子野数限值对左乳腺癌根治术后调强放疗计划的剂量学影响  

Effect of limiting value of subfield number on dosimetry of intensity-modulatedradiotherapeutic plan for left-breast radical mastectomy

作　　者：刘映 张惠玲[1] 阳萍 饶岚 LIU Ying;ZHANG Huiling;YANG Ping;RAO Lan(Oncology Center,Ziyang Municipal First People’s Hospital,Ziyang,Sichuan 641300,China)

机构地区：[1]资阳市第一人民医院肿瘤中心,四川资阳641300

出　　处：《重庆医学》2024年第8期1204-1208,1213,共6页Chongqing medicine

基　　金：资阳市医学科学课题项目(KY2023026)。

摘　　要：目的探讨子野数限值对左乳腺癌根治术后调强放疗(IMRT)计划的剂量学影响,以寻求最优的子野数限值。方法回顾性分析2022年3月1日至2023年3月31日该院收治的30例左乳腺癌根治术后放疗患者的临床资料,所有患者均使用Oncentra 4.3计划系统设计5种IMRT计划,子野数限值分别为15、25、35、45、55(所有IMRT计划根据子野数限值命名,其余优化参数和目标函数相同),统计5种计划的计划靶体积(PTV)剂量学参数、危及器官(OAR)受量和机器跳数并比较分析。结果不同子野数限值IMRT计划的PTV D 2%(F=104.439,P<0.05)、D 98%(F=20.748,P<0.05)、D mean(F=89.578,P<0.05)、均匀度(HI,F=101.794,P<0.05)和适形指数(CI,F=26.453,P<0.05)均有明显差异,左肱骨头V 50(F=76.991,P<0.05)有明显差异,其余OAR无明显差异(P>0.05)。plan 35的PTV D 2%、D 98%、D mean、CI和HI值均优于plan 15和plan 25,差异有统计学意义(P<0.05)。与plan 35相比,plan 45和plan 55的PTV D 98%和CI值无明显差异(P>0.05);PTV D 2%、D mean和HI值更低,差异有统计学意义(P<0.05)。plan 15和plan 25的左肱骨头V 50偏高,不能满足临床要求,plan 35、plan 45和plan 55均能较好地保护OAR,且OAR受量之间无明显差异(P>0.05)。plan 35的机器跳数低于plan 45和plan 55,差异有统计学意义(P<0.05)。结论子野数限值为35时,PTV剂量分布和OAR受量满足临床剂量学要求,同时机器跳数更低,可作为左侧乳腺癌根治术后IMRT计划设计的参考值。Objective To investigate the effect of the limiting value of subfield number on the dosimetry of intensity-modulated radiotherapy(IMRT)plan for left-breast radical mastectomy in order to seek the optimal limiting value of subfield number.Methods The clinical data of 30 patients with left-breast radical mastectomy in this hospital from March 1,2022 to March 31,2023 were retrospectively analyzed.All patients used the Oncentra 4.3 planning system to design 5 kinds of IMRT plans,and the limiting values of subfield number were 15,25,35,45 and 55 respectively(all IMRT plans were named according to the subfield number limiting value,the other optimization parameters and objective function were the same),planning target volume(PTV)dosimetric parameters,organ at risk(OAR)receiving dosage and monitor units were statistically analyzed and compared.Results The PTV D 2%(F=104.439,P<0.05),D 98%(F=20.748,P<0.05),D mean(F=89.578,P<0.05),homogeneity index(HI,F=101.794,P<0.05)and conformity index(CI,F=26.453,P<0.05)among different subfields number limiting values of IMRT had statistical differences,the left side humeral head V 50(F=76.991,P<0.05)had significant difference and the other OAR had no significant difference(P>0.05).The PTV D 2%,D 98%,D mean,CI and HI values of plan 35 were significantly superior to those of plan 15 and plan 25,and the differences were statistically significant(P<0.05).Compared with plan 35,there were no statistically significant difference in PTV D 98%and CI of plan 45 and plan 55(P>0.05),while the PTV D 2%,D mean and HI were lower,and the difference was statistically significant(P<0.05).The V 50 of left humeral head in plan 15 and plan 25 were too high to meet the clinical request.The plan 35,plan 45 and plan 55 could protect the OAR well,moreover there were no significant difference in the receiving dosage of the OAR(P>0.05).The monitor units of plan 35 was lower than that of plan 45 and plan 55,and the difference was statistically significant(P<0.05).Conclusion When the limiting value of subfield nu

关 键 词：调强放疗 子野数限值 乳腺癌 剂量学 

分 类 号：R737.9[医药卫生—肿瘤]