摘要
目的:比较左侧乳腺癌保乳术后瘤床X射线同步推量(SIB)与电子线后程补量(SBT)放射治疗剂量学特点,探讨不同加量方法对瘤床、心脏和肺受照体积及剂量的影响。方法:选取在医院就诊的10例接受左侧乳腺癌保乳手术患者,将瘤床银夹所标记范围外扩2.0 cm,定义为肿瘤靶区(GTVtb),全乳腺定义为临床靶区(CTV),GTVtb和CTV分别外扩1.5~2.0 cm和0.5 cm,定义为计划靶区(PTVtb和PTV)。每例患者分别设计SIB和SBT两种放射治疗计划,比较两种不同加量方法的靶区和危及器官剂量学差异。结果:两种计划比较瘤床靶区的平均剂量(Dmean)、D95、V105及剂量均匀性(CI)和适形度指数(HI)差异无统计学意义;瘤床的最大剂量(Dmax)、V110两种计划比较差异有统计学意义(t=-3.077,t=-4.283;P<0.05);危及器官患侧肺V20、V5和Dmean,健侧肺V2.5,对侧乳腺Dmax、Dmean两种计划比较差异无统计学意义,但SBT计划心脏V30、V40高于SIB计划,差异有统计学意义(t=-6.415,t=-8.973;P<0.05)。结论:SIB计划方法对心脏的保护作用优于SBT计划方法,且SIB方法能减少患者总的治疗时间,提高工作效率,具有临床应用价值。
Objective:To compare the dosimetric characteristics of simultaneous integrated boost(SIB)and sequential boost(SBT)of intensity modulated radiation therapy(IMRT)of postoperative tumor bed of breast conserving surgery of left breast carcinoma so as to explore the effects of different dosage methods on the radiation volume and dose of tumor bed,heart and lung.Methods:Ten patients who underwent breast conserving surgery were selected.The marked range of the silver-clip was externally expanded 2.0cm,and whole region was defined as gross tumor volume(GTV-tb).The whole breast was defined as the clinical target volume(CTV),and GTV-tb and CTV were respectively expanded by 1.5-2.0 cm and 0.5 cm,and they were defined as PTV-tb and PTV.Each patient was designed with two types of radiotherapy plans:SIB and SBT.And then the dosimetric differences of target region and organ at risk(OAR)between the two different methods were compared.Results:There were no significant differences in the mean doses(Dmean),D95,V105,conformal index(CI)and homogeneity index(HI)between the two kinds of plans.But the differences of the maximum dose(Dmax)and V110 of tumor bed between two kinds of plans were significant(t=-3.077,t=-4.283,P<0.05).There were no significant differences in the V20,V5,Dmean of affected side lung,V2.5 of the contralateral lung,and Dmax and Dmean of the contralateral breast of OAR between the two kinds of plans,but the heart V30 and V40 of SBT group were significantly higher than those of SIB group(t=-6.415,t=-8.973,P<0.05).Conclusion:The SIB method is superior to the SBT method in the effect of protecting heart,and the SIB method can reduce the total treatment time of patient and improve the work efficiency,and it has worthy of clinical application.
作者
刘小龙
杨波
庞皓文
何丽佳
杨红茹
孙小杨
LIU Xiao-long;YANG Bo;PANG Hao-wen(Department of Oncology,The Affiliated Hospital of Southwest Medical University,Luzhou 646000,China;不详)
出处
《中国医学装备》
2020年第6期15-18,共4页
China Medical Equipment
关键词
乳腺癌保乳术后
同步推量
电子线补量
剂量差异
Breast conserving surgery
Simultaneous integrated boost(SIB)
Electronic line compensation
Dose difference
