胸中段食管癌适形调强放疗和三维适形放疗方案的应用探讨  

Comparison between IMRT and 3D-CRT in the Therapy of Mid-thoracic Esophageal Cancer

作　　者：咸婧[1] 张伶[1] 李小凯[1] 潘兴国[1] 蒋朝阳[1] 王岩松[1] 李智慧[1] 

机构地区：[1]成都军区总医院肿瘤诊治中心放射治疗科,610083

出　　处：《西南军医》2011年第4期583-585,共3页Journal of Military Surgeon in Southwest China

基　　金：浙江省自然科学基金(Y207353)

摘　　要：目的比较胸中段食管癌适形调强放疗(IMRT)和三维适形放疗(3D-CRT)两种不同技术中计划靶区(PTV)及正常组织的受量。方法对52例ⅡB-Ⅳ期胸中段食管癌患者用同一放疗计划系统分别设计IMRT和3D-CRT根治性放疗计划,应用剂量体积直方图(DVH)比较两种方法中计划靶区和正常组织受量并且计算计划靶区适形指数(CI)和剂量不均匀指数(HI)。结果 IMRT方法的PTV适形度优于3D-CRT;脊髓剂量的最大值低于3D-CRT,但无统计学差异;心脏接受V25和V40的体积百分比低于3D-CRT;IMRT显著降低了肺部V10和V20的有效体积,但其肺部的V5大于3D-CRT。结论在可接受的放射性损伤的基础上,IMRT技术较3D-CRT能够提高行根治性放疗的ⅡB-Ⅳ期胸中段食管癌患者靶区剂量,靶区适形度高,但可使肺组织受到更大容积的低剂量照射。Objective To compare the radiation dosages of IMRT and 3D-CRT in PTV and the normal tissues of the patients with mid-thoracic esophageal cancer.Methods IMRT and 3D-CRT were designed within the same treatment planning system for 52 cases with mid-thoracic esophageal cancer at the stage of IIB to IV;the radiation dosages in PTV and normal tissues of the 2 therapeutic methods were compared through DVH,and CI and HI were calculated.Result The CI of IMRT was superior to that of 3D-CRT and the dosage maximum of spinal cord was lower than that of 3D-CRT but the difference was of no statistical significance;the volume percentage of V25 and V40 that the heart received was lower than that of 3D-CRT;IMRT reduced the effective volume of V10 and V20 in lung while it caused the V5 in lung bigger than that of 3D-CRT.Conclusions IMRT can raise PTV radiation dosage with high CI while it will cause a bigger low-dosage radiation in lung tissue.

关 键 词：食管癌 三维适形放射治疗 调强适形放射治疗 剂量学 

分 类 号：R735.1[医药卫生—肿瘤]