中上段食管癌三野与四野三维适形照射的比较  

Comparison between 3-fields and 4-fields 3-dimensional conformal radiotherapy for mid-thoracic or upper-thoracic Esophageal carcinoma

作　　者：严伟[1] 邱大[1] 吴丽华[1] 王颖[1] 

机构地区：[1]重庆市肿瘤研究所放疗科,重庆400030

出　　处：《重庆医科大学学报》2008年第12期1525-1527,共3页Journal of Chongqing Medical University

摘　　要：目的:比较中上段食管癌三维适形放射治疗常见的三野照射与四野照射方法的临床物理参数,优化放疗治疗计划。方法:随机选取中上段食管癌患者,采用VARIAN公司Eclipse治疗计划系统。按照ICRU50号报告指导原则勾画靶区,并分别设计三野与四野三维适形治疗计划,PTV所有方向上均放相同的边界8mm。然后利用体积剂量直方图DVH对两种布野方式的治疗计划靶区量分布,危及器官保护等参数进行分析和比较。处方剂量60Gy/30F。结果:两种照射方式靶区剂量分布情况相似,脊髓受照射剂量差别微小。在肺V20以及V30指标中,三野照射明显优于四野照射,但在肺V5指标上劣于四野照射计划。结论:中上段食管癌三维适形放疗中,三野照射在肺V20、V30指标上优于四野照射计划,从预防严重放射性肺损伤角度上具有优势。Objective： To compare the clinical factors and physical parameters between 3-fields and 4-field 3-dimensional con- formal radiotherapy （3DCRT） for mid-thoracic nr upper-thoracic esophageal carcinoma. Methods： Patients with mid-thoracic or upper-thoracic esophageal carcinoma were chosen at random and treated with 3DCRT. Contouring and treatment planning were performed with VARIAN Eclipse treatment planning system（TPS）.The target volume was determined according to guidelines from ICRU Report No.50.The three-beams treating plan and the four-beams treating plan were performed and a 8ram isotropic margin was added for the planning target volume（PTV） in beam setting.The different plans were evaluated with dose volume histograms （DVH） in terms of dose coverage of PTV and protection of organs at risk （OAR）.The prescribed dose was 60 Gy/30 F to the PTV. Results： There was no significant difference in the dose coverage to PTV and the explored dose to spinal cord with the two model of 3DCRT. When the three-beams treating plan was compared with four-beams treating plan, lungs V20 and V30 were significantly better,and at the same time lungs V5 was higher. Conclusions： 3-fields 3DCRT is better than 4-fields 3DCRT with lower lungs V20 and V30 so as to prevent acute radial injury of lungs in radiotherapy of mid-thoracic or upper-thoracic esophageal carcinoma.

关 键 词：食管肿瘤 放射治疗 三维适形放疗 放射性肺损伤 

分 类 号：P735.1[天文地球—海洋生物学]