左乳腺癌保乳术后CRT和FIF—IMRT及逆向IMRT剂量学比较  

Dosimetry of conformal radiotherapy, field-in-field intensity-modulated radiotherapy, and inverse- planned intensity.modulated radiotherapy after breast-conserving surgery for left-sided breast cancer：a comparative analysis

作　　者：霍雯[1] 宁博 胡静[1] 许梅[1] 刘刚[1] 

机构地区：[1]石河子大学医学院第一附属医院放疗科,新疆石河子832008

出　　处：《中华放射肿瘤学杂志》2016年第7期745-747,共3页Chinese Journal of Radiation Oncology

摘　　要：目的 比较左乳腺癌保乳术后CRT、FIF-IMRT和IMRT剂量学差异。方法 随机选取31例左乳腺癌保乳术后患者,分别制定CRT、FIF-IMRT、IMRT计划。通过DVH图进行自身对照研究,采用非参数检验法比较靶体积及OAR受量分布差异。结果 3种方法均能达到处方剂量要求。CRT组靶区V105高、心脏V30、Dmax较高（P=0.000、0.000、0.000）;IMRT组V5、Dmean较高（P=0.000、0.000）,左肺V5较高（P=0.000）、V40较低（P=0.000）;FIF-IMRT组Dmean最低（P=0.000）,IMRT组右肺及脊髓Dmean、Dmax均高于其他两组（P=0.000、0.000、0.000、0.000）。单次跳数FIF-IMRT组明显低于其他两组（P=0.000）。结论 CRT在靶区有较好的剂量分布但对周围组织损伤较大,相比而言FIF-IMRT对OAR保护更好且对机器损耗小。Objective To investigate the differences in dosimetry between conformal radiotherapy （CRT）, field-in-field intensity-modulated radiotherapy （FIF-IMRT）, and intensity-modulated radiotherapy （IMRT） after breast-conserving surgery for left-sided breast cancer. Methods A total of 31 patients who underwent breast-conserving surgery for left-sided breast cancer were randomly selected, and the plans for CRT, FIF-IMRT, and IMRT were developed. The dose-volume histogram （DVH） was used for self-control study, and the non-parametric test was used to compare the differences in target volume and doses to organs at risk （OARs）. Results All the three methods met the requirements of the prescribed doses. The CRT group had a higher V105 of the target volume and higher heart V30 and Dmax（P=0.000,0.000,0.000）. The IMRT group had higher V5 and Dmean（P=0.000,0.000）, as well as a higher lung V5 and a lower lung V40（P=0.000,0.000）. The FIF-IMRT group had the lowest Dmean（P=0.000）, and the IMRT group had significantly higher Dmean and Dmax of the right lung and the spinal cord than the other two groups （P=0.000,0.000,0.000,0.000）. The FIF-IMRT group had a significantly lower single hop count than the other two groups （P=0.000）. Conclusions CRT has a good dose distribution in the target volume, but greatly injures the surrounding tissues. FIF-IMRT can well protect OARs and cause less damage to the device.

关 键 词：乳腺肿瘤/放射疗法 放射疗法 常规 放射疗法 逆向调强 放射疗法 野中野调强 剂量学 

分 类 号：R737.9[医药卫生—肿瘤] R730.55[医药卫生—临床医学]