乳腺癌根治术后调强放射治疗下不同硅胶设置的肺组织剂量评估  

Assessment of lung dose in breast IMRT after radical mastectomy with different bolus settings

作　　者：刘婷婷[1] 刘志强[1] 欧阳水根[1] 陶娜[1] 魏玺仪[1] 高力英[1] 

机构地区：[1]甘肃省肿瘤医院放疗科,甘肃兰州730000

出　　处：《中国医学物理学杂志》2016年第11期1121-1125,共5页Chinese Journal of Medical Physics

基　　金：甘肃省卫生行业科研计划项目(GSWSKY-2015-27)

摘　　要：目的:比较乳腺癌患者调强放射治疗在不加硅胶、半程硅胶和全程硅胶下的肺剂量差异,探讨最优治疗方案。方法:选取22例乳腺癌患者,Oncertra系统上调强放射治疗计划设计。每个病例有3种方案,即不加硅胶、半程硅胶和全程硅胶。处方剂量50 Gy,覆盖90%的靶区体积。利用SPSS统计软件分析3种方案中靶区最大剂量以及肺剂量的差异,评估并探讨最佳方案。结果:对3种方案的剂量学参数进行比较,三者肺组织剂量无显著变化;靶区D_(50)、D_(90)无明显差别;D_(max)分别为(62.64±2.36)、(57.91±0.99)、(57.46±1.51)Gy,以及均匀性指数为0.21±0.03、0.15±0.02、0.13±0.01,均有统计学差异(P<0.05)。且加硅胶优于不加硅胶,半程硅胶与全程硅胶无差异。结论:加硅胶优于不加硅胶,半程硅胶既达到靶区预防,也能提高患者生命质量。Objective To achieve an optimal treatment plan by comparing lung doses of breast cancer patients treated by intensity-modulated radiotherapy （IMRT） with full-bolus, half-bolus and no-bolus. Methods For 22 selected patients with breast cancer, IMRT plans were designed with Oncentra planning system. Three plans were designed for each patient （full- bolus, half-bolus and no-bolus）. The prescription dose was 50 Gy, covering 90% of the target volume. The differences in the maximum dose （Dmax） of target area and lung dose between the three plans were analyzed by using SPSS statistical software to evaluate and discuss the optimal treatment plan. Results The dosimetric parameters of three plans were compared, and no significant differences were found in lung doses, target D50 and D90. Dmax of the three plans （all-bolus, half-bolus and no-bolus） was （62.64±2.36）, （57.91±0.99）, （57.46±1.51）Gy, respectively, and homogeneity index was 0.21±0.03, 0.15±0.02, 0.13±0.01, respectively, with statistical significance （P〈0.05）. The resuRs of bolus were better than those of no-bolus, but no differences were found between all-bolus and half-bolus. Conclusion Bolus can achieve a better result for patients with breast cancer, ：and half-bolus is more conducive to patients in achieving preventive effect and improving the life quality.

关 键 词：乳腺癌 调强放疗 硅胶 肺 剂量 

分 类 号：R144[医药卫生—公共卫生与预防医学]