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
2013年
3期
282-285
,共4页
郑亚琴%邢晓汾%马永强%崔桐%郑旭亮%褚薛刚%孟慧敏
鄭亞琴%邢曉汾%馬永彊%崔桐%鄭旭亮%褚薛剛%孟慧敏
정아금%형효분%마영강%최동%정욱량%저설강%맹혜민
乳腺癌%保乳术%快速旋转调强%调强放疗%剂量学
乳腺癌%保乳術%快速鏇轉調彊%調彊放療%劑量學
유선암%보유술%쾌속선전조강%조강방료%제량학
Breast cancer%Breast-conserving surgery%RapidArc%Intensity modulated radiotherapy%Dosimetry
目的 比较乳腺癌保乳术后RapidArc计划与五野动态调强(5F-IMRT)计划的剂量学差异.方法 选择8例左侧乳腺癌保乳术后女性患者,处方剂量为50 Gy/ 25次.分别设计RapidArc计划与5F-IM RT计划.比较两种计划的靶区适形度指数、均匀性指数、靶区覆盖度和危及器官的受照剂量体积,同时比较两组计划实施时的治疗时间和机器跳数.结果 在两种计划的靶区比较中,RapidArc计划的靶区适形度指数为(0.88±0.03),高于5F-IMRT计划的(0.79±0.02)(t =8.28,P＜0.05)；RapidArc计划的均匀性指数为(9.01±0.73),优于5F-IMRT计划的(10.44±1.08)(t=-2.73,P＜0.05).两组计划在同侧肺受照剂量体积比较中RapidArc计划的Dmean、V0、V20、V30小于5F-IMRT计划(t=-7.53、-7.20、-8.39、-7.80,P＜0.05),但RapidArc计划中的V5较5F-IMRT计划增加了约16％(t=5.67,P＜0.05)；心脏的受照剂量体积比较中RapidArc计划中的Dmean、V5、V10均高于5F-IMRT(t=10.46、28.76、5.40,P＜0.05),但在RapidArc计划中心脏的V30低于5F-IMRT(t=-6.12,P＜0.05).对侧肺和对侧乳腺的V5在RapidArc计划中明显高于5F-IMRT计划(肺:t =21.50,P＜0.05;乳腺:t=5.44,P＜0.05).RapidArc计划中机器跳数减少了25％,平均治疗时间节省了60％.结论 乳腺癌保乳术后RapidArc计划与5F-IMRT计划比较提高了靶区的适形度和均匀度,减少了高剂量区的受照体积,降低了机器跳数,缩短了治疗时间,但增加了正常组织低剂量区的受照体积.
目的 比較乳腺癌保乳術後RapidArc計劃與五野動態調彊(5F-IMRT)計劃的劑量學差異.方法 選擇8例左側乳腺癌保乳術後女性患者,處方劑量為50 Gy/ 25次.分彆設計RapidArc計劃與5F-IM RT計劃.比較兩種計劃的靶區適形度指數、均勻性指數、靶區覆蓋度和危及器官的受照劑量體積,同時比較兩組計劃實施時的治療時間和機器跳數.結果 在兩種計劃的靶區比較中,RapidArc計劃的靶區適形度指數為(0.88±0.03),高于5F-IMRT計劃的(0.79±0.02)(t =8.28,P＜0.05)；RapidArc計劃的均勻性指數為(9.01±0.73),優于5F-IMRT計劃的(10.44±1.08)(t=-2.73,P＜0.05).兩組計劃在同側肺受照劑量體積比較中RapidArc計劃的Dmean、V0、V20、V30小于5F-IMRT計劃(t=-7.53、-7.20、-8.39、-7.80,P＜0.05),但RapidArc計劃中的V5較5F-IMRT計劃增加瞭約16％(t=5.67,P＜0.05)；心髒的受照劑量體積比較中RapidArc計劃中的Dmean、V5、V10均高于5F-IMRT(t=10.46、28.76、5.40,P＜0.05),但在RapidArc計劃中心髒的V30低于5F-IMRT(t=-6.12,P＜0.05).對側肺和對側乳腺的V5在RapidArc計劃中明顯高于5F-IMRT計劃(肺:t =21.50,P＜0.05;乳腺:t=5.44,P＜0.05).RapidArc計劃中機器跳數減少瞭25％,平均治療時間節省瞭60％.結論 乳腺癌保乳術後RapidArc計劃與5F-IMRT計劃比較提高瞭靶區的適形度和均勻度,減少瞭高劑量區的受照體積,降低瞭機器跳數,縮短瞭治療時間,但增加瞭正常組織低劑量區的受照體積.
목적 비교유선암보유술후RapidArc계화여오야동태조강(5F-IMRT)계화적제량학차이.방법 선택8례좌측유선암보유술후녀성환자,처방제량위50 Gy/ 25차.분별설계RapidArc계화여5F-IM RT계화.비교량충계화적파구괄형도지수、균균성지수、파구복개도화위급기관적수조제량체적,동시비교량조계화실시시적치료시간화궤기도수.결과 재량충계화적파구비교중,RapidArc계화적파구괄형도지수위(0.88±0.03),고우5F-IMRT계화적(0.79±0.02)(t =8.28,P＜0.05)；RapidArc계화적균균성지수위(9.01±0.73),우우5F-IMRT계화적(10.44±1.08)(t=-2.73,P＜0.05).량조계화재동측폐수조제량체적비교중RapidArc계화적Dmean、V0、V20、V30소우5F-IMRT계화(t=-7.53、-7.20、-8.39、-7.80,P＜0.05),단RapidArc계화중적V5교5F-IMRT계화증가료약16％(t=5.67,P＜0.05)；심장적수조제량체적비교중RapidArc계화중적Dmean、V5、V10균고우5F-IMRT(t=10.46、28.76、5.40,P＜0.05),단재RapidArc계화중심장적V30저우5F-IMRT(t=-6.12,P＜0.05).대측폐화대측유선적V5재RapidArc계화중명현고우5F-IMRT계화(폐:t =21.50,P＜0.05;유선:t=5.44,P＜0.05).RapidArc계화중궤기도수감소료25％,평균치료시간절성료60％.결론 유선암보유술후RapidArc계화여5F-IMRT계화비교제고료파구적괄형도화균균도,감소료고제량구적수조체적,강저료궤기도수,축단료치료시간,단증가료정상조직저제량구적수조체적.
Objective To compare the dosimetric differences between two plans of RapidArc and 5F-IMRT for breast cancer radiotherapy after breast-conserving surgery.Methods Eight female patients with left-sided breast cancer after breast-conserving surgery were selected.A dose of 50 Gy in 25 fractions was prescribed for plans of RapidArc and 5F-IMRT.Target conformity index (CI),homogeneity index (HI),target coverage,exposure dose volume delivered to organ at risk were compared between two plans.At the same time,treatment delivery time and monitor units (MU) were also compared.Results The target conformity index (CI) in RapidArc plan (·0.88 ±0.03) was higher than that in 5F-IMRT plan (0.79 ±0.02,t =8.28,P ＜ 0.05).The homogeneity index (HI) in RapidArc plan 9.01 ± 0.73 was significantly lower than that in 5F-IMRT plan10.44 ± 1.08 (t =-2.73,P ＜0.05).For the dose volume delivered to the ipsilateral lung in two plans,the values of V10,V20,V30,and Dmean in RapidArc plan were lower than those in 5F-IMRT plan(t =-7.53,-7.20,-8.39,-7.80,P ＜ 0.05).However,the value of V5 in RapidArc plan was higher than that in 5F-IMRT plan (t =5.67,P ＜0.05).For the heart,the values of V5,V10 and Dmean in RapidArc plan were higher than those in IMRT plan(t =10.46,28.76,5.40,P ＜ 0.05),while the value of V30 in RapidArc plan was lower than that in 5F-IMRT plan(t =-6.12,P ＜0.05).The values of V5 in contralateral lung and breast were higher in RapidArc plan than those in 5F-IMRT plan(lung:t =21.50,P ＜0.05;breast:t =5.44,P ＜0.05).The MU in RapidArc plan was decreased by 25％,and the average treatment delivery time was saved by 60％,compared with that of 5F-IMRT plan.Conclusions During breast cancer radiotherapy after breast-conserving surgery,compared with 5F-IMRT plan,the RapidArc plan could improve the target HI,and reduce both the irradiated dose in high-dose volume and MU,and shorten the treatment time,but increased the exposed volume in low-dose volume of normal tissues.
