肿瘤研究与临床
腫瘤研究與臨床
종류연구여림상
Cancer Research and Clinic
2015年
8期
543-546
,共4页
郑亚琴%邢玉荣%褚薛刚%王晋丽%石丽琴%邢晓汾
鄭亞琴%邢玉榮%褚薛剛%王晉麗%石麗琴%邢曉汾
정아금%형옥영%저설강%왕진려%석려금%형효분
乳腺肿瘤%乳房切除术,根治性%放射疗法,调强适形%放射治疗剂量
乳腺腫瘤%乳房切除術,根治性%放射療法,調彊適形%放射治療劑量
유선종류%유방절제술,근치성%방사요법,조강괄형%방사치료제량
Breast neoplasms%Mastectomy,radical%Radiotherapy,intensity-modulated%Radiotherapy dosage
目的 探讨乳腺癌根治术后减少呼吸运动影响、改善靶区剂量分布、尽可能降低心肺受量放疗计划的设计方法.方法 选择12例乳腺癌根治术后患者,处方剂量为50 Gy,2Gy/次,5次/周.用治疗计划系统分别设计4野调强放疗(4FIMRT)治疗计划和2野适形放疗加4野调强放疗(2FCRT+4FIMRT)混合治疗计划,比较两种计划的靶区适形度指数(CI)、均匀性指数(HI)、危及器官的受照剂量体积.结果 2FCRT+ 4FIMRT计划的HI为1.08±0.01,优于4FIMRT计划的1.11±0.01 (P＜0.05);2FCRT+ 4FIMRT计划的CI为0.74±0.08,低于4FIMRT计划的0.80±0.03(P＜ 0.05).2FCRT+ 4FIMRT计划的同侧肺受照剂量体积V5、V10、平均剂量(Dmean)低于4FIMRT计划,同侧肺V5、V10、Dmean分别较4FIMRT计划降低了13％、23％、7％(均P＜0.05).2FCRT+ 4FIMRT计划的对侧肺Dmean、心脏Dmean、对侧乳腺Dmean及V5均低于4FIMRT计划,差异均具有统计学意义(均P＜ 0.05).两种计划同侧肺V20、V30、心脏V30差异无统计学意义(P＞0.05).结论 混合照射方式理论上减少了呼吸运动对靶区的影响,提高了靶区剂量的均匀性,降低了乳腺癌放疗并发症的发生风险.
目的 探討乳腺癌根治術後減少呼吸運動影響、改善靶區劑量分佈、儘可能降低心肺受量放療計劃的設計方法.方法 選擇12例乳腺癌根治術後患者,處方劑量為50 Gy,2Gy/次,5次/週.用治療計劃繫統分彆設計4野調彊放療(4FIMRT)治療計劃和2野適形放療加4野調彊放療(2FCRT+4FIMRT)混閤治療計劃,比較兩種計劃的靶區適形度指數(CI)、均勻性指數(HI)、危及器官的受照劑量體積.結果 2FCRT+ 4FIMRT計劃的HI為1.08±0.01,優于4FIMRT計劃的1.11±0.01 (P＜0.05);2FCRT+ 4FIMRT計劃的CI為0.74±0.08,低于4FIMRT計劃的0.80±0.03(P＜ 0.05).2FCRT+ 4FIMRT計劃的同側肺受照劑量體積V5、V10、平均劑量(Dmean)低于4FIMRT計劃,同側肺V5、V10、Dmean分彆較4FIMRT計劃降低瞭13％、23％、7％(均P＜0.05).2FCRT+ 4FIMRT計劃的對側肺Dmean、心髒Dmean、對側乳腺Dmean及V5均低于4FIMRT計劃,差異均具有統計學意義(均P＜ 0.05).兩種計劃同側肺V20、V30、心髒V30差異無統計學意義(P＞0.05).結論 混閤照射方式理論上減少瞭呼吸運動對靶區的影響,提高瞭靶區劑量的均勻性,降低瞭乳腺癌放療併髮癥的髮生風險.
목적 탐토유선암근치술후감소호흡운동영향、개선파구제량분포、진가능강저심폐수량방료계화적설계방법.방법 선택12례유선암근치술후환자,처방제량위50 Gy,2Gy/차,5차/주.용치료계화계통분별설계4야조강방료(4FIMRT)치료계화화2야괄형방료가4야조강방료(2FCRT+4FIMRT)혼합치료계화,비교량충계화적파구괄형도지수(CI)、균균성지수(HI)、위급기관적수조제량체적.결과 2FCRT+ 4FIMRT계화적HI위1.08±0.01,우우4FIMRT계화적1.11±0.01 (P＜0.05);2FCRT+ 4FIMRT계화적CI위0.74±0.08,저우4FIMRT계화적0.80±0.03(P＜ 0.05).2FCRT+ 4FIMRT계화적동측폐수조제량체적V5、V10、평균제량(Dmean)저우4FIMRT계화,동측폐V5、V10、Dmean분별교4FIMRT계화강저료13％、23％、7％(균P＜0.05).2FCRT+ 4FIMRT계화적대측폐Dmean、심장Dmean、대측유선Dmean급V5균저우4FIMRT계화,차이균구유통계학의의(균P＜ 0.05).량충계화동측폐V20、V30、심장V30차이무통계학의의(P＞0.05).결론 혼합조사방식이론상감소료호흡운동대파구적영향,제고료파구제량적균균성,강저료유선암방료병발증적발생풍험.
Objective To study how to design the treatment plan to reduce the influence of respiratory movement and the dose of heart and lung as few as possible,to improve the dosage distribution in the target area after radical mastectomy of breast cancer.Methods Twelve patients with breast cancer after radical mastectomy were selected.A dose of 50 Gy with 2 Gy every day and 5 times per week was prescribed.Based on the treatment planning system (TPS),4-field intensity modulated radiotherapy (4FIMRT) and hybrid intensity modulated treatment planning 2-field conformal radiotherapy (2FCRT) + 4FIMRT were designed respectively.The two plans were compared from the aspects of target conformity index (CI),the homogeneity index (HI) and exposure dose volume delivered to organ at risk.Results According to the hybrid plan of 2FCRT + 4FIMRT,HI was 1.08±0.01,which was superior to that from 4FIMRT (1.11±0.01,t =9.587,P ＜ 0.05).While CI was 0.74±0.08,based on the plan of 2FCRT+4FIMRT,which was slightly lower than that from 4FIMRT (0.80±0.03,t =2.497,P ＜ 0.05).Considering the dose volumes on ipsilateral lung in two plans,the values of V5,V10,Dmean of 2FCRT+4FIMRT plan were significantly less than those of 4FIMRT plan.V5,V10,Dmean from the former plan were 13 ％,23 ％,7 ％ less than those from the latter plan (t =6.002,P ＜ 0.05;t =6.826,P ＜ 0.05;t =3.645,P ＜ 0.05).Meanwhile,Dmean of contralateral lung,Dmean of heart,Dmean and V5 of contralateral breast from the 2FCRT +4FIMRT plan were all lower than those of 4FIMRT plan.Those differences between two plans were statistically significant (P ＜ 0.05).Differences of V20 and V30 of ipsilateral lung,and V30 of heart between two plans did not make sense by the statistics analysis (P ＞ 0.05).Conclusion Hybrid radiotherapy theoretically reduces the influence of respiratory movement,improves the uniformity of target dose and lowers the risk of complications of radiation therapy on breast cancer.
