乳腺癌保乳术后野中野三维适形放疗与双切线野三维适形放疗的剂量学比较  

Dosimetric comparison between field-in-field three-dimensional conformal radiation therapy and bitangent field three-dimensional conformal radiation therapy after breast conserving surgery for breast cancer

作　　者：廖小文[1] 牛道立[2] 

机构地区：[1]福建医科大学附属第二医院放疗科 [2]广州医科大学附属第一医院放疗科

出　　处：《中国实用医药》2016年第20期26-27,共2页China Practical Medicine

摘　　要：目的比较早期乳腺癌保乳术后野中野三维适形放疗与双切线野三维适形放疗的剂量学差异。方法 10例早期乳腺癌保乳术后患者,分别设计双切线野三维适形放疗(双切线野组)与野中野三维适形放疗(野中野组)两组放疗计划。比较两组靶区剂量分布的均匀性、适形度以及全肺、心脏受量的差异。结果野中野组中全乳靶区剂量分布中的最大剂量(Dmax)、平均剂量(Dmean)、均匀指数(HI)、适形指数(CI)指标均优于双切线野组(P<0.05);野中野组全肺受量V5、Dmean分别为(19.19±4.83)%、(544.33±140.38)cGy,均低于双切线野组的(24.38±4.84)%、(673.38±141.89)cGy(P<0.05);野中野组心脏受量V20、V40、Dmean均低于双切线野组(P<0.05)。结论野中野三维适形放疗可有效改善早期乳腺癌保乳术后全乳靶区剂量分布的适形度和均匀性,同时不增加肺和心脏的受照剂量。Objective To compare dosimetric difference between field-in-field three-dimensional conformal radiation therapy and bitangent field three-dimensional conformal radiation therapy after breast conserving surgery for early breast cancer. Methods Bitangent field three-dimensional conformal radiation therapy（bitangent field group） and field-in-field three-dimensional conformal radiation therapy（field-in-field group） were respectively applied after breast conserving surgery for 10 early breast cancer patients. Comparison was made on homogeneity of target dose distribution, conformation degree, whole lung and heart exposure dose between the two groups. Results Field-in-field model had all better maximum dose（Dmax）, mean dose（Dmean）, homogeneity index（HI）, and conformation index（CI） than bitangent field model（P〈0.05）. Field-in-field model had lower whole lung exposure dose V5 and Dmean as（19.19±4.83） % and（544.33±140.38） cGy than（24.38±4.84） % and（673.38±141.89） cGy of bitangent field model（P〈0.05）, and its heart exposure dose V20, V40 and Dmean were all lower than bitangent field model（P〈0.05）. Conclusion Field-in-field three-dimensional conformal radiation therapy can effectively improve conformation degree and homogeneity after breast conserving surgery for early breast cancer, without increased lung and heart exposure dose.

关 键 词：乳腺癌 保乳术后 双切线野 野中野 三维适形放疗 

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