant difference between the two groups（ P〈0. 05）. On whole breast target volume,the difference was not significant between the two groups（ P〈0. 05）. D_（mix）、D_（mean）、V_（95）、V_（105）、V_（110）were not significant between the two groups（ P〈0. 05）. On aspect of homogeneity index and conformal index,there was no significant difference between the two groups（ P〈0. 05）. V_5、V_（10）、V_（20）、D_（mean） of the right lung,D_（mean） of the left lung,V_（20） of the whole lung,V_5、V_（15）、D_（mean） of the heart,D_（max） of Spinal cord,D_（mean） of the left breast were not significant between two groups（ P〈0. 05）. Conclusion The tumor bed target volume of the group without silver clip was too large,although there were no significant differences between the group with silver marks and the group without silver marks on homogeneity index and conformal index,D_（mean）、V_（105）、V_（110）of the whole breast were obviously higher and D_（mix）、V_（95）were obviously lower in the group without silver,to a certain extent,these results affected the uniformity of the target volume. It is recommended that markers should be placed accurately when perform breast- conserving surgery,it will help to determine the boundaries of the tumor bed and make target volume of the tumor more accurate,at the same time,it can avoid omitting irradiation or unnecessary irradiation and make the whole breast target dose more uniform.
出处
《吉林医学》
CAS
2016年第4期816-819,共4页
Jilin Medical Journal
关键词
乳腺癌
保乳术
银夹标记
同步整合补量
调强放疗
Breast cancer
Breast-conserving surgery
Silver clip marks
Simultaneous integrated boost
Intensity-modulated radiotherapy
