适行放射治疗前列腺癌剂量学疗效比较及对生活质量的影响  

Comparison of three conformal radiotherapies in three dimensional dosimetric planning for prostate cancer and the effect on quality of life

作　　者：杜世锁[1] 吴铮[1] 曾昭冲[1] 李文如[1] 陈刚[1] 王健[1] 

机构地区：[1]复旦大学附属中山医院肿瘤中心放射治疗科,上海市200052

出　　处：《中国临床康复》2005年第10期27-29,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:应用三维适形放射治疗计划系统评价前列腺癌不同的照射方法,以明确前列腺癌三维适形放射治疗(3D-sCRT)改善生活质量的优势。方法:选用2000-09/2004-09复旦大学附属中山医院45例T1,T2,T3前列腺癌病例,随机分3组,每组15例,分别用常规四野、四野适形、六野适形3个不同放射治疗技术,适行放疗采用CMS公司FOCUS2.6.1三维适形放射治疗计划系统设计治疗计划,计划的总剂量均为70Gy。用剂量体积直方图(DVH)比较靶区剂量和正常组织的受照射剂量差异。结果:3种治疗计划均能满足靶区剂量要求,但六野适形放射治疗计划靶区剂量明显优于常规放射治疗(P<0.05),而六野适形放射治疗计划与四野适形放射治疗之间差异无显著性意义(P>0.05)。常规四野、四野适形、六野适形放射治疗计划适形指数分别为0.33,0.55,0.56;50%直肠的受照射剂量为47.48,39.15,38.45Gy,50%膀胱受照射剂量为49.32,9.42,3.11Gy,股骨头最大剂量为49.84,34.00,26.24Gy。常规放射治疗组患者生活质量评分为(15.2±2.90)分,而四野适形、六野适形组为(18.30±3.90),(19.10±4.30)分,明显优于常规放射(P<0.05)。结论:前列腺癌的常规设野方法基本能满足靶区剂量学要求,然而正常组织的受照射剂量明显高于其他两种计划。AIM:To assess the different radiation therapies for prostate cancer by using three dimensional treatment plan system,and identify the preponderance of three dimensional conformal radiation therapy(3D CRT) for improving the quality of life(QOL).METHODS:Forty five patients with stage T1,T2,T3 prostate cancer selected from the Affiliated Zhongshan Hospital of Fudan University between September 2000 and September 2004 were randomized into three groups with 15 cases in each group.Using the FOCUS 2.6.1 3D CRT planning system of CMS Company,three different methods of radiotherapy planning:conventional planning,a conformal planning with four fields and a conformal planning with six fields were designed for each group.The total radiation dose was 70 Gy and dose volume histogram(DVH) was used to compare the difference between dosage in target areas and that in normal tissues.RESULTS:All of the three designs could meet the demands of target volume,but the conformal planning with six fields was better than the conventional planning with four fields(P< 0.05),and no significant difference was found between the conformal planning with six fields and the conformal planning with four fields(P >0.05).No significant dosimetric disparity in the target volume was found among the three designs,according to anticipated therapeutic requirements.The conformity indices were 0.33,0.55,and 0.56 for the conventional planning with four fields,the conformal planning with four fields and the conformal planning with six fields respectively.The radiation dose to 50% rectum was 47.48,39.15,38.45 Gy,and 50% bladder was 49.32,9.42 and 3.11 Gy.The maximum dose to feormal head was 49.84,34.00 and 26.24 Gy respectively.The score for QOL in the conformal planning with four fields and six fields were (18.30± 3.90) and (19.10± 4.30) points respectively,significantly higher than that for the conventional planning with four fields[(15.2± 2.90) points](P< 0.05).CONCLUSION:Conventional radiotherapy planning is able to meet the demands of dosi

关 键 词：前列腺肿瘤 放射治疗剂量 生活质量 

分 类 号：R73[医药卫生—肿瘤]