乳腺癌保乳术后同步加量调强和混合调强的放疗计量学比较  

Dosimetry comparison of simultaneously integrated boost intensity modulated radiotherapy and hybrid intensity modulated radiotherapy for breast cancer after breast conserving surgery

作　　者：方美芳 蔡汉飞[1] 殷红梅[1] 徐露 

机构地区：[1]蚌埠医学院第一附属医院,安徽蚌埠233004

出　　处：《中国民康医学》2017年第22期11-13,共3页Medical Journal of Chinese People’s Health

摘　　要：目的:比较乳腺癌保乳术后同步加量调强(Intensity modulated radiotherapy,IMRT)和混合调强(Hybrid intensity modulated radiotherapy,Hy_IMRT)的放疗计量学差异。方法:选取10例乳腺癌术后患者(右乳7例、左乳3例)作为观察对象,分别给予患者IMRT和Hy_IMRT放疗计划。比较两种放疗计划的治疗参数和危及器官剂量。结果:IMRT放疗计划的CI值明显优于Hy_IMRT放疗计划,PTV2内超过处方剂量107%的体积明显低于Hy_IMRT放疗计划,机器跳数(Monitor units,Mu)及子野数明显多于Hy_IMRT放疗计划(P<0.05);Hy_IMRT放疗计划患侧肺与心脏的V5、V10、危及器官(双肺、心脏和左侧乳腺)的Dmean均明显低于IMRT放疗计划(P<0.05);两种放疗计划患侧肺V20、V30比较,差异无统计学意义(P>0.05)。结论:同步加量调强放疗计划能提高靶区剂量的适行度,降低靶区内高剂量区的体积;混合调强放疗计划能更好降低危及器官的照射剂量,提高机器治疗效率。Objective:To compare difference of dosimetry between simultaneously integrated boost intensity modulated radiotherapy(SIB IMRT) and hybrid intensity modulated radiotherapy(Hy_IMRT) after breast conserving surgery for breast cancer.Methods:10 cases of patients with breast cancer after surgery(right breast in 7 cases,3 cases of left breast) were selected as the observation objects and given SIB IMRT and Hy_IMRT,separately.The treatment parameters and the doses to the organs at risk of the two treatment plans were compared.Results:Compared with Hy_IMRT,the CI value of SIB IMRT was significantly higher,more than107% of the prescribed dose volume of PTV2 was significantly lower,and the machine monitor units and the number of segments were obviously higher(P<0.05).However,the V5 and V10 of the affected lung and heart as well as the the Dmean of double lungs,heart and left breast of Hy_IMRT were significantly lower than those of IMRT(P<0.05).Further,there were no significant differences in V20 and V30 between the two radiotherapy plans(P>0.05).Conclusions:The SIB IMRT plan can improve the fitness of the target dose and reduce the volume of high dose area in the target area,while the Hy_IMRT plan can reduce the radiation dose of dangerous organs and improve the efficiency of machine treatment.

关 键 词：乳腺癌 同步加量调强 剂量学 混合调强 

分 类 号：R737.9[医药卫生—肿瘤]