胸壁野与区域淋巴结野混合调强放疗在乳腺癌根治术后的应用效果  

Application Effect of Combined Mixed Intensity Modulated Radiation Therapy of Chest Wall Field and Regional Lymph Node Field after Radical Mastectomy

作　　者：郑维奇 李瑞锋[1] 李小阳 叶景乐[1] ZHENG Weiqi;LI Ruifeng;LI Xiaoyang;YE Jingle(Guangqian Hospital,Quanzhou 362321,China)

机构地区：[1]福建省泉州市光前医院,福建泉州362321

出　　处：《中国医学创新》2021年第22期37-40,共4页Medical Innovation of China

基　　金：2015年泉州市卫生计生科研资助项目(泉卫计函[2015]248号)。

摘　　要：目的:探讨乳腺癌根治术后,胸壁野与区域淋巴结野混合调强放疗技术对比传统放疗结束的剂量学分布特点及其优势。方法:回顾性分析2016年1月-2017年10月本院就诊的60例乳腺癌根治术后胸壁野和区域淋巴结野均需放疗患者的临床资料,根据放疗方法将患者分为对照组(n=29)与观察组(n=31)。对照组给予患者传统的切线野三维适形放射治疗(3D-CRT)加锁骨上区电子线照射的方法治疗,观察组给予患者胸壁野与区域淋巴结野混合调强放疗的方法治疗。比较两组IMRT靶区剂量分布适形性、均匀性及危及器官的受量。结果:两组靶区D_(min)、D_(mean)比较,差异均无统计学意义(P>0.05),观察组靶区的Dmax、V95、V105、V110、HI均小于对照组,CI大于对照组,差异均有统计学意义(P<0.05)。左侧乳腺癌中,两组心脏V20、D_(mean)比较,差异均无统计学意义(P>0.05),观察组心脏V10、V30、V40均小于对照组,差异均有统计学意义(P<0.05)。右侧乳腺癌中,两组心脏V_(10)、V_(20)、V_(30)、V_(40)、D_(mean)比较,差异均无统计学意义(P>0.05)。观察组肺V_(10)、V_(20)、V_(30)、V_(40)、D_(mean)均小于对照组,差异均有统计学意义(P<0.05)。观察组对侧乳房和对侧肺D_(mean)均小于对照组,差异均有统计学意义(P<0.05)。结论:在乳腺癌根治术后采用胸壁野与区域淋巴结野混合调强放疗解决了剂量不均匀、提高靶区剂量适形性和射野间衔接问题,能够更好地保护心、肺等器官,值得临床推广。Objective:To investigate the dosimetric characteristics and advantages of combined mixed intensity modulated radiation therapy of chest wall field and regional lymph node field compared with traditional radiotherapy after modified radical mastectomy of breast cancer.Method:The clinical data of 60 patients with breast cancer who needed radiotherapy for chest wall field and regional lymph node field after modified radical mastectomy in our hospital from January 2016 to October 2017 were retrospective analyzed,they were divided into control group (n=29) and observation group (n=31) according to different radiotherapy methods.The control group were treated with traditional tangential field three-dimensional conformal radiotherapy (3D-CRT) plus electron line irradiation in the supraclavicular region,the observation group were treated with mixed intensity modulated radiation therapy combined with chest wall field and regional lymph node field.The conformal and homogeneity of IMRT target dose distribution and the dose of organs at risk were compared between two groups.Result:There were no statistically significant differences in D_(min) and D_(mean) of target region between two groups (P>0.05).The Dmax,V95,V105,V110 and HI of target region of observation group were lower than those of control group,and the CI of observation group was higher than that of control group,the differences were statistically significant (P<0.05).In left breast cancer,there were no statistically significant differences in heart V20 and D_(mean) between two groups (P>0.05),while heart V_(10),V_(30) and V_(40) of observation group were lower than those of control group,the differences were statistically significant (P<0.05).In right breast cancer,there was no statistically significant difference in heart V_(10),V_(20),V_(30),V_(40) and D_(mean) between two groups (P>0.05).Lung V_(10),V_(20),V_(30),V_(40) and D_(mean) of observation group were lower than those of control group,and the differences were statistically significant (P<0.05).The D_(mean

关 键 词：胸壁 区域淋巴结 混合调强放疗 乳腺癌根治术 

分 类 号：R737.9[医药卫生—肿瘤]