摘要
目的:探讨断层径照(TD)技术在乳腺癌保乳术后放射治疗中的应用,为临床治疗提供参考。方法:选取30例乳腺癌保乳术后患者,对其分别设计TD适形放射治疗(TD-CRT)、TD调强放射治疗(TD-IMRT)及常规调强放射治疗(IMRT)三组计划,计划靶区(PTV)处方剂量为50Gy/25次。根据剂量体积直方图(DVH)评估靶区和危及器官(OAR)受量,并根据三种技术的治疗时长评估执行效率。结果:TD-IMRT组计划PTV的Dmean、D2、D98及适形度指数(CI)均优于IMRT及TD-CRT,且差异有统计学意义(F=8.847,F=4.837,F=5.175,F=9.622;P<0.05),靶区均匀性指数(HI)无统计学意义;对于OAR,TD-IMRT所受辐射剂量均低于IMRT及TD-CRT,且差异有统计学意义;TD-IMRT治疗时间长于TD-CRT,但是较IMRT治疗时间明显缩短。结论:三种技术均能达到乳腺癌保乳术后放射治疗临床要求,TD-IMRT技术具有更好的靶区剂量分布,同时危及器官受量明显降低,且治疗时间合理,因此,TDIMRT可作为乳腺癌保乳术后放射治疗的优选技术。
Objective： To explore the application of tomo direct（TD） technique in postoperative radiotherapy for patient with breast cancer received breast-conservative surgery so as to provide reference for clinical treatment. Methods： 30 patients received breast-conservative surgery were divided into tomo direct-conformal radiation therapy（TD-CRT group, TD-intensity modulated radiation therapy（TD-IMRT）group and IMRT group. The prescription dose was 50 Gy/25 F in planning target volume（PTV）. The doses of target region and organ at risk（OAR） were evaluated according to dose volume histogram（DVH）, and the execution efficiency was evaluated depended on the treatment time of different techniques. Results： The Dmean, D2, D98 and CI of TD-IMRT group was better than that of other groups, and the differences among them were significant（F=8.847, F=4.837, F=5.175, F=9.622; P〈0.05）, while the differences of HI among them were not significant. For OAR, the received dose of TD-IMRT group lower than that of other groups, and the differences among them were significant. The therapeutic time of TD-IMRT group was longer than that of TD-CRT group, while was obviously shorter than that of IMRT group. Conclusion： All of three techniques can satisfy the clinical requirement of postoperative radiotherapy for breast-conservative surgery. While the TD-IMRT technique has better dose distribution for target region, and its received dose of OAR is obviously lower, and its therapeutic time is reasonable. Therefore, TD-IMRT can be adopted as the optimal technique for postoperative radiotherapy of breast-conservative surgery.
出处
《中国医学装备》
2017年第7期1-5,共5页
China Medical Equipment
基金
国家重点研发计划(2016YFC0904600)"以生物组学特征与多模态功能影像为基础的多线束精准放疗方案研究"
关键词
乳腺癌
保乳术后
放射治疗
断层径照技术
Breast cancer
Breast-conservative surgery
Radiotherapy
Tomo direct technique
