食管癌术后调强适形放疗靶区剂量分布的临床观察  

Study of clinical dose distribution on patients with esophagectomy treated by intensity modulated radiation therapy

作　　者：徐池[1] 翟振宇[1] 

机构地区：[1]江苏省肿瘤医院放疗科,南京210009

出　　处：《临床肿瘤学杂志》2009年第5期443-445,共3页Chinese Clinical Oncology

摘　　要：目的:观察食管癌术后调强适形放疗靶区剂量分布的特点。方法:采用Varius 6.0治疗计划系统,对28例食管癌术后患者实施调强适形放疗计划。分别观察靶区剂量分布的均匀度、肺V20、V30和脊髓受量等指标,并对肺受照体积与急性放射性肺炎的关系进行初步分析。结果:临床靶区(CTV)靶体积内的剂量均匀度为93%～103%,脊髓平均受量为处方剂量的22.5%,最大受量为63.1%;肺V20和V30分别为(24.1±6.3)%和(16.1±5.0)%;急性放射性肺炎0、1、2、3和4级发生率分别为64.3%、25.0%、7.1%、3.6%和0;放射性肺炎组V20和V30分别为(27.8±7.4)%和(19.1±8.4)%,无放射性肺炎组V20和V30分别为(16.3±4.2)%和(9.3±5.6)%,两者差异有统计学意义(P<0.05)。结论:食管癌术后调强适形放疗技术靶区剂量分布均匀,肺和脊髓等正常组织受量低。Objective：To analysis dosage distribution of esophageal cancer patients after esophagectomy treated by intensity modulated radiotherapy（IMRT）. Methods：By Varius 6.0 TPS, 28 patients with esophagectomy were treated by IMRT. Distribution of target dosage, the value of V20and V30 of lungs,the dosage of spinal cord were separately observed. The dose distribution and its correlation with acute pheumonitis due to iradiation were analysised. Results ： The average dose of clinical target volume could well reach the prescription one of radiation planning. The maximum dose of spinal cord was 63. 1% of the prescription dose, and the value of V20 and V30 parameters of lung was （ 24. 1 ± 6. 3 ） % and （ 16. 1 ± 5.0 ） %. The occurrences of acute radiation pneumonitis were 64. 5%, 25.0% ,7.1% ,3.6% and 0 in grade 0,1,2,3 and 4, respectively. The values of V20 and V30 parameters of lung was （27.8 ± 7.4） % and （19. 1 ±8.4）% , in group pneumonitis were significantly differences to those, （16. 3 ± 4. 2）% and（9. 3 ±5.6）% , in non-pneumonitis group. Conclusion：There were much better dose distribution and lower radiation dose on normal tissue in patients with esophagectomy treated by IMRT.

关 键 词：食管癌 调强放疗 剂量分布 

分 类 号：R735.1[医药卫生—肿瘤] R730.55[医药卫生—临床医学]