胸中段食管癌调强放疗照射野设计探讨与分析  

Discussion and analysis of the radiation field design in the treatment of the middle- thoracic esophageal cancer

作　　者：陈丽[1] 谭飞[1] 武文娟[1] 蒋亚齐[1] 

机构地区：[1]江苏省苏北人民医院肿瘤科,江苏扬州225001

出　　处：《现代肿瘤医学》2017年第6期942-944,共3页Journal of Modern Oncology

基　　金：扬州市科技计划项目(编号:YZ2014181)

摘　　要：目的:比较多种三维调强放疗计划治疗胸中段食管癌的剂量学差异。方法:选择65例胸中段食管癌患者,对于每例患者设计四种放疗计划,方案一:0°、72°、144°、216°、288°五野等分,方案二:0°、50°、150°、210°、310°不等分五野。方案三:0°、51°、102°、153°、204°、255°、306°七野等分。方案四:0°、40°、80°、120°、160°、200°、240°、280°、320°九野均分方案,比较这四种方案的靶区、危机器官的剂量学差异。结果:四种IMRT计划都可以满足靶区D_(95)的全覆盖,四种方案剂量学上的差异没有统计学意义。危机器官(OARs)方面,5野非均分方案在肺的Dmean、V_5、V_(10)的剂量学比较上有明显优势,在心脏受量方面5野非均分方案相对较高,但没有统计学差异。在脊髓受量方面5野非均分方案也相对较高,但是同样没有统计学差异。结论:相同靶区相同处方剂量下,5野非均分方案可以有效降低肺部的照射剂量。Objective： To compare the dosimetric difference of several 3D IMRT treatments of the middle- thoracic esophageal carcinoma. Methods： The data of 65 cases of esophageal cancer were selected,and four radiotherapy plans were designed for each patient. The first plan,0°,72°,144°,216°,288°,The second plan,0°,50°、150°,210°,310°,The third plan,0°,51°,102°,153°,204°,255°,306°,The fourth plan,0°,40°,80°,120°,160°,200°,240°,280°,320°,Compare the dosimetric differences of the four methods of target organ and crisis. Results： Four IMRT plans can cover the target area D95. Four plans on the dosimetric differences were not statistically significant,about OARs,The second plan was obvious advantages in the lung dosimetry by comparing of Dmean,V5,V10. Heart radiation dose was higher,but there was no statistical difference. In the spinal cord dose is also relatively high,but there is no statistical difference. Conclusion： In the same target area of the same prescription dose,the five fields unequal division plan can effectively reduce the exposure dose of the lung.

关 键 词：食管癌 三维适形调强放疗 危机器官 处方剂量 

分 类 号：R735.1[医药卫生—肿瘤]