中华放射医学与防护杂志
中華放射醫學與防護雜誌
중화방사의학여방호잡지
Chinese Journal of Radiological Medicine and Protection
2008年
2期
163-166
,共4页
李建彬%卢洁%范廷勇%刘娟%白瞳%孙涛%邢军%王永胜%邵倩
李建彬%盧潔%範廷勇%劉娟%白瞳%孫濤%邢軍%王永勝%邵倩
리건빈%로길%범정용%류연%백동%손도%형군%왕영성%소천
保乳治疗%常规放疗%调强放疗%瘤床补量%治疗计划
保乳治療%常規放療%調彊放療%瘤床補量%治療計劃
보유치료%상규방료%조강방료%류상보량%치료계화
Breast-conservative surgery%Conventional radiotherapy%Intensity-modulated radiotherapy%Tumor bed boost%Treatment planning
目的 探讨乳腺癌保乳术后全乳加瘤床照射不同治疗计划靶区剂量适形度、靶区剂量分布均匀性及肺脏、心脏和对侧乳腺受照剂量体积的差异.方法 选择术腔各边界放置银夹且无腋窝淋巴结转移的12例左侧乳腺癌保乳术后患者,每例患者分别制定常规放疗(CRT)、无挡肺子野调强放疗(IMRT-F)、挡肺子野调强(IMRT-F-L)和瘤床同步整合补量调强放疗(SIB-IMRT)计划.比较不同治疗计划全乳靶区和瘤床靶区的剂量适形度和剂量分布均匀性,对比不同治疗计划肺脏、心脏和对侧乳腺受照剂量体积.结果 各计划中V处方剂量-PTV1/VPTV1、VPTV1-处方剂量/VPTV2、V处方剂量-PTV2/VPTV2/VPTV2、VPTV2-处方剂量/VPTV2组间差异均有统计学意义;CRT计划中患侧肺V20显著高于不同方式的IMRT计划,但不同方式的IMRT计划之间V20差异无统计学意义;CRT计划中心脏受照剂量显著高于IMRT和SIBIMRT计划.CRT计划中对侧乳腺最大照射剂量Dmax和平均剂量Dmean明显高于不同实现方式的IMRT计划,但不同实现方式的IMRT计划中Dmax和Dmean差异无统计学意义.结论 IMRT-F、IMRT-F-L、SIBIMRT计划均显著优于CRT计划,而不同方式IMRT计划间除个别参数外差异无统计学意义.
目的 探討乳腺癌保乳術後全乳加瘤床照射不同治療計劃靶區劑量適形度、靶區劑量分佈均勻性及肺髒、心髒和對側乳腺受照劑量體積的差異.方法 選擇術腔各邊界放置銀夾且無腋窩淋巴結轉移的12例左側乳腺癌保乳術後患者,每例患者分彆製定常規放療(CRT)、無擋肺子野調彊放療(IMRT-F)、擋肺子野調彊(IMRT-F-L)和瘤床同步整閤補量調彊放療(SIB-IMRT)計劃.比較不同治療計劃全乳靶區和瘤床靶區的劑量適形度和劑量分佈均勻性,對比不同治療計劃肺髒、心髒和對側乳腺受照劑量體積.結果 各計劃中V處方劑量-PTV1/VPTV1、VPTV1-處方劑量/VPTV2、V處方劑量-PTV2/VPTV2/VPTV2、VPTV2-處方劑量/VPTV2組間差異均有統計學意義;CRT計劃中患側肺V20顯著高于不同方式的IMRT計劃,但不同方式的IMRT計劃之間V20差異無統計學意義;CRT計劃中心髒受照劑量顯著高于IMRT和SIBIMRT計劃.CRT計劃中對側乳腺最大照射劑量Dmax和平均劑量Dmean明顯高于不同實現方式的IMRT計劃,但不同實現方式的IMRT計劃中Dmax和Dmean差異無統計學意義.結論 IMRT-F、IMRT-F-L、SIBIMRT計劃均顯著優于CRT計劃,而不同方式IMRT計劃間除箇彆參數外差異無統計學意義.
목적 탐토유선암보유술후전유가류상조사불동치료계화파구제량괄형도、파구제량분포균균성급폐장、심장화대측유선수조제량체적적차이.방법 선택술강각변계방치은협차무액와림파결전이적12례좌측유선암보유술후환자,매례환자분별제정상규방료(CRT)、무당폐자야조강방료(IMRT-F)、당폐자야조강(IMRT-F-L)화류상동보정합보량조강방료(SIB-IMRT)계화.비교불동치료계화전유파구화류상파구적제량괄형도화제량분포균균성,대비불동치료계화폐장、심장화대측유선수조제량체적.결과 각계화중V처방제량-PTV1/VPTV1、VPTV1-처방제량/VPTV2、V처방제량-PTV2/VPTV2/VPTV2、VPTV2-처방제량/VPTV2조간차이균유통계학의의;CRT계화중환측폐V20현저고우불동방식적IMRT계화,단불동방식적IMRT계화지간V20차이무통계학의의;CRT계화중심장수조제량현저고우IMRT화SIBIMRT계화.CRT계화중대측유선최대조사제량Dmax화평균제량Dmean명현고우불동실현방식적IMRT계화,단불동실현방식적IMRT계화중Dmax화Dmean차이무통계학의의.결론 IMRT-F、IMRT-F-L、SIBIMRT계화균현저우우CRT계화,이불동방식IMRT계화간제개별삼수외차이무통계학의의.
Objective To explore the difference of conformity and homogeneity of dose distribution in the whole breast and tumor bed targets and dose-volume parameters of the irradiated heart,lung and contralateral breast between the different treatment plannings for whole breast irradiation with tumor bed boost after breast-conservative surgery.Methods Twelve left-side breast cancer patients received breast-conservative surgery with negative axillary lymph node and with silver slips set in the cavity were selected.The different plannings including conventional radiotherapy(CRT),forward intensity-modulated radiotherapy with no lung block segments(IMRT-F),forward intensity-modulated radiotherapy with lung block segments(IMRT-F-L)and simultaneous integrated boost intensity-modulated radiotherapy(SIB-IMRT)were completed for each patient.The difference of conformity and homogeneity of dose distribution in the whole breast and tumor bed targets,the related irradiated dose-volume parametem of the ipsilateral lung,heart and Contralateral breast were compared among the different plannings.Results There were statistical differences of the ratios of breast volume contained by the prescribed dose given to PTV1(Vdose-PTV1)to VPTV1,volume of PTV1 contained by the prescribed dose given to PTV1(VPTV1-dose)to VPTV2,conformal index of PTV1(CIPTV1)and conformal index of PTV2(CIPTV2)among the different plannings.The volume of the lung which received more than 20 Gy(V20)in CRT planning was statistically higher those that in three IMRT plannings,but there was no significant difference among three types of IMRT.The dose irradiated to the heart in the CRT planning was significantly higher than that in IMRT-F,IMRT-F-L and SIB-IMRT planning.Dmax and Dmean in the contralateral breast for CRT plan were significantly higher than those in three types of IMRT plannings,but with no significant difference of Dmax and Dmean among three types of IMRT plannings.Conclusions Comparing the different types of treatment plannings for whole breast irradiation with tumor bed boost for the patients with left breast cancer after breast-conservative surgery,IMRT-F,IMRT-F-L and SIB-IMRT plannings are all statistically superior to CRT planning.but there are no statistical differences among three types of IMRT plannings except some other parameters.