CAJ | 학술논문

目的探讨乳腺癌术胸壁及锁骨上区两种照射模式的剂量学特点，为临床选择提供参考。方法选取10例乳腺癌伴锁骨上区淋巴结转移的患者，分别设计三维适形计划（3DCRT）和混合逆向调强计划（Hy-IMRT），计划靶区（PTV）处方剂量为50 Gy分25次。利用剂量体积直方图（ DVH）评价两种计划的靶区剂量、均质性指数（ HI）及危及器官（ OAR）的受量。结果<br>　　Hy-IMRT靶区的近似最大剂量D2％分别为明显低于3DCRT（t＝-9.821，P＜0.05），近似最小剂量D98％明显高于3DCRT计划（t＝3.879，P＜0.05）；混合调强计划靶区剂量均质指数（HI）明显好于3DCRT计划（t＝-7.657，P＜0.05）；靶区平均剂量Dmeam两种计划之间无统计学意义。患侧肺的V20、V30混合逆向调强计划明显低于适形计划（ t＝-3.401、-4.117， P＜0.05），其他危及器官受量无差异。结论胸壁及锁骨上区混合调强技术计划在剂量分布、危及器官保护、HI等方面都好于3DCRT计划。
목적탐토유선암술흉벽급쇄골상구량충조사모식적제량학특점，위림상선택제공삼고。방법선취10례유선암반쇄골상구림파결전이적환자，분별설계삼유괄형계화（3DCRT）화혼합역향조강계화（Hy-IMRT），계화파구（PTV）처방제량위50 Gy분25차。이용제량체적직방도（ DVH）평개량충계화적파구제량、균질성지수（ HI）급위급기관（ OAR）적수량。결과<br>　　Hy-IMRT파구적근사최대제량D2％분별위명현저우3DCRT（t＝-9.821，P＜0.05），근사최소제량D98％명현고우3DCRT계화（t＝3.879，P＜0.05）；혼합조강계화파구제량균질지수（HI）명현호우3DCRT계화（t＝-7.657，P＜0.05）；파구평균제량Dmeam량충계화지간무통계학의의。환측폐적V20、V30혼합역향조강계화명현저우괄형계화（ t＝-3.401、-4.117， P＜0.05），기타위급기관수량무차이。결론흉벽급쇄골상구혼합조강기술계화재제량분포、위급기관보호、HI등방면도호우3DCRT계화。
Objective To evaluate the dosimetric benefits of the hybridintensity modulated radiotherapy ( Hy-IMRT) after breast-conserving surgery.Methods For each of 10 chosen patients with breast cancer ,three-dimensional conformal radiotherapy (3DCRT) and Hy-IMRT were designed.The prescribed dose for planning target volume (PTV) was 50 Gy/25f.Dosimetric comparisons of PTV dose distribution,homogeneity index (HI) and dose of organs at risk(OAR) between the two plans were performed on each patient by dose volume histogram (DVH).Results The D2%of Hy-IMRT was statistically lower than that of 3DCRT(t=-9.821,P<0.05), and the D98%was statistically higher than that of 3DCRT(t=3.879,P<0.05);The HI of Hy-IMRT was statistically lower than that of 3DCRT(t=-7.657,P<0.05);There was no signifeicant difference in the mean dose (Dmean ) between the two plans.The lung (V20、V30) in Hy-IMRT paln was lower than 3DCRT plan(t=-3.401、-4.117,P<0.05).There was no statistical difference of ex-posure dose to other OARs between the two plans .Conclusion Hy-IMRT can improve target dose uniformity ,HI and protect the organs at risk well compared to the 3DCRT in patients with breast cancer after the breast-conserving surgery .