CAJ | 학술논문

目的：分析9 MeV电子线照射乳腺癌根治术后胸壁靶区的剂量学分布特点。方法：以椭圆柱型调强体模上模拟人体胸壁靶区，分别设计5种治疗方案：①单野垂直照射；②单野30度照射；③两野照射,机架角度15°和43°；④三野照射,机架角度为15°、30°和43°；⑤模拟拉弧照射,机架角度从15°到44°，每度一个射野。比较各计划剂量分布，肺V20，PTV 95%，Dmax以及高量图。结果：单野垂直照射剂量分布呈楔形分布。5种方案PTV 95%分别为：4172 cGy、4885 cGy、4923 cGy、4911 cGy、4900 cGy；肺V20分别为：14.23%、18.00%、17.82%、17.91%、17.93%；Dmax分别为：6081 cGy、6400 cGy、5661 cGy、5620 cGy、5598 cGy。结论：增加射野数目和变换射野入射方向是优化电子线治疗计划的2个有效手段。针对乳腺癌根治术后胸壁靶区PTV形状狭窄，弧度大且包绕肺面积广的病案，建议实施三野夹角电子线照射。
목적：분석9 MeV전자선조사유선암근치술후흉벽파구적제량학분포특점。방법：이타원주형조강체모상모의인체흉벽파구，분별설계5충치료방안：①단야수직조사；②단야30도조사；③량야조사,궤가각도15°화43°；④삼야조사,궤가각도위15°、30°화43°；⑤모의랍호조사,궤가각도종15°도44°，매도일개사야。비교각계화제량분포，폐V20，PTV 95%，Dmax이급고량도。결과：단야수직조사제량분포정설형분포。5충방안PTV 95%분별위：4172 cGy、4885 cGy、4923 cGy、4911 cGy、4900 cGy；폐V20분별위：14.23%、18.00%、17.82%、17.91%、17.93%；Dmax분별위：6081 cGy、6400 cGy、5661 cGy、5620 cGy、5598 cGy。결론：증가사야수목화변환사야입사방향시우화전자선치료계화적2개유효수단。침대유선암근치술후흉벽파구PTV형상협착，호도대차포요폐면적엄적병안，건의실시삼야협각전자선조사。
Objective:To analyze the characteristics of postmastectomy chest wall irradiation with 9 MeV electron beam. Methods:On IMRT phantom, five radiation plannings were designed with 9 MeV electron beam: ①single-field vertllal planning; ②single-field planning with the gantry of 30°;③double-field planning with the gantry of 15° and 43°; ④triple-field planning with the gantry of 15°,30°and 43°; ⑤simulate-arc planning with the gantry from 15° to 43°.Then the dose distribution, lung-V 20, PTV 95%and Dmax were compared. Results: The dose distribution of the single-field veryical planning were cuneate.For the 5 plannings, the lung-V20 were 4172 cGy、4885 cGy、4923 cGy、4911 cGy and 4900 cGy,the PTV95% were:14.23%, 18.00%、17.82%、17.91% and 17.93%,and the Dmax were 6081cGy、6400cGy, 5661 cGy,5620cGy and 5598cGy respectively. Conclusion: Increasing the field number and changing the incidence direction were the effective means to optimize the electron beam radiation planning and the triple-field planning was suitable for the paitent whose chest wall target was both narrow and long around the lung.