左侧乳腺癌保乳术后三种调强放疗计划的剂量学研究  

Dosimetric Study of Three Intensity Modulated Radiotherapy for Left-sided Breast Cancer after Breast Conserving Surgery

作　　者：滕建建[1] 叶淑敏 张利文[1] TENG Jianjian;YE Shumin;ZHANG Liwen(Department of Radiation Oncology,Cancer Center,First People’s Hospital of Foshan City,Guangdong Province 528000)

机构地区：[1]广东省佛山市第一人民医院肿瘤放射物理科,528000

出　　处：《医学理论与实践》2021年第13期2187-2189,共3页The Journal of Medical Theory and Practice

摘　　要：目的:研究左侧乳腺癌保乳术后容积调强、动态调强、野中野调强三种计划之间的剂量学差异。方法:随机选取15例左侧乳腺癌保乳术后患者,分别设计容积调强(VMAT)、动态调强(IMRT)、野中野调强(FiF)三种计划。比较靶区的适形性和均匀性,患侧肺、心脏、健侧肺和健侧乳腺的剂量参数之间的差别。结果:VMAT和IMRT计划相对于FiF计划改善了靶区的适形性和均匀性。对于患侧肺,各项参数VMAT计划最高,FiF计划的V 5最低,V_(20)及D_(mean)和IMRT计划之间的差别无统计学意义(P>0.05),VMAT计划和IMRT计划降低了V_(30);IMRT计划降低了心脏的V_(30)但增加了其D_(mean);FiF计划健侧肺和健侧乳腺的D 2%和D_(mean)最小(P<0.05)。结论:VMAT计划和IMRT计划改善了靶区的均匀性和适形性,降低了患侧肺和心脏的高剂量区域,FiF计划则更好地保护了健侧乳腺和健侧肺。Objective:To evaluate the dosimetric difference for left-sided breast cancer after breast conserving surgery among 3 different intensity-modulated radiotherapy plans.Methods:The volume modulated arc therapy(VMAT),intensity modulated radiotherapy(IMRT)and field in filed(FiF)plans were generated retrospectively for 15 patients with left-sided breast cancer randomly enrolled.The dose conformity and homogeneity of planning target volume(PTV),the dosimetric parameters of ipsilateral lung,heart,contralateral lung and contralateral breast were compared among three plans.Results:The VMAT and IMRT plans provided a higher dose conformity index and lower homogeneity index than FiF plan.All the dosimetric parameters of VMAT plan were worst.The V 5 of FiF plan was best,while there was no statistical significance in the V_(20) and D_(mean) of ipsilateral lung between FiF and IMRT plans(P>0.05).The V_(30) of ipsilateral lung in the VMAT and IMRT plans were lower than the FiF plan.The IMRT plan reduced the V_(30) but increased the D_(mean) of the heart.The D 2%,D_(mean) of contralateral lung and contralateral breast were lower in FiF plan than those of the other two plans(P<0.05).Conclusion:Our study showed that the VMAT and IMRT plans provided a better dose conformity and homogeneity at the same time reduced the high dose area of the ipsilateral lung and heart,while the FiF plan better protected contralateral lung and contralateral breast.

关 键 词：左侧乳腺癌 保乳术 容积调强 动态调强 野中野调强 

分 类 号：R737.9[医药卫生—肿瘤]