VMAT和IMRT在早期右侧乳腺癌保乳术后放射治疗中的比较剂量学研究  

Comparative dosimetric study of VMAT and IMRT in radiation therapy for early right breast cancer after breast conserving surgery

作　　者：刘洋[1] 冯革[2] 张振勇[1] 田欣[1] 吴荣[1] Liu Yang;Feng Ge;Zhang Zhenyong;Tian Xin;Wu Rong(The Second Oncology Department,Shengjing Hospital of China Medical University,Liaoning Shenyang 110022,China;Radiation Department,Shengjing Hospital of China Medical University,Liaoning Shenyang 110022,China)

机构地区：[1]中国医科大学附属盛京医院肿瘤二病房,辽宁沈阳110022 [2]中国医科大学附属盛京医院放疗科,辽宁沈阳110022

出　　处：《现代肿瘤医学》2020年第12期2117-2121,共5页Journal of Modern Oncology

摘　　要：目的:比较三种放射治疗计划对右侧乳腺癌保乳术后放射治疗的剂量学差异。方法:选择11名早期右侧乳腺癌保乳术后的患者,采用处方剂量5000 cGy,分别设计2FIMRT、4FIMRT和2arcVMAT三种计划。使用剂量体积直方图(dose volume histogram,DVH)来分析PTV和OARs的每个评估指标。结果:VMAT和IMRT为所有患者实现了整个乳房的良好的剂量均匀性。VMAT计划比两个IMRT计划有更好的HI,并减少了V107。在乳腺体积>503 mm^3的患者中,2arcVMAT具有更好的HI。2FIMRT在OARs,包括心脏,左、右肺,对侧乳腺,食管,脊髓和肝脏,对比4FIMRT和2arcVMAT,受照射剂量更低,差异具有统计学意义。结论:这三种计划可以满足右侧乳腺癌术后放疗的临床剂量要求,综合靶区剂量分布及OARs进行评分,整体考虑使用2FIMRT可能比其他两种计划具有临床优势。Objective:To compare the dosimetric differences among the three radiotherapy plans for radiation therapy after breast conserving surgery in right breast cancer patients.Methods:Eleven patients with early breast cancer after breast-conserving surgery were enrolled.The prescription dose of 5000 cGy was used to design 2 FIMRT,4 FIMRT and 2 arcVMAT.Dose volume histogram(DVH)was used to analyze each of the assessment targets for PTV and OARs.Results:Both VMAT and IMRT achieved good dose uniformity throughout the breast for all patients.The VMAT program has a better HI than the two IMRT plans and has reduced the V107.2 arcVMAT has a better HI in patients with the breast volume more than 503 mm^3.2 FIMRT has the lowest doses in the OARs,including the heart,left and right lung,contralateral breast,esophagus,spinal cord and liver,compared with 4 FIMRT and 2 arcVMAT.The differences were statistically significant.Conclusion:These three plans can meet the requirements of the clinical dose for postoperative radiotherapy of right breast cancer.Considering both of target dose distribution and OARs score,we suggested that 2 FIMRT may have clinical advantages in postoperative adjuvant radiation therapy in early-stage right breast cancer patients.

关 键 词：乳腺癌 IMRT VMAT 剂量 

分 类 号：R737.9[医药卫生—肿瘤]