中华放射医学与防护杂志

郑亚琴,邢晓汾,马永强,等.快速旋转调强与五野动态调强在乳腺癌保乳术后放疗中的剂量学比较[J].中华放射医学与防护杂志,2013,33(3):282-285.ZHENG Ya-qin,XING Xiao-fen,MA Yong-qiang,et al.A dosimetric comparison of volumetric modulated Arc therapy with conventional intensity-modulated radiotherapy for breast cancer radiotherapy after breast-conserving surgery[J].Chin J Radiol Med Prot,2013,33(3):282-285

快速旋转调强与五野动态调强在乳腺癌保乳术后放疗中的剂量学比较

A dosimetric comparison of volumetric modulated Arc therapy with conventional intensity-modulated radiotherapy for breast cancer radiotherapy after breast-conserving surgery

投稿时间：2012-10-20

DOI：10.3760/cma.j.issn.0254-5098.2013.03.016

中文关键词: 乳腺癌保乳术快速旋转调强调强放疗剂量学

英文关键词:Breast cancer Breast-conserving surgery RapidArc Intensity modulated radiotherapy Dosimetry

基金项目:

作者	单位	E-mail
郑亚琴	030013 太原, 山西省肿瘤医院放射治疗中心
邢晓汾	030013 太原, 山西省肿瘤医院放射治疗中心	tyxxf@126.com
马永强	030013 太原, 山西省肿瘤医院放射治疗中心
崔桐	030013 太原, 山西省肿瘤医院放射治疗中心
郑旭亮	030013 太原, 山西省肿瘤医院放射治疗中心
褚薛刚	030013 太原, 山西省肿瘤医院放射治疗中心
孟慧敏	030013 太原, 山西省肿瘤医院放射治疗中心

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中文摘要:

目的比较乳腺癌保乳术后RapidArc计划与五野动态调强(5F-IMRT)计划的剂量学差异。方法选择8例左侧乳腺癌保乳术后女性患者,处方剂量为50 Gy/ 25次。分别设计RapidArc计划与5F-IMRT计划。比较两种计划的靶区适形度指数、均匀性指数、靶区覆盖度和危及器官的受照剂量体积,同时比较两组计划实施时的治疗时间和机器跳数。结果在两种计划的靶区比较中,RapidArc计划的靶区适形度指数为(0.88±0.03),高于5F-IMRT计划的(0.79±0.02)(t=8.28,P<0.05);RapidArc计划的均匀性指数为(9.01±0.73),优于5F-IMRT计划的(10.44±1.08)(t=-2.73,P<0.05)。两组计划在同侧肺受照剂量体积比较中RapidArc计划的D_mean、V₁₀、V₂₀、V₃₀小于5F-IMRT计划(t=-7.53、-7.20、-8.39、-7.80,P<0.05),但RapidArc计划中的V₅较5F-IMRT计划增加了约16% (t=5.67,P<0.05);心脏的受照剂量体积比较中RapidArc计划中的D_mean、V₅、V₁₀均高于5F-IMRT(t=10.46、28.76、5.40,P<0.05),但在RapidArc计划中心脏的V₃₀低于5F-IMRT (t=-6.12,P<0.05)。对侧肺和对侧乳腺的V₅在RapidArc计划中明显高于5F-IMRT计划 (肺:t=21.50,P<0.05;乳腺:t=5.44,P<0.05)。RapidArc计划中机器跳数减少了25%,平均治疗时间节省了60%。结论乳腺癌保乳术后RapidArc计划与5F-IMRT计划比较提高了靶区的适形度和均匀度,减少了高剂量区的受照体积,降低了机器跳数,缩短了治疗时间,但增加了正常组织低剂量区的受照体积。

英文摘要:

Objective To compare the dosimetric differences between two plans of RapidArc and 5F-IMRT for breast cancer radiotherapy after breast-conserving surgery.Methods Eight female patients with left-sided breast cancer after breast-conserving surgery were selected. A dose of 50 Gy in 25 fractions was prescribed for plans of RapidArc and 5F-IMRT. Target conformity index (CI), homogeneity index (HI), target coverage, exposure dose volume delivered to organ at risk were compared between two plans. At the same time, treatment delivery time and monitor units (MU) were also compared. Results The target conformity index (CI) in RapidArc plan (0.88±0.03) was higher than that in 5F-IMRT plan (0.79±0.02, t=8.28,P<0.05). The homogeneity index (HI) in RapidArc plan 9.01±0.73 was significantly lower than that in 5F-IMRT plan10.44±1.08 (t=-2.73, P<0.05). For the dose volume delivered to the ipsilateral lung in two plans, the values of V₁₀,V₂₀,V₃₀, and D_mean in RapidArc plan were lower than those in 5F-IMRT plan(t=-7.53,-7.20,-8.39,-7.80,P<0.05). However, the value of V₅ in RapidArc plan was higher than that in 5F-IMRT plan (t=5.67,P<0.05). For the heart, the values of V₅,V₁₀ and D_mean in RapidArc plan were higher than those in IMRT plan(t=10.46,28.76,5.40,P<0.05), while the value of V₃₀ in RapidArc plan was lower than that in 5F-IMRT plan(t=-6.12,P<0.05). The values of V₅ in contralateral lung and breast were higher in RapidArc plan than those in 5F-IMRT plan(lung:t=21.50,P<0.05;breast:t=5.44,P<0.05). The MU in RapidArc plan was decreased by 25%, and the average treatment delivery time was saved by 60%, compared with that of 5F-IMRT plan. Conclusions During breast cancer radiotherapy after breast-conserving surgery, compared with 5F-IMRT plan, the RapidArc plan could improve the target HI, and reduce both the irradiated dose in high-dose volume and MU, and shorten the treatment time, but increased the exposed volume in low-dose volume of normal tissues.

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