摘要
目的 :比较全乳野中野正向调强放疗(FP-FIF-IMRT)技术和逆向调强放疗(IP-IMRT)技术在乳腺癌保乳术后病人正常组织的剂量分布差异。方法:回顾性分析2016年1月至7月乳腺癌保乳术后病人,以调强技术行全乳放疗,并分层抽样。全乳处方剂量为50 Gy/25次,后续瘤床加量10 Gy/5次。在定位CT片上对抽样病人全心和患侧肺进行勾画,并在ADAC Pinnacle系统上收集心肺剂量-体积参数。结果:左乳FP-FIF-IMRT组和IP-IMRT组分别有33例和15例,右乳分别有23例和17例。与IP-IMRT组相比,左侧乳腺癌病人FP-FIF-IMRT组心脏V2、V5参数平均值均较低(P<0.05),但心脏V40则略高(分别为4.31%±2.47%比2.39%±1.74%,P=0.009 5)。右侧乳腺癌病人心脏平均剂量及V2、V5、V10也均较低(P<0.05)。与IP-IMRT组相比,左、右侧乳腺癌病人FP-FIF-IMRT组患侧肺平均剂量及V5、V10、V20均较低(P<0.05)。结论:乳腺癌保乳术后放疗中,与IP-IMRT技术相比,FP-FIF-IMRT技术降低正常组织低剂量照射区体积,但IP-IMRT在限制心脏高剂量区体积方面表现更佳。
Objective To explore the difference in dose distribution in normal tissue between forward-planned field in field intensity modulated radiation therapy（FP-FIF-IMRT）and inverse-planned intensity modulated radiation therapy（IP-IMRT）after breast conserving surgery in breast cancer. Methods The patients with breast cancer who received radiotherapy after breast conserving surgery from January 2016 to July 2016 were retrospectively studied. The prescribed dose was 50 Gy in 25 sessions to breast and 10 Gy in 5 sessions to tumor bed subsequently. The whole heart and ipsilateral lung were outlined on CT. Whose dose-volume histogram parameters of heart and lungs were quantified in the radiotherapy planning system（ADAC Pinnacle）. Results A total of 33 cases with left breast cancer received FP-FIF-IMRT and 15 cases received IP-IMRT. Twenty-three case with right breast cancer received FP-FIF-IMRT and 17 cases received IP-IMRT. V2 and V5 of heart in left breast cancer patients with FP-FIF-IMRT were lower than with IP-IMRT（P0.05）. However, V40 of heart receiving FP-FIF-IMRT was slightly higher than with IP-IMRT（4.31%±2.47% vs. 2.39%±1.75%, P=0.009 5）. Mean dose, V2 and V5 and V10 of the heart in right breast cancer patients were also lower than those receiving IP-IMRT（P0.05）. Mean dose, V5, V10 and V20 of ipsilateral lung in both left and right breast cancer patients receiving FP-FIF-IMRT were lower than those receiving IP-IMRT（P0.05）. Conclusions FP-FIF-IMRT could reduce the volume of low dose irradiated area of normal tissue of breast cancer patients in radiotherapy after breast conserving surgery when compared with IP-IMRT. However, IP-IMRT was more effective in limiting the volume of high dose irradiated area of heart.
出处
《外科理论与实践》
2017年第5期401-406,共6页
Journal of Surgery Concepts & Practice
关键词
乳腺癌
放射治疗
野中野正向调强放疗
逆向调强放疗
剂量分布
Breast cancer
Radiotherapy
Forward-planned field in field intensity modulated radiation therapy
In-verse-planned intensity modulated radiation therapy
Dose distribution
