中华放射医学与防护杂志

李永武,孙晓南,王奇,刘海,施国治.乳腺癌术后胸壁大体积复发二野和六野调强放疗剂量学比较[J].中华放射医学与防护杂志,2013,33(2):155-157

乳腺癌术后胸壁大体积复发二野和六野调强放疗剂量学比较

A dosimetric comparison of the tangential beams IMRT with multifield beams IMRT of the chest wall in postmastectomy breast cancer recurrent patients

投稿时间：2012-08-13

DOI：10.3760/cma.j.issn.0254-5098.2013.02.011

中文关键词: 乳腺癌切除术后复发胸壁调强放疗治疗计划

英文关键词:Postmastectomy breast cancer Recurrence Chest wall Intensity modulated radiotherapy Treatment planning

基金项目:

作者	单位	E-mail
李永武	310016 杭州,浙江大学医学院附属邵逸夫医院放疗科
孙晓南	310016 杭州,浙江大学医学院附属邵逸夫医院放疗科	sunxiaonan@hotmail.com
王奇	310016 杭州,浙江大学医学院附属邵逸夫医院放疗科
刘海	310016 杭州,浙江大学医学院附属邵逸夫医院放疗科
施国治	310016 杭州,浙江大学医学院附属邵逸夫医院放疗科

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中文摘要:

目的比较乳腺癌术后胸壁大体积复发2野和6野调强放疗的计划差异。方法对8例乳腺切除术后胸壁大体积复发病例,Pinnacle计划系统上分别对PTV进行2野调强和6野调强放疗计划设计,PTV处方剂量为50 Gy/25次(GTV后续计划补量至66~70 Gy),比较2种计划95%处方剂量PTV适形指数(CI)、均匀性指数(HI)及心脏、同侧肺剂量。结果 6野IMRT计划的CI和HI均优于2野IMRT计划,6野和2野的CI分别为(0.66±0.08)和(0.53±0.10)(t=7.99, P＜0.05), HI分别为(1.36±0.08)和(2.19±0.78)(t=9.04, P＜0.05)。2个计划中肺V₅、V₁₀、V₂₀、V₃₅和心脏D_max、V₃₅、D_mean值比较差异无统计学意义。结论乳腺癌切除术后胸壁大体积复发患者行放疗,6野静态逆向调强放疗计划靶区覆盖优于2野,而心肺受量方面无明显差异。

英文摘要:

Objective To compare the dose distribution of reserved planned tangential beam IMRT(2-field IMRT) with multifields beams IMRT(6-field IMRT) of the bulk-recurrent chest wall in postmastectomy breast cancer patients. Methods For 8 patients with chest wall in postmastectomy breast cancer bulk-recurrence, 2-field IMRT and 6-field IMRT plans were generated on PTV in Pinnacle Planning System. The prescribed dose of PTV was 50 Gy in 25 fractions and GTV was 66-70 Gy which irradiated incrementally by subsequent plan in 8-10 fractions. The conformal index (CI) and homogeneity index (HI) of 95% of prescribed dose over PTV were compared, while the dose distribution on ipsilateral lung and heart were evaluated. Results The CI of PTV by 6-field IMRT (0.66±0.08) was higher than that of the 2-field IMRT (0.53±0.10)(t=7.99, P＜0.05). The HI of PTV by 6-field IMRT (1.36±0.08) was lower than that of 2-field IMRT (2.19±0.78)(t=9.04, P＜0.05).There was no statistical difference in V₅, V₁₀, V₂₀ and V₃₅ for ipsilateral lung and in D_max, V₃₅ and D_mean for heart between two plans. Conclusions Compared with 2-field IMRT, 6-field IMRT might have a better dose distribution on planning target volume(PTV) for chest wall in postmastectomy breast cancer bulk-recurrence patients, but there is no significant difference in dose-volume of ipsilateral lung and heart between two plans.

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