摘要
目的分析乳腺癌改良根治术后胸壁及区域淋巴引流区整体调强放疗(IMRT)的剂量学特点,为临床选择适当的放疗技术提供依据。方法选择19例乳腺癌改良根治术后患者,CT扫描后在治疗计划系统上将胸壁和区域淋巴引流区作为整体勾画靶区,每位患者分别采用三维适形调强和电子线两种放疗计划,用剂量-体积直方图进行评价,比较两种计划的剂量学差异。结果三维适形调强计划的HI、CI优于电子线计划,PTVVD95%、PTVDmean亦高于电子线计划,而PTVDMax和PTVVD110%低于电子线放疗计划,差异有统计学意义(P<0.05);三维适形调强放疗的患侧肺V20、心脏V40低于电子线计划,患肺V5高于电子线计划,差异有统计学意义;而患肺DMean、心脏DMean、心脏V30二者差异无统计学意义(P>0.05)。结论应用整体调强技术,能明显改善靶区剂量分布的适形性和均匀性,而相应的危及器官受量没有明显增加,此技术安全可靠。
Objective To discuss the dosimetric characteristics of Intensity Modulated Radiotherapy （IMRT） for treating the chest and regional lymph nodes after modified radical mastectomy, and provide the basis for selection of appropriately radiotherapy. Methods 19 patients of modified radical mastectomy were selected. All 19 patients of modified radical mastectomy, every cases were used CT positioning , each patient was and used TPS design two plans, IMRT and electron beam radiation, then , compared the difference of dosimetry between two ways. Results The IMRT plan ＇s Conformal HI, CI iwas better than electronic beam plan , PTVVD95 %, and PTVDmean arewere also higher than electronic beam plan,, PTVDMax, and PTVVD110% were lower thanunder than the electron beam plan, there was a statistically significant difference （ P 〈 0.05 ）. Three dimensional Conformal intensity modulated radiotherapy for ipsilateral lung V20 and V40 arewere lower than the electronic beam , ipsilateral lung V5 iwas higher than the electronic beam plan, there was significant . However, the difference of ipsilateral lung ＇s DM heart ＇s DMean and V30, the difference was not statistically significant. Conclusion Theapplication of the whole IMRT,can significantly improve the dose distribution in the target. And the risky dose of the organ at risk is not significantly increased. This technology is safe and reliable.
出处
《宁夏医学杂志》
CAS
2017年第2期132-134,共3页
Ningxia Medical Journal
关键词
乳腺癌
三维适形放射治疗
靶区
剂量学
Breast cancer
Three - dimensional conformal intensity modulated radiotherapy
Target
Dosimetry
