
1. (苏州大学附属第二医院 ),苏州,215004
[ "孙彦泽,男,1986年4月出生,2012年于苏州大学获硕士学位,生物医学工程专业,现主要研究方向为肿瘤放射治疗物理,助理工程师" ]
[ "朱雅群,主任医师,副教授,硕士生导师,E-mail: szzhuyaqun@sina.com E-mail:szzhuyaqun@sina.com" ]
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孙彦泽, 钱建军, 周 钢, 等. 乳腺癌保乳术后瘤床同步加量两种放疗技术的比较[J]. 辐射研究与辐射工艺学报, 2014,32(4):40202-040202.
孙彦泽, 钱建军, 周 钢, 等. 乳腺癌保乳术后瘤床同步加量两种放疗技术的比较[J]. 辐射研究与辐射工艺学报, 2014,32(4):40202-040202. DOI: 10.11889/j.1000-3436.2014.rrj.32.040202.
比较早期乳腺癌保乳术后瘤床同步加量三维适形野中野放疗(FIF-CRT)与容积旋转调强放疗(VMAT)技术靶区及危及器官的剂量学差异。选取15例左侧乳腺癌保乳术后女性患者,对每位患者分别设计三维适形野中野放疗计划和容积旋转调强计划。在剂量体积直方图上比较靶区的适形度指数、均匀性指数、靶区覆盖率和危及器官的受照剂量体积和所需机器跳数(MU),并进行统计学差异分析。VMAT计划较FIF-CRT计划,PTV1处方剂量覆盖率增加了5.62%(p<0.001);瘤床PGTV处方剂量覆盖率增加了10.64%(p<0.001);VMAT计划PTV的适形度指数(CI)和均匀性指数(HI)均优于FIF-CRT计划。两种计划左肺V20,心脏的V10和Dmax均无统计学差异,但VMAT的左肺V5、V10和Dmean,心脏的V5,右乳和右肺的V5、Dmean,脊髓的Dmax明显增高且有统计学差异(p<0.05);VMAT的左肺V30、V40和心脏的V20低于FIF-CRT计划;VMAT和FIF-CRT的平均机器跳数分别是745 MU和250 MU(p<0.001)。早期乳腺癌保乳术瘤床同步加量VMAT放疗与FIF-CRT相比能明显改善靶区的剂量覆盖率和均匀性,但正常组织高剂量区域受照体积减少,低剂量区域受照体积增加,机器跳数增加。
To compare the dosimetric difference between three dimensional conformal radiotherapy using the field-in-field (FIF-CRT) and volumetric modulated arc therapy (VMAT) for whole breast irradiation with tumor bed boost after breast-conserving surgery, fifteen female patients with early left-sided breast cancer after breast-conserving surgery were selected. Treatment planning was performed by volumetric modulated arc therapy and three-dimensional conformal radiotherapy using the field-in-field on the same CT, respectively. The target dose distribution, homogeneity and the irradiation dose and volume for the lungs, heart, and contralateral breast were read in the dose volume histogram (DVH) and compared between FIF-CRT and VMAT. The treatment delivery monitor unit was also compared. In comparison with the FIF-CRT planning, the target coverage of PTV1 and PGTV was significantly higher by 5.62% and 10.64% in VMAT. The conformal index and homogeneity of planning target volume by the VMAT planning were better than those by FIF-CRT planning. There were no significant difference in the maximum dose (Dmax) and V10 for the heart and V20 for the left-lung between the VMAT and FIF-CRT planning, but the values of V10, V5, and Dmean for the left-lung; V5 for the heart; V5, Dmean for the contralateral breast and lung; Dmax for the spine cord were increased compared with those by the FIF-CRT planning. The V30, V40 of the left-lung and V20 of the heart by the VMAT planning were lower than those by FIF-CRT. The mean MU of the VMAT was 745 MU, which is significantly higher than that by FIF-CRT planning(250 MU, p<0.001). The VMAT planning improves the dose distribution and homogeneity of PTV for breast cancer radiotherapy after breast—conserving surgery. However, it significantly enlarges the volume of normal tissues irradiated in low dose areas, and increases the MU value in comparison with FIF-CRT.Cited
乳腺癌保乳术容积旋转调强放疗三维适形野中野放疗剂量学
Breast cancerBreast-conserving surgeryVolume modulated arc therapyCRT using field-in-fieldDosimetry
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