中华放射肿瘤学杂志
中華放射腫瘤學雜誌
중화방사종류학잡지
CHINESE JOURNAL OF RADIATION ONCOLOGY
2015年
1期
65-69
,共5页
李夏东%邓清华%马胜林%王佳浩%吴稚冰%夏冰%任垚%金献测%林胜友
李夏東%鄧清華%馬勝林%王佳浩%吳稚冰%夏冰%任垚%金獻測%林勝友
리하동%산청화%마성림%왕가호%오치빙%하빙%임요%금헌측%림성우
乳腺肿瘤/术后放射疗法%常规调强计划%容积调强计划%剂量学
乳腺腫瘤/術後放射療法%常規調彊計劃%容積調彊計劃%劑量學
유선종류/술후방사요법%상규조강계화%용적조강계화%제량학
Breast neoplasms/postoperative radiotherapy%Routine intensity-modulated panning%Volumetric modulated planning%Dosimetry
目的 研究乳腺癌根治术后不同放疗技术靶区、正常组织剂量学差异.方法 对2012-2013年间31例乳腺癌(左侧9例、右侧22例)根治术后患者采用改良野中野IMRT计划(P1)、4个野IMRT计划(P2)、含心脏正对野5个野IMRT计划(P3)、含心脏正对弧VMAT计划(P4)分别计算靶区CI、HI,心脏、冠状动脉左前降支、右冠状动脉、患侧肺剂量学参数,分别用NTCP_RSM、NTCP_Lyman、LQ-TCP-Poisson模型计算左右侧乳腺癌患者放射性心脏病概率、RP概率、TCP,结果用方差分析或x2检验.结果 P1-P4间左侧和右侧乳腺癌患者靶区CI、HI值均不同(P=0.009、P=0.000和P =0.000、0.000),放射性心脏病概率平均值相近[左侧2.7％、1.1％、1.3％、0.86％(P=0.397);右侧0.19％、4.76×10-3％、0、0(P=0.568)],RP概率平均值也相近[左侧9.73％、7.52％、8.86％、10.73％ (P =0.953),右侧11.73％、8.65％、7.02％、11.25％ (P=0.437)],但TCP均不同(左侧P=0.000,右侧P=0.000).结论 乳腺癌根治术后增加心脏正对射野(弧)不同放疗计划对放射性心、肺并发症概率均无显著影响,但可显著改善计划靶区的CI、HI,增加TCP;5个野IMRT和VMAT技术可选为乳癌根治术后放疗手段.
目的 研究乳腺癌根治術後不同放療技術靶區、正常組織劑量學差異.方法 對2012-2013年間31例乳腺癌(左側9例、右側22例)根治術後患者採用改良野中野IMRT計劃(P1)、4箇野IMRT計劃(P2)、含心髒正對野5箇野IMRT計劃(P3)、含心髒正對弧VMAT計劃(P4)分彆計算靶區CI、HI,心髒、冠狀動脈左前降支、右冠狀動脈、患側肺劑量學參數,分彆用NTCP_RSM、NTCP_Lyman、LQ-TCP-Poisson模型計算左右側乳腺癌患者放射性心髒病概率、RP概率、TCP,結果用方差分析或x2檢驗.結果 P1-P4間左側和右側乳腺癌患者靶區CI、HI值均不同(P=0.009、P=0.000和P =0.000、0.000),放射性心髒病概率平均值相近[左側2.7％、1.1％、1.3％、0.86％(P=0.397);右側0.19％、4.76×10-3％、0、0(P=0.568)],RP概率平均值也相近[左側9.73％、7.52％、8.86％、10.73％ (P =0.953),右側11.73％、8.65％、7.02％、11.25％ (P=0.437)],但TCP均不同(左側P=0.000,右側P=0.000).結論 乳腺癌根治術後增加心髒正對射野(弧)不同放療計劃對放射性心、肺併髮癥概率均無顯著影響,但可顯著改善計劃靶區的CI、HI,增加TCP;5箇野IMRT和VMAT技術可選為乳癌根治術後放療手段.
목적 연구유선암근치술후불동방료기술파구、정상조직제량학차이.방법 대2012-2013년간31례유선암(좌측9례、우측22례)근치술후환자채용개량야중야IMRT계화(P1)、4개야IMRT계화(P2)、함심장정대야5개야IMRT계화(P3)、함심장정대호VMAT계화(P4)분별계산파구CI、HI,심장、관상동맥좌전강지、우관상동맥、환측폐제량학삼수,분별용NTCP_RSM、NTCP_Lyman、LQ-TCP-Poisson모형계산좌우측유선암환자방사성심장병개솔、RP개솔、TCP,결과용방차분석혹x2검험.결과 P1-P4간좌측화우측유선암환자파구CI、HI치균불동(P=0.009、P=0.000화P =0.000、0.000),방사성심장병개솔평균치상근[좌측2.7％、1.1％、1.3％、0.86％(P=0.397);우측0.19％、4.76×10-3％、0、0(P=0.568)],RP개솔평균치야상근[좌측9.73％、7.52％、8.86％、10.73％ (P =0.953),우측11.73％、8.65％、7.02％、11.25％ (P=0.437)],단TCP균불동(좌측P=0.000,우측P=0.000).결론 유선암근치술후증가심장정대사야(호)불동방료계화대방사성심、폐병발증개솔균무현저영향,단가현저개선계화파구적CI、HI,증가TCP;5개야IMRT화VMAT기술가선위유암근치술후방료수단.
Objective To evaluate the dosimetry for the patients with breast cancer in postmastectomy radiotherapy.Methods Thirty one patients from Nov 2012 to May 2013 with breast cancer were treated with mastectomy surgery followed by radiotherapy.They were planned using:1) improved tangential wedge-based fields IMRT (P1) ;2) 4 beam rotary inverse IMRT (P2) ;3) 5 beam-field IMRT (P3) ;and 4) Dual arc VMAT (P4).The PTV and OAR including the cardiac,left anterior descending artery (LAD),the right coronary artery (RCA),ipsilateral lung.The CI and HI of PTV and volumetric dose PRV-OAR were analyzed by single factor variance analysis or x2 test methods.Results The CI and HI for P1-P4 with both sides were L:P =0.009,R:P =0.000.The NTCP_Heart with tumor in right side was:0.19％,4.76 ×10-3 ％,0,0 (P =0.568),with tumor in the other side was:2.7 ％,1.1％,1.3 ％,0.86％ (P =0.390).The NTCP_ Lung_Sick for P1-P4 were left side:9.73％,7.52％,8.86％,10.73％ (P =0.953) ; Right side:11.73％,8.65％,7.02％,11.25％ (P =0.437).The TCP for P1-P4 with both sides were L:P =0.000,R:P =0.000).Conclusions There had no statistically difference of NTCP_Heart and NTCP_Lung_Sick in plans employed with heart faced (involved) beams or arc within our research group,while had statistically benefit to improve the CI of PTV and the dose homogeneity of target,5 beam-field IMRT or VMAT plan could be choose as cardiac safe and efficient techniques for patients with breast cancer in post-mastectomy surgery.
