摘要
目的比较左侧乳腺癌保乳术后调强放疗与常规放疗靶区内剂量均匀性、心脏照射剂量和体积的差异。方法对38例左侧乳腺癌保乳术后,应用逆向调强计划,实施全乳腺两野调强放疗。处方剂量为靶区X线46Gy,瘤床应用常规电子线追加14Gy,总量为60Gy。在同一病例CT片上设计常规全乳切线野照射46Gy。在两种治疗方法剂量体积直方图上比较靶区和心脏受照剂量。应用SPSS11.0软件进行配对T检验,以确定调强放疗是否可改善靶区内剂量均匀度并减少心脏受照剂量。结果调强放疗、常规放疗计划中CTV的D95分别为(4541±34)、(4517±62)cGy,V105%分别为17.5%±17.6%、29.4%±26.3%(P<0.01);V110%分别为0.3%±0.8%和3.7%±8.2%(P=0.010)。心脏的V30分别为4.6%±4.3%、18.8%±12.2%(P<0.01);V40分别为1.4%±2.3%、14.3%±11.0%(P<0.01)。结论左侧乳腺癌保乳术后,调强放疗能改善靶区剂量分布、减少心脏受照剂量和体积。
Objective To compared intensity modulated radiation therapy （DMRT） with conventional radiotherapy（CR） for the left side breast cancer after breast-conserving surgery in regard to the homogeneity of dose in the target area, cardiac dose and irradiation volume in the target area. Methods Thirty-eight patient received inverse planning of IMRT with dynamic multi-leaf collimation （ dMLC ）. Prescription dose was 46 Gy in breast volume with X-ray, and added electron boost dose was 14 Gy in the tumor bed, with a total dose of 60 Gy. Clinical target volume（CTV） and heart were evaluated with dose-volume histograms（DVH） in the two plans, with the t test taken with SPSS 11.0. Results Average received dose of 95 % breast volume（D95） was （4541＋ 34） , （4517 ＋ 62） cGy, volume of 105% of dose prescription（V105% ） was 17.5% ＋ 17.6% ,29.4% ＋ 26.3%, while V110% was 0.3% ＋0.8%,3.7% ＋8.2% with IMRT and CR, respectively. Received 30 Gy by the heart（V50） was 4.6% ＋4.3%,18.8% ＋ 12.2%（P 〈0.01） ;V40 was 1.4% ＋ 2.3%,14.3% ＋ 11.0%（P 〈0.01） with IMRT and CR, respectively. Conclusion IMRT can improve CTV dose distribution and reduce the cardiac dose and volume for the left breast cancer after breast-conserving surgery.
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2006年第3期192-195,共4页
Chinese Journal of Radiation Oncology
