计算网格对乳腺癌改良根治术后调强放射治疗计划质量的影响  

The Effect of Calculation Grid Size on the Quality of Intensity Modulated Radiotherapy Planning After Modified Radical Mastectomy for Breast Cancer

作　　者：朱伟 Zhu Wei(Xiushui County First People's Hospital,Jiujiang Jiangxi 332400,China)

机构地区：[1]修水县第一人民医院,江西九江332400

出　　处：《医疗装备》2024年第13期28-31,共4页Medical Equipment

摘　　要：目的探讨计算网格(GS)对乳腺癌改良根治术后调强放射治疗(IMRT)计划质量的影响。方法选取2022年1月至2023年12月于医院接受乳腺癌改良根治术后IMRT的15例患者作为研究对象,首先采用3 mm GS设计IMRT计划(3 mm计划),然后改变GS为2 mm(其余参数不变),重新设计计划(2 mm计划)。比较两种计划的计划靶区(PTV)剂量学指标[包括D2%、D98%、D_(mean)、均匀性指数(HI)及适形性指数(CI)]、危及器官(OARs)剂量学指标(患侧肺V_(5)、V_(20)、V_(30)、D_(mean)及健侧肺V_(5)、心脏D_(mean)、脊髓D_(max)),以及机器跳数(MU)和优化时间(OT)。结果PTV剂量学指标中,2 mm计划的D_(mean)低于3 mm计划,CI高于3 mm计划,差异均有统计学意义(P<0.05);OARs剂量学指标中,2 mm计划的脊髓D_(max)低于3 mm计划,差异有统计学意义(P<0.05);2 mm计划的OT为3 mm计划的2.96倍,差异有统计学意义(P<0.05)。结论2 mm GS IMRT计划的剂量学指标优于3 mm计划,对脊髓的保护效果更优,但计算效率更低。因此,设计乳腺癌改良根治术后IMRT计划时,应合理选择GS,以达到剂量计算准确性和计算效率的最佳平衡。Objective To investigate the effect of calculation grid size(GS)on the quality of intensity modulated radiotherapy(IMRT)planning after modified radical mastectomy for breast cancer.Methods With the selection of fifteen patients who received IMRT after modified radical mastectomy for breast cancer in hospital from January 2022 to December 2023 as the study subjects,firstly,the 3 mm GS was adopted to design the IMRT plan(3 mm plan).Then,the GS was changed to 2 mm(other parameters remained unchanged),and the plan was redesigned(2 mm plan).The dosimetry indicators for planning target volume(PTV)[Including D2%,D98%,D_(mean),homogeneity index(HI)and conformity index(CI)],and organ at risk(OARs)(Affected lung V_(5),V_(20),V_(30),D_(mean),and healthy lung V_(5),heart D mean,spinal cord D_(max)),and monitor unit(MU)and optimization time(OT)were compared between the two plans.Results In the dosimetric indexes of PTV,the D_(mean) of 2 mm plan was lower than that of 3 mm plan,and the CI was higher than that of 3 mm plan,with statistical significance(P<0.05);In the dosimetric indexes of OARs,the spinal cord D_(max) of 2 mm plan was lower than that of 3 mm plan,and the difference was statistically significant(P<0.05);The OT of the 2 mm plan was 2.96 times that of the 3 mm plan,and the difference was statistically significant(P<0.05).Conclusions The dosimetric indicators of the 2 mm GSIMRT plan were better than those of the 3 mm plan,and the protective effect on the spinal cord was better,but the computational efficiency was lower.Therefore,GS should be selected reasonably in the design of IMRT plan after modified radical mastectomy for breast cancer to achieve the best balance between dose calculation accuracy and calculation efficiency.

关 键 词：计算网格 乳腺癌改良根治术 调强放射治疗 计划质量 计划靶区 危及器官 

分 类 号：R737.9[医药卫生—肿瘤]