容积弧形动态旋转调强与固定野调强放疗技术在乳腺癌根治术后患者中的剂量学分布特征  

Dosimetry Distribution Characteristics of Volumetric Modulated Arc Therapy and Fixed-Field Intensity Modulated Radiotherapy Techniques in Patients after Radical Mastectomy

作　　者：张敬慧 徐文中 ZHANG Jing-hui;XUWen-zhong(Department of Radiation Oncology,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,China)

机构地区：[1]河南科技大学第一附属医院肿瘤放疗科,洛阳471000

出　　处：《四川解剖学杂志》2024年第2期17-20,共4页Sichuan Journal of Anatomy

摘　　要：目的:探讨乳腺癌根治术后患者开展容积弧形动态旋转调强放疗(VMAT)与固定野调强放疗(IMRT)技术的剂量学分布.方法:选取本院2022年2月至2023年6月收治的60例乳腺癌患者作为研究对象.采用随机数字表法将其分为研究组(n=30,采用VMAT技术)和对照组(n=30,采取IMRT技术).对两组患者靶区剂量分布、危及器官剂量分布、体内受照剂量分布及加速器输出机器跳数与治疗时间进行统计学比较.结果:VMAT与IMRT两种技术均符合靶区处方要求,为确保比较的可操作性,将计划靶区95%剂量统一为5000cGy.与对照组比较,研究组患者V100、D98%靶区剂量分布较高,Dmean与CI值较高,D2%、Dmax、HI值较低,差异均有统计学意义(P<0.05);两组患者V106、D95%比较,差异无统计学意义(P>0.05).与对照组比较,研究组患者健侧乳腺Dlcc、Dmax、Dmean较低,健侧肺V5、Dmax较低,患侧肺V20、V30、Dmax、Dmean较低,心脏V5、V20、V30、Dmean较低,肝V5、V50、Dmax较低,脊髓Dlcc、Dmean值较低,差异均有统计学意义(P<0.05);其余指标比较,差异均无统计学意义(P>0.05).与对照组比较,研究组患者V5、V10、V20、V30参数较低,差异均有统计学意义(P<0.05),两组患者V40、V50参数比较,差异均无统计学意义(P>0.05).与对照组比较,研究组患者平均机器跳数较少,平均治疗时间缩短,差异均有统计学意义(P<0.05).结论:对乳腺癌根治术后患者采取VMAT技术,较采取IMRT,更有利于确保靶区剂量分布均匀与适形度,减少体内受照与危及器官剂量,加速器输出机器跳数更少,治疗时间更短.Objective:To explore the dosimetry distribution of volumetric modulated arc therapy(VMAT)and fixed-field intensity modulated radiotherapy(IMRT)in patients after radical mastectomy.Methods:A total of 60 patients with breast cancer admitted to our hospital from February 2022 to June 2023 were selected as research objects.And they were divided into study group(n=30,using VMAT technology)and control group(n=30,using IMRT technology)by random number table method.The dose distribution in the target area,the dose distribution in the organs at risk,the dose distribution in vivo,the number of machine hops and the treatment time of the accelerator were compared between the two groups.Results:Both plans met the requirements of target prescription.To ensure the operability of comparison,95%of the target dose was unified into 5000cGy.Compared with control group,the target dose distribution of V100 and D98%in study group was higher,Dmean and CI values were higher,and D2%,Dmax and HI values were lower,and the differences were statistically significant(P<0.05).There was no significant difference in V106 and D95%between the two groups(P>0.05).Compared with control group,Dlcc,Dmax and Dmean of healthy mammary gland in study group were lower,V5,Dmax of healthy lung were lower,V20,V30,Dmax and Dmean of affected lung were lower,V5,V20,V30 and Dmean of heart were lower,V5,V50 and Dmax of liver were lower,and Dlcc and Dmean values of spinal cord were lower,and the differences were statistically significant(P<0.05).Compared with control group,the V5,V10,V20 and V30 parameters of study group were lower,and the difference was statistically significant(P<0.05).However,there were no statistically significant differences in V40 and V50 parameters between the two groups(P>0.05).Compared with control group,the average number of machine hops in study group was lower and the average treatment time was shorter(P<0.05).Conclusion:VMAT technique is more beneficial to ensure the uniform dose distribution and conformal degree of target area,reduce th

关 键 词：乳腺癌根治术 固定野调强放疗 容积弧形动态旋转调强 剂量学分布 

分 类 号：R737.9[医药卫生—肿瘤]