右乳腺癌保乳术后留置银夹对后程同步整合补量调强放射治疗瘤床靶区作用  

Dosim etry study of silver clip marker on simultaneous integrated boost intensity modulated radiotherapy for right breast after breast-conserving surgery

作　　者：张凯恋 林菲[1] 张芬[1] 潘香[1] 赵彪[1] 杨毅[1] 

机构地区：[1]昆明医科大学第三附属医院,云南昆明650118

出　　处：《生物医学工程与临床》2016年第2期157-161,共5页Biomedical Engineering and Clinical Medicine

摘　　要：目的探讨右乳腺癌保乳术后有银夹标记瘤床同步整合补量调强放射治疗临床剂量学特点。方法选取行早期右乳腺癌保乳术后加放射治疗的女性患者30例．年龄25～61岁，中位年龄44．2岁。根据右乳腺癌保乳术中瘤床有无放置银夹分为有银夹组15例．无银夹组15例。给予调强放射治疗后程同步瘤床电子线补量照射，并比较两种方法的剂量学参数。结果无银夹组瘤床靶体积大于有银夹组．两者比较，差异有统计学意义（P〈0．05）；两组全乳腺靶体积差异无统计学意义（P〉0．05）．无银夹组瘤床靶体积与全乳腺靶体积比值大于有银夹组，差异有统计学意义（P〈0．05），两组瘤床靶体积平均厚度差异无统计学意义（P〉0．05）；两组全乳腺靶区Dmax、Dmin和V95差异无统计学意义（P〉0．05），两组Dmean、V105和V110差异有统计学意义（P〈0．05）；两组全乳腺靶区适形度和均匀指数差异无统计学意义（P〉0．05），瘤床靶区适形度差异有统计学意义（P〈0．05），瘤床靶区均匀指数差异无统计学意义（P〉0．05）；右肺V5、V10、V20左肺Dmean、全肺V20，心脏V5，V15、Dmean，脊髓Dmax、左乳腺Dmean，两组比较，差异无统计学意义（P〉0．05）。结论有银夹组与无银夹组大部分剂量学参数差异无统计学意义．但有银夹组瘤床靶区体积及适形度方面比无银夹组有一定的优势。Objective To study the clinical dosimetry characteristics of fight breast conserving surgery patients with silver clip marker on simultaneous integrated boost intensity modulated. Methods A total of 30 right breast conserving surgery female patients were enrolled, which aged 25 - 61 years old with median age of 44.2 years old. All of them were divided into 2 groups, silver clip marker group（n = 15） and without silver clip marker group（n = 15）, which performed simultaneous integrated boost intensity modulated radiotherapy, and compared differences on dosimetry between 2 groups. Results On tumor bed tar- get volume（Vcrvl）, the without silver clip marker group was larger than that of silver clip marker group, there was significant difference between 2 groups（P 〈 0.05）. On whole breast target volume（VCTV）, the difference was no significant between 2 groups （P 〉 0.05）. In comparison with VCTV1/VCTV, the group without silver clip marker was obviously larger than that of silver clip marker group, there was significant difference between 2 groups（P 〈 0.05）. There was no significant of mean thickness of tumor bed between 2 groups （P 〉 0.05）. On Dmax, Dmin, V95 of target volume were no significant between 2 groups （P 〉 0.05）, but Dneab, V105, V110 were significant difference （P 〈 0.05）. On homogeneity index and conformal index of whole breast, there was signifi- cant difference between 2 groups （P 〈 0.05）, and on conformal index of tumor bed target volume, there was significant differ- ence（P 〈 0.05）, but on homogeneity index, there was no significants（P 〉 0.05）. On V5, V10, V20 of fight lung, Dmean of left lung, V20 of whole lung, V5, V15 and Dmean of heart, Dmax of spinal cord and Dmean of left breast were no significant between 2 groups（P 〉 0.05）. Conclusion It is demonstrated that the most of dosage parameters are no significant between silver clip marker group and without silver clip marker group, but silver clip marker group shows more advant

关 键 词：乳腺癌 保乳术 银夹标记 同步电子线补量 调强放射治疗 瘤床靶区 

分 类 号：R737.9[医药卫生—肿瘤]