中华放射医学与防护杂志

孙涛,卢洁,尹勇,刘同海,陈进琥,林秀桐,朱健,白瞳,刘波.乳腺癌保乳术后正向与逆向调强放疗计划的比较[J].中华放射医学与防护杂志,2009,29(4):401-404

乳腺癌保乳术后正向与逆向调强放疗计划的比较

Comparison of forward and inverse intensity modulation radiotherapy planning for breast cancer after breast-conservative surgery

投稿时间：2009-04-24

DOI：

中文关键词: 乳腺肿瘤乳房保留术正向调强放射治疗逆向调强放射治疗

英文关键词:Breast neoplasm Breast-conservative surgery Forward intensity-modulated radiotherapy Inverse intensity-modulated radiotherapy

基金项目:

作者	单位	E-mail
孙涛	250117 济南, 山东省肿瘤医院放射物理室
卢洁	250117 济南, 山东省肿瘤医院放射物理室
尹勇	250117 济南, 山东省肿瘤医院放射物理室	yinyongsd@yahoo.com.cn
刘同海	250117 济南, 山东省肿瘤医院放射物理室
陈进琥	250117 济南, 山东省肿瘤医院放射物理室
林秀桐	250117 济南, 山东省肿瘤医院放射物理室
朱健	250117 济南, 山东省肿瘤医院放射物理室
白瞳	250117 济南, 山东省肿瘤医院放射物理室
刘波	250117 济南, 山东省肿瘤医院放射物理室

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中文摘要:

目的比较乳腺癌调强放疗计划的正向和逆向2种设计模式的区别。方法针对6例左侧乳腺癌保乳术后的患者应用Pinnacle³7.4f计划系统,分别设计正向和逆向调强放疗计划,在射野方向相同、保证处方剂量线包绕95%靶区体积的前提下,比较2种计划的剂量体积直方图参数和加速器总跳数。结果 2种调强计划相比,正向及逆向调强计划的计划靶区体积适形度指数值分别为0.67±0.06和0.66±0.06(t=2.423,P>0.05),均匀性指数值分别为(28.2±6.0)%和(26.1±6.8)%(t=2.164,P>0.05);左肺V₂₀分别为(18.7±3.3)%和(17.0±2.8)%(t=5.087,P<0.05),V₃₀分别为(15.5±3.0)%和(14.0±2.6)%(t=7.272,P<0.05);心脏V₃₀分别为(4.1±3.1)%和(3.5±2.5)%(t=1.916,P>0.05);机器跳数分别为(262±5)MU和(308±14)MU(t=7.515,P<0.05)。结论与正向调强放疗计划相比,乳腺癌逆向调强计划中靶区适形度和均匀性无差别,左肺受量降低,心脏受量无差别;但机器跳数显著增加,增加了机器的磨损和治疗实施时间。

英文摘要:

Objective To compare the dosimetric difference inforwardintensity modulationradiotherapy(fIMRT) and inverse IMRT (iIMRT) planning for breast cancer.Methods Six patients received radiotherapyalone after left breast-conserving surgery were selected.For each patient, two treatment plans (fI MRT andiI MRT) were designed with Pinnacle³7.4f.In each plan, the volume of PTV received prescription dose was notless than 95%.The dosi metric parameters were assessed with dose volume histograms in planning target volume(PTV) and organ of around risk (OAR). Results of fIMRT and iIMRT plans, the PTV average confor malindex were (0.67±0.06) and (0.66±0.06) (t=2.423, P>0.05), average homogeneity index were(28.2±6.0)% and (26.1±6.8)% (t=2.164, P>0.05); the volume of left lung received 20 Gy (V₂₀)were (18.7±3.3)% and (17.0±2.8)% (t=5.087, P<0.05), and V₃₀of left lung were (15.5±3.0)% and (14.0±2.6)% (t=7.272, P<0.05); V₃₀of heart were (4.1±3.1)% and (3.5±2.5)% (t=1.916, P>0.05); the total monitor units were (262±5) MU and (308±14) MU (t=7.515, P<0.05).Conclusions There were no significant differences of CI, HI, and V₃₀of heart between fIMRT and iIMRT.Because of fewer MUs, fI MRT plan could reduce the machine abrasion and treatment ti me, but V₂₀ and V₃₀ of left lung are higher significantly than iI MRT plan.

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