实用癌症杂志
實用癌癥雜誌
실용암증잡지
THE PRACTICAL JOURNAL OF CANCER
2014年
8期
984-986
,共3页
艾秀清%木妮热?木沙江%司马义力?买买提尼亚孜%朱相露
艾秀清%木妮熱?木沙江%司馬義力?買買提尼亞孜%硃相露
애수청%목니열?목사강%사마의력?매매제니아자%주상로
乳腺癌%保乳术后%调强放疗%剂量学
乳腺癌%保乳術後%調彊放療%劑量學
유선암%보유술후%조강방료%제량학
Breast cancer%Breast Conserving Surgery%Intensity modulated radiation therapy%Dosimetry
目的：分析左侧乳腺癌保乳术后调强放疗（ IMRT）靶区以及心脏、同侧肺的照射剂量分布情况。方法对保乳术后接受调强放疗的37例左侧乳腺癌患者采取CT 定位并行调强放射治疗，采用IMRT 及3D-CRT 2种照射计划，总剂量均为50 Gy，1次/d，5 d/周，共照射25次。观察比较两种计划的剂量学差异。结果 IMRT 计划D95剂量高于3D-CRT 计划，而IMRT 的V105％、V110％、HI 明显低于3D-CRT，具有统计学差异（P ＜0．05）。IMRT 的肺V20、V30、V40以及心脏V5、V30、V40均显著低于3D-CRT 的，具有统计学差异（P ＜0．05）。15例患者左侧乳腺体积超过500 cm3，22例小于500 cm3，经比较发现，两组患者IMRT 计划的D95、V105、V110、HI 比较无显著差异。结论 IMRT 靶区剂量更接近于处方剂量，靶区剂量分布较3D-CRT 更均匀，有更好的适形性，能更好地保护肺脏、心脏等周围组织，而且IMRT 放射治疗受CTV 影响较小，靶区内剂量均匀性较好。
目的：分析左側乳腺癌保乳術後調彊放療（ IMRT）靶區以及心髒、同側肺的照射劑量分佈情況。方法對保乳術後接受調彊放療的37例左側乳腺癌患者採取CT 定位併行調彊放射治療，採用IMRT 及3D-CRT 2種照射計劃，總劑量均為50 Gy，1次/d，5 d/週，共照射25次。觀察比較兩種計劃的劑量學差異。結果 IMRT 計劃D95劑量高于3D-CRT 計劃，而IMRT 的V105％、V110％、HI 明顯低于3D-CRT，具有統計學差異（P ＜0．05）。IMRT 的肺V20、V30、V40以及心髒V5、V30、V40均顯著低于3D-CRT 的，具有統計學差異（P ＜0．05）。15例患者左側乳腺體積超過500 cm3，22例小于500 cm3，經比較髮現，兩組患者IMRT 計劃的D95、V105、V110、HI 比較無顯著差異。結論 IMRT 靶區劑量更接近于處方劑量，靶區劑量分佈較3D-CRT 更均勻，有更好的適形性，能更好地保護肺髒、心髒等週圍組織，而且IMRT 放射治療受CTV 影響較小，靶區內劑量均勻性較好。
목적：분석좌측유선암보유술후조강방료（ IMRT）파구이급심장、동측폐적조사제량분포정황。방법대보유술후접수조강방료적37례좌측유선암환자채취CT 정위병행조강방사치료，채용IMRT 급3D-CRT 2충조사계화，총제량균위50 Gy，1차/d，5 d/주，공조사25차。관찰비교량충계화적제량학차이。결과 IMRT 계화D95제량고우3D-CRT 계화，이IMRT 적V105％、V110％、HI 명현저우3D-CRT，구유통계학차이（P ＜0．05）。IMRT 적폐V20、V30、V40이급심장V5、V30、V40균현저저우3D-CRT 적，구유통계학차이（P ＜0．05）。15례환자좌측유선체적초과500 cm3，22례소우500 cm3，경비교발현，량조환자IMRT 계화적D95、V105、V110、HI 비교무현저차이。결론 IMRT 파구제량경접근우처방제량，파구제량분포교3D-CRT 경균균，유경호적괄형성，능경호지보호폐장、심장등주위조직，이차IMRT 방사치료수CTV 영향교소，파구내제량균균성교호。
Objective To investigate dosimetry study on intensity modulated radiation therapy ( IMRT) on heart,left lung of breast cancer patients after conservative surgery .Methods 37 female patients received IMRT after left side breast cancer conservative surgery were selected in our study .All patients were given conventional radiotherapy ( CRT) plan using same CT in-formation.Prescription dose was 50 Gy in breast volume with X-ray,1 time each week,5 days per-week,and 25 times total.Clini-cal target volume(CTV),planning tumor volume (PTV),and heart were evaluated and compared in the 2 plans.Results The D95 of IMRT were higher than that of 3D-CRT,and the V105%,V110%,HI of IMRT were lower than 3D-CRT,the differences had statistical significance (P<0.05).The lung V20,V30,V40 and heart V5,V30,V40 of IMRT were lower than 3D-CRT,the differences had statistical significance (P<0.05).The D95,V105,V110,HI had no obvious difference between patients with breast volume≤500 cm3 and >500 cm3 .Conclusion IMRT has higher efficacy of taking tumor volume irradiation and has lower volume of high dose compared with 3D-CRT.IMRT can improve dose distribution and reduce the cardiac dose and volume for the left breast cancer after breast conserving surgery .
