危及器官不同定义对乳腺癌调强放疗计划的影响  

The influence of different definition of organ at risk( OAR) on the plan of intensity-modulated radiotherapy( IMRT) for breast cancer radiotherapy

作　　者：贺春钰[1] 王巨武[1] 古丽扎热叶.艾库拉 司马义力.买买提尼牙亚孜 木妮热.木沙江 

机构地区：[1]新疆医科大学附属肿瘤医院乳腺放疗科,新疆乌鲁木齐830011

出　　处：《现代肿瘤医学》2014年第7期1685-1688,共4页Journal of Modern Oncology

基　　金：新疆医科大学创新基金(编号:XJC201273)

摘　　要：目的:探讨危及器官的不同定义对左侧乳腺癌逆向调强放疗计划的影响。方法:各20例改良根治术和保乳术的左侧乳腺癌患者纳入本研究,放疗前均行增强定位CT薄层扫描。当靶区包括内乳区时,比较将全心(A组)和全心+冠状动脉左前降支(LAD)(B组)作为危及器官时计划靶区(PTV)和各危及器官(OAR)的剂量-体积的变化。结果:2组计划的PTV、双侧肺的剂量-体积无明显差异,但B组的心脏和LAD的部分剂量-体积参数明显低于A组,而患侧肺的部分剂量-体积参数却高于A组,差异均具有统计学意义(P<0.05)。结论:为更好地保护心脏、LAD,左侧乳腺癌放疗内乳区时应增加LAD作为独立的危及器官。Objective：To study the influence of different definition of organ at risk（OAR） on the dose and volume in the plan of intensity -modulated radiotherapy （IMRT）for left - sided breast cancer radiotherapy. Methods：All 40 patients with post - operatively confirmed left - sided breast cancer were enrolled in the study who were scanned using contrast enhanced CT before radiotherapy. With internal mammary case, two plans of IMRT with and without the left anterior descending coronary （LAD） - sparing were separately designed. Plans were compared according to dose - voulme histograms. Results ：The dose and volume of PTV （plan target volume）and bilateral lung was no significant difference in two cases. Compared with group A, a part of the dose - values of the heart and LAD in group B were sig- nificantly lower,while a part of the values of ipsilateral lung were higher （P 〈 0.05 ）. Conclusion： To protect the heart better and LAD, especially for the left - sided breast cancer patient with the internal mammary radiotherapy, the LAD shoud be contoured and analyzed respectively.

关 键 词：乳腺癌 逆向调强放疗 冠状动脉左前降支 

分 类 号：R737.9[医药卫生—肿瘤]