中上段食管癌3D-CRT与IMRT肺损伤剂量学的对比研究  

Dosimetric Comparison of Intensity-modulated Radiotherapy Versus 3D Conformal Radiotherapy in Treatment of Cancer of Upper/Mid Esophagus

作　　者：张莉[1] 罗辉[2] 

机构地区：[1]南昌大学研究生院医学部,2008级南昌330006 [2]江西省肿瘤医院放疗科,南昌330029

出　　处：《南昌大学学报（医学版）》2011年第2期52-54,57,共4页Journal of Nanchang University：Medical Sciences

摘　　要：目的应用三维适形放疗(3D-CRT)计划比较中上段食管鳞癌3D-CRT和调强放疗(I MRT)的放射性肺损伤情况从而探讨理想的治疗计划模式。方法 8例患者每例分别设计4个放疗计划(CRT-5、CRT-7、I MRT-5及I MRT-7),规定PTV至少达到95%处方剂量前提下用DVH评价每个计划的V5、V10、V20、V30及肺MLD。采用SPSS 11.5软件包进行数据统计与分析。结果采用3D-CRT技术时,5野的V10优于7野(P=0.006);5野与7野的肺Mean、肺V5、V20、V30(P>0.0083)之间无统计学意义;采用I MRT技术时,5野与7野之间各参数的对比差异无统计学意义(P>0.008 3);3D-CRT与I MRT相比,3D-CRT的肺V5优于I MRT,I MRT的肺Mean、V20、V30优于3D-CRT(P<0.008 3)。结论在食管癌放疗中,I MRT与3D-CRT相比可以减少肺Mean、V20和V30,有利于肺的保护,无论是3D-CRT还是I MRT,5野和7野在肺组织的保护方面无明显差异。Objective To compared 3D-conformal radiotherapy（3D-CRT）-induced and intensity-modulated radiotherapy（IMRT）-induced pulmonary injury by using 3D treatment planning system,and to explore the optimum treatment strategy for upper/mid esophageal carcinoma.Methods Eight patients with upper/mid esophageal carcinoma were selected in this study.Four different radiotherapy plans were developed for each patient,including 5-field 3D-CRT（CRT5）,7-field 3D-CRT（CRT7）,5-field IMRT（IMRT5） and 7-field IMRT（IMRT7）.The planning target volume（PTV） received at least 95% of the prescription dose.The mean lung dose（MLD）,V5,V10,V20 and V30 were evaluated using dose volume histogram（DVH）.All statistics were analyzed using the SPSS version 11.5 software.Results CRT5 plan reduced lung V10 compared with CRT7（P=0.006）,but V5,V20,V30 and MLD were not different between the two plans（P0.008 3）.There were no significant differences in lung parameters between IMRT5 and IMRT7.Compared with IMRT plans,V20,V30 and MLD were increased by 3D-CRT,while V5 was decreased by 3D-CRT（P0.0083）.Conclusion Compared with 3D-CRT,IMRT can reduce the MLD,V20 and V30 to achieve lung sparing in treatment of upper/mid esophageal carcinoma.There were no significant differences in the protection of lung tissues between 5-field and 7-field techniques for both 3D-CRT and IMRT plans.

关 键 词：食管肿瘤/放射疗法 放射性肺损伤 三维适形放疗 调强放疗 

分 类 号：R735.1[医药卫生—肿瘤]