乳腺癌保乳术后三维适形放疗靶区及肺受照剂量分析  

The target area and lung illuminated dose analysis of postoperative breast conservative therapy by three-dimensional conformal radiotherapy of breast cancer

作　　者：金诚[1] 邱福铭[2] 

机构地区：[1]浙江省肿瘤医院物理室,浙江杭州310022 [2]浙江大学医学院附属第二医院肿瘤科,浙江杭州310012

出　　处：《中国现代医生》2013年第36期39-41,共3页China Modern Doctor

基　　金：浙江省钱江人才计划项目(2013R10053)

摘　　要：目的对乳腺癌保乳术后三维适形放疗（3D-CRT）靶区及肺受照剂量进行分析。方法选取2011年7月～2012年7月到我院进行治疗的52例早期乳腺癌患者。52例患者保乳术后接受3D-CRT．所有患者在同一CT定位片上进行CRT的设计。结果3D-CRT的V95％（处方剂量）和CRT接近（t=1．9090，P=0．0591）；而V105％、V110％、V115％等高剂量区则明显降低（P=0．0000）。3D-CRT和CRT计划中H1分别为（1．07±0．01）和（1．17±0．11），3D-CRT明显低于CRT（t=6．5286，P=0．0000，P〈0．01）。3D-CRT组患侧肺的V20和V30值分别高于CRT：Dmean、D5、V20平均值患侧肺分别是1．96、9．26Gy和1．59％。健侧肺分别是0．19、0．86Gy和0。结论3D-CRT用于早期乳腺癌保乳治疗，其剂量分布均匀度比较高，同时治疗效果良好，未病变组织受照量比较低，美容效果更佳，值得临床广泛应用和推广。Objective To study the target area and lung illuminated dose of postoperative breast conservative therapy by three-dimensional conformal radiotherapy of breast cancer. Methods A total of 52 patients with early breast cancer, treated in our hospital from July 2011 to July 2012, were selected as the study objects. 52 patients with confirmed breast surgery received three-dimensional conformal radiation therapy, and all of the patients were in the same CT po- sitioning piece for the design of CRT. Results V95 % value of three-dimensional conformal radiation therapy （prescription dose） was similar to that of conventional radiation therapy （t = 1.9090, P = 0.0591）; While high dose area such as V105%, V110%, V115% were reduced significantly （P= 0.0000）. HI in the three-dimensional conformal radiation therapy and conventional radiation therapy were （1.07±0.01） and （1.17±0.11）,respectively. HI in the three-di- mensional conformal radiation therapy was significantly lower than that in the conventional radiation therapy （t = 6.5286, P = 0.0000, P 〈 0.01）. Lung V20 and V30 value of three-dimensional conformal radiation therapy group were higher than that of conventional radiation therapy, respectively; D mean,D5 ,V20 average value of diseased lung were 1.96, 9.26 Gy and 1.59% respectively, and the contralateral lung was 0.19, 0.86 Gy and 0% respectively. Conclusion The dose distribution uniformity of three-dimensional eonformal radiation therapy treating early breast cancer, is higher, and treatment effect is good, and exposure doses of health organizations are lower, and cosmetic effect is better. It is worthy of clinical extensive application and promotion.

关 键 词：乳腺癌 保乳术 三维适形放疗 受照剂量 

分 类 号：R737.9[医药卫生—肿瘤]