摘要
目的分析将全乳野中野适形调强放射治疗技术应用在乳腺癌保乳手术后的作用。方法选择2018年9月至2021年9月中国人民武装警察部队河南省总队医院收治的76例乳腺癌保乳手术后病患为研究主体。全部病患均于计算机断层扫描成像技术(CT)模拟机下开展乳腺部位薄层定位扫描,另外针对定位图像,将其传输到治疗计划系统内,并设计全乳野中野计划。于全乳两切线适形野前提下挡去高剂量区部位,另外制定2~4个小跳数射野,进而使靶区最高剂量下降,同时对高剂量范围和部位进行合理调整。处方剂量是25次50 Gy,95%靶区必须接受处方剂量照射。之后通过其CT模拟定位资料,依据常规切线野射野方式在治疗计划上模拟常规切线野治疗计划,针对野中野计划及常规射野计划实施靶区适形性、危及器官受量和靶区均匀性进行对比。结果两种方式在平均剂量方面对比,差异无统计学意义(P>0.05);调强野中野照射技术适形度高于常规切线照射野技术,均匀度及>55 Gy体积均低于常规切线照射野技术,差异有统计学意义(P<0.05)。两种方式在心脏V5剂量分布方面对比,差异无统计学意义(P>0.05);调强野中野照射技术适形度在肺部V5、V10、V20及心脏V30、平均剂量方面剂量均低于常规切线照射野技术,差异有统计学意义(P<0.05)。结论将全乳野中野适形调强治疗技术应用于乳腺癌保乳手术后,能够发挥良好的全乳照射效果。
Objective To analyze the effect of field-in-field technology in whole breast intensity modulated radiation therapy(IMRT)after breast conserving surgery for breast cancer.Methods A total of 76 patients with breast cancer after breast conserving surgery in Henan provincial Corps Hospital of the Chinese people's armed police force from September 2018 to September 2021 were selected as the subjects of the study.All patients performed thin-layer localization scanning of the breast under the computer tomography(CT)simulator.In addition,the localization image was transmitted to the treatment planning system,and field-in-field technology in whole breast was designed.Under the premise of two tangent conformal fields in the whole breast,the high dose area were blocked,and 2~4 small hop fields were formulated,so as to reduce the maximum dose in the target area,and reasonably adjust the high dose range and location.The prescription dose is 50 Gy for 25 times,and 95%of the target area must be exposed to the prescription dose.Then,based on the CT simulation positioning data,the conventional tangential field treatment plan was simulated in the treatment plan according to the conventional tangential field shooting field mode,and the target area fitness,endangered organ dose and target area uniformity were compared for the field in field plan and the conventional shooting field plan.In the conformal field,the high-dose scanning areas were kept off to design 2-4 minimum hop count fields,decrease the maximum doses in the target region and adjust the high-dose ranges and locations.The radiation doses were 50Gy for 25 times and located in the 95%target area.CT stimulated location data was acquired.The“field-in-field”and conventional radiation therapy were performed.The conformity index,involved organ dose and radiation uniformity based on field-in-field and conventional radiation therapy were compared.Results The mean radiation doses based on two modes were not significantly different(P>0.05);the conformity index based on field-in-field radiation therapy was higher than conventional radiation therapy;the radiation uniformity and area with>55 Gy based on field-in-field radiation therapy were lower than conventional radiation therapy(P<0.05);V5 dose distribution conditions of the heart based on two modes were not significantly different(P>0.05);the lung V5,V10 and V20,the heart V30 and mean doses based on field-in-field radiation therapy were lower than conventional radiation therapy(P<0.05).Conclusion The“field-in-field”conformal intensity-modulated radiation therapy is clinically proven to be effective after breast-preserving surgery of breast carcinoma.
作者
谷美林
GU Meilin(Department of Oncology and Hematology,Henan Provincial Corps Hospital of the Chinese people's armed police force,Zhengzhou Henan 450000,China)
出处
《临床研究》
2022年第7期11-14,共4页
Clinical Research
关键词
调强放射治疗
适形
野中野
全乳
乳腺癌保乳术
临床靶体积
计划靶体积
intensity-modulated radiation therapy
conformal
field-in-field
whole breast
breast-preserving surgery
clinical target volume
planned target volume
