Bias Plan剂量叠加法对左乳腺癌术后放疗计划的影响研究  

Impact of Bias Plan dose superposition on postoperative radiotherapy planning for left breast cancer

作　　者：刘攀 董建伟 赵文龙[1] 刘景[1] 朱彤[1] LIU Pan;DONG Jianwei;ZHAO Wenlong;LIU Jing;ZHU Tong(Department of Radiation Oncology,Ji’an Central People’s Hospital,Ji’an,Jiangxi 343000,China)

机构地区：[1]吉安市中心人民医院肿瘤科,江西吉安343000

出　　处：《重庆医学》2025年第3期620-624,共5页Chongqing Medical Journal

基　　金：江西省科学技术厅科技计划项目(20161BBG70036);江西省吉安市科技局科技计划项目(20233-043504)。

摘　　要：目的探讨Monaco计划系统中Sum Plan与Bias Plan两种剂量叠加方法在左侧乳腺癌术后添加组织补偿物分段放疗计划中的剂量学影响。方法选取2023年3月至2024年2月在该院接受放疗的29例左乳腺癌根治术患者为研究对象,基于Monaco计划系统在相同优化条件下,以一程计划为基础,依次使用Sum Plan、Bias Plan方法设计二程计划,生成Sum Plan C1、Bias Plan C2计划,比较两种剂量叠加方法下的调强放疗(IMRT)计划剂量学差异。结果与Sum Plan C1比较,Bias Plan C2的计划靶区(PTV)中适形性指数(CI)更差、均匀性指数(HI)更优,危及器官中心脏平均剂量(D_(mean))、V_(5)、V_(10)、V_(30)、V_(40),患侧肺D_(mean)、V_(5)、V_(20)和对侧肺V_(5)更低,正常组织V_(5)、V_(10)、V_(15)、V_(20)、V_(25)、V_(30)更低,V_(35)更高,子野数和机器跳数更多,差异有统计学意义(P<0.05)。结论左侧乳腺癌术后添加组织补偿物分段放疗计划设计中推荐Bias Plan剂量叠加法。Objective To investigate the dosimetry effect of Sum Plan and Bias Plan in the Monaco planning system for the addition of compensatory agents after left breast cancer surgery.Methods Twenty-nine patients with radical left mastectomy who received radiotherapy in this hospital from March 2023 to February 2024 were selected as the study objects.Based on the Monaco planning system and under the same optimal conditions,Sum Plan and Bias Plan were used to design the second-course plan based on the first-course plan.Sum Plan C1 and Bias Plan C2 were generated to compare the dosimetry differences of intensity modulated radiotherapy(IMRT)plans under the two dosimetric superposition methods.Results Compared with Sum Plan C1,the conformability index(CI)in the planned target area(PTV)of Bias Plan C2 was worse,the homogeneity index(HI)was better,and the mean cardiac dose(D_(mean)),V_(5),V_(10),V_(30),V_(40)in the organs at risk were better than that of Sum Plan C1.The D_(mean),V_(5),V_(20)and contralateral V_(5)in the affected lung were lower,while the V_(5),V_(10),V_(15),V_(20),V_(25),V_(30)in the normal tissue were lower,while V 35 was higher,and the number of subfields and machine hops were more,the difference was statistically significant(P<0.05).Conclusion Bias Plan dose overlay method was proposed in the design of segmental radiotherapy with compensator after left breast cancer surgery.

关 键 词：Sum Plan Bias Plan 乳腺癌术后 剂量学 Monaco 

分 类 号：R730.55[医药卫生—肿瘤]