体表大体积肿瘤的内外照射技术的剂量学比较  

Comparing of Dose Distribution between the Internal and External Irradiation for Large-volume-neurofibromatosis

作　　者：孙小扬[1] 杨波[1] 张建文[1] 庞皓文[1] 罗惠群[1] 吴虹[1] 吴敬波[1] 

机构地区：[1]泸州医学院附属医院肿瘤科,四川泸州646000

出　　处：《四川医学》2015年第6期788-790,共3页Sichuan Medical Journal

摘　　要：目的比较1例体表大体积的神经纤维瘤不同放疗计划的剂量学分布,并分析各计划特点。方法在外生型肿瘤患者的插值治疗时CT图像基础上,分别制作两野对穿照射,两野交角加楔照射,四野照射,调强和组织间插值治疗。测量靶区剂量的D95,D50;全肺V5,V10,V20和V30;心脏V40和脊髓Dmax。结果两野对穿照射,两野交角加楔照射,四野照射,调强和组织间插值治疗的CI分别为:0.50,0.48,0.53,0.87和0.65;D95分别为(c Gy):5016,5023,5386,6036和6023;全肺V5,V10,V20和V30分别为(%):5.33,3.63,2.12和1.37;68.86,59.66,10.59和3.46;42.87,33.74,25.05和9.53;80.88,62.56,24.24和8.03;46.85,21.77,6.66和2.36;心脏V40为(%):4.45,42,8.9,18.95和16.02;脊髓Dmax(c Gy):42,1590,3531,2425和135。结论从剂量学上的表现不建议采用两野交角加楔照射,从保护肺心脏器官考虑,建议两野对穿照射;从给予靶区最大剂量角度综合考虑,建议采用组织间插值治疗方式。Objective To comparing the characteristics of dose distribution for different radiation treatment plans in a case of large-volume-neurofibromatosis. Methods For a case of neurofibromatosis, two-field radiotherapy, two-cross-field with wedge radiotherapy, four-field radiotherapy, intensity modulated radiotherapy （ IMRT ） , Percutaneous Interstitial Brachytherapy （PIBT） were designed in the radiotherapy planning system. And the D95, D50, lung V5, V10, V20 and V30 of lung; V40 of heart and cord Dmax were counted. Results The CI of two-field radiotherapy, two-cross-field with wedge radiotherapy, four-field radiotherapy, IMRT, PIBT were：0. 50, 0. 48, 0. 53, 0. 87 and 0. 65;and the D95 was（cGy）：5016,5023,5386,6036和6023;lung V5, V10, V20 and V30 were（%）：5. 33, 3. 63, 2. 12 and 1. 37;68. 86, 59. 66, 10. 59 and 3. 46;42. 87, 33. 74, 25. 05 and 9. 53;80. 88, 62. 56, 24. 24 and 8. 03;46. 85, 21. 77, 6. 66 and 2. 36;heart V40 was （%）：4. 45, 42, 8. 9, 18. 95 and 16. 02;cord Dmax （cGy）：42, 1590, 3531, 2425 and 135. Conclusion We do not suggest the two-cross-field with wedge ra-diotherapy because of no advantage in the dose distribution. The dose of heart and cord reached the minimum in two-field radio-therapy. And the PIBT should be a good choice for exposure of garget and protect of normal tissue.

关 键 词：大体积肿瘤 放射治疗 组织间插值治疗 调强 

分 类 号：R730.55[医药卫生—肿瘤]