不同厚度补偿膜对乳腺癌放疗计划剂量的影响  

Effect of Different Thickness Compensation on Planned Dose of Radiotherapy For Breast Cancer

作　　者：杨玉刚[1] 尚革[1] 许林[1] 郝洁[1] 齐洪志[1] YANG Yugang;SHANG Ge;XU Lin;HAO Jie;QI Hongzhi(Department of Cancer Center,The First Affiliated Hospital of Xinjiang Medical University,Urumqi Xinjiang 830054,China)

机构地区：[1]新疆医科大学第一附属医院肿瘤中心,新疆乌鲁木齐830054

出　　处：《中国医疗设备》2022年第4期74-77,共4页China Medical Devices

基　　金：国家自然科学基金项目(81860360)。

摘　　要：目的通过评估不同厚度胸壁补偿膜在乳腺癌放疗计划中对靶区和正常组织器官剂量的影响,来评价不同厚度补偿膜在乳腺癌放疗中的优劣。方法选择本院2019—2020年收治的乳腺癌患者46人(包括29例乳腺癌根治术后和17例乳腺癌保乳术后),回顾对比分析29例乳腺癌根治术后患者,采取0.5、1.0 cm厚度补偿膜厚度时,乳腺癌放疗计划中剂量和加速器跳数的差异性;针对17例乳腺癌保乳术后,在放疗计划系统中设计组织补偿膜厚度分别为0、0.3、0.5、1.0 cm,对比分析剂量和加速器跳数的差异性。结果在29例乳腺癌根治术术后患者的放疗计划中,0.5、1.0 cm厚度补偿膜对靶区适形指数、加速器跳数和左、右肺的V_(20)评估有不同的影响,而在心脏、肝脏、脊髓的评估方面无临床差异。通过对比发现0.5 cm补偿膜优于1.0 cm的。另选取0、0.3、0.5、1.0 cm组织补偿膜,分析其对17例乳腺癌保乳术术后放疗计划的剂量和加速器跳数的影响,发现靶区适形指数、肺的V_(20)及加速器跳数都随补偿膜厚度的增加而减小。结论0.5、1.0 cm的补偿膜都可应用于乳腺癌根治术术后放疗计划中,但两者对剂量和加速器跳数的影响略有不同。Objective To evaluate the advantages and disadvantages of chest wall tissue compensation with different thickness in breast cancer radiotherapy by evaluating the difference of target volume and normal tissue and organ dose in breast cancer radiotherapy plan.Methods A total of 46 patients with breast cancer in our hospital from 2019 to 2020 were selected,including 29 patients after radical mastectomy and 17 patients after breast conserving surgery.The differences in dose and the number of monitor units(MU)in breast cancer radiotherapy planning when chest wall tissue compensation with 0.5 cm and 1.0 cm thickness was used were retrospectively analyzed in 29 patients with breast cancer after radical mastectomy.For 17 breast cancer patients after breast conserving surgery,the tissue compensation thickness was designed to be 0,0.3,0.5 and 1.0 cm in the radiotherapy planning system,and the difference of dose and MU was compared and analyzed.Results In the radiotherapy plan of 29 patients after radical mastectomy for breast cancer,0.5 cm and 1.0 cm thickness compensation in breast cancer radiotherapy had different effects on the evaluation of target volume conformity index(CI),MU and V_(20) of left and right lungs,while those of heart,liver and spinal cord had no significant effect.The 0.5 cm compensation was better than 1.0 cm.In addition,0,0.3,0.5,and 1.0 cm tissue compensation were selected to analyze their effects on the dose and MU,of them,CI,lung V_(20) and MU in the postoperative radiotherapy plan for 17 cases of breast cancer both decreased with the increase of the thickness of the compensation.Conclusion Tissue compensation with thickness of 0.5 and 1.0 cm both can be used in radiotherapy planning after radical mastectomy for breast cancer,but their effects on dose and MU are slightly different.

关 键 词：乳腺癌 放疗计划 补偿膜厚度 剂量学 加速器跳数 

分 类 号：R815[医药卫生—放射医学] R737.9[医药卫生—临床医学]