左侧乳腺癌根治术后放疗心脏受照剂量的临床观察  

The Clinical Observation of Radiation Dose on the Left Side After Radical Mastectomy for Breast Cancer

作　　者：王鸣 王晶 刘春梅 于丽丽 WANG Ming;WANG Jing;LIU Chunmei;YU Lili(Department of Oncology,Yanda Hospital,Hebei Province,Sanhe Hebei 065201,China)

机构地区：[1]河北燕达医院肿瘤科,河北三河065201

出　　处：《中国卫生标准管理》2020年第20期49-51,共3页China Health Standard Management

摘　　要：目的分析左侧乳腺癌根治术后放疗心脏受照剂量的临床观察。方法随机选择2015年6月—2017年6月我院收治的乳腺癌根治术的45例患者,所有患者均符合左侧乳腺癌的诊断特征,且符合术后适合接受放疗的患者。(1)摆位、固定及CT模拟扫描;(2)勾画靶区;(3)设计治疗计划。正常组织照射剂量主要参考某特定剂量包含该组织器官平均照射剂量及器官的体积百分比。心脏:V5、V10、V20、V30。观察患者靶区的均匀性、均匀指数及正常组织的受照量。结果三维适形和调强放疗的Dmax、Dmean差异有统计学意义(P<0.05);而2种放疗技术的Dmin无明显差异(P>0.05)。调强放疗对心脏V5、V10受照体积明显高于三维适形放疗,差异有统计学意义(P<0.05)。结论对乳腺癌根治术后的三维适形和调强放疗计划均有较好的覆盖,但调强放疗剂量分布均匀适形度好且有效降低照射剂量。Objective To analyze the clinical observation of cardiac radiation dose after radical mastectomy for left breast cancer.Methods 45 patients with radical mastectomy in our hospital from June 2015 to June 2017 were randomly selected.All patients met the diagnostic characteristics of left breast cancer and were suitable for postoperative radiotherapy.(1)Setting,fixation and CT simulation scanning;(2)delineating the targetarea;(3)designing the treatment plan.The normal tissue irradiationdose mainly refers to a specific dose,including the average radiationdose of the tissue and organ and the volume percentage of the organ.Heart:V5,V10,V20,V30.The uniformity,uniformity indexand exposuredoseof normal tissue were observed. Results There was significantdifference in Dmax, Dmean between three-dimensional conformalradiotherapy and intensity-modulated radiotherapy (P < 0.05), but there wasno significant difference in Dmin between the two radiotherapy techniques(P > 0.05).The volume of V5 and V10 in IMRT was significantly higher thanthat in 3D-CRT (P < 0.05). Conclusion The three-dimensional conformalradiotherapy and intensity-modulated radiotherapy plan have good coverageafter radical mastectomy,but the dose distribution of intensity-modulatedradiotherapy is uniform,the conformal degree is good,and the radiation doseis effectively reduced.

关 键 词：左侧乳腺癌 根治术 心脏 三维适形放疗 调强放疗 受照剂量 

分 类 号：R737[医药卫生—肿瘤]