左侧乳腺癌根治术后调强放疗两种勾画指南的比较研究  

Comparison Study on Two Contour Guidelines About Intensitymodulated Radiotherapy for Left Breast Cancer Patients After Radical Surgery

作　　者：陈诚[1] 黄蕾[1] 何侠[1] 王晓华[1] 

机构地区：[1]江苏省肿瘤医院,江苏南京210009

出　　处：《肿瘤学杂志》2015年第12期978-981,共4页Journal of Chinese Oncology

摘　　要：[目的]比较左侧乳腺癌改良根治术后调强放疗(IMRT)两种靶区勾画指南的差异,为临床选择提供参考。[方法]入组20例左侧乳腺癌改良根治术后患者,对所有患者均采用RTOG和ESTRO勾画指南分别勾画,运用TPS计划系统比较两种勾画指南的靶区体积和心、肺组织的受量。[结果]患侧胸壁(CTV-C)、锁骨上淋巴结区(CTV-S)和腋窝淋巴结Ⅱ区(CTV-Ⅱ)靶区体积有明显差异(P<0.01),而腋窝淋巴结Ⅲ区(CTV-Ⅲ)靶区体积无明显差异性(P=0.91)。患侧肺受量(V5、V10、V20)和心脏受量(V20、V30、V40)比较无明显差异(P>0.05)。[结论]ESTRO标准有效减少了部分照射体积,在临床的合理性和操作的重复性上更有优势。[Purpose] To compare two contour guidelines about intensity-modulated radiotherapy（IMRT）for left breast cancer patients after radical surgery,in order to provide the basis for breast cancer radiotherapy. [Methods] Twenty left breast cancer patients after radical surgery were enrolled in our study. After target volume delineation for all patients according to the guidelines of RTOG and ESTRO by two radiation oncologists,the treatment planning system was used to study target volume and lung,heart tissue dose about two kinds of radiotherapy treatment planning.[Results] The results showed that there were significant differences in target volume of ipsilateral chest wall（CTV-C）,supraclavicular region（CTV-S）and axilla-level Ⅱregion（CTV-Ⅱ）between two contour guidelines,while no significant differences in target volume of axilla-level Ⅲ region（CTV-Ⅲ）. There was no significant difference in ipsilateral lung dose（V5,V10,V20）and heart dose（V20,V30,V40）. [Conclusion] ESTRO guideline decreases target volume and has advantages in clinical rationality and practical repeatability.

关 键 词：乳腺肿瘤 调强放疗 勾画指南 

分 类 号：R737.9[医药卫生—肿瘤]