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目的对比常规放疗、三维立体适形放疗(3DCRT)、sliding window调强(SMLC-IMRT)和MIMiC调强放疗(MIMiC-IMRT)在食管癌放疗的临床靶体积(clinical targer volume,CTV)剂量和心、肺、脊髓保护的差别,探讨其理想的模式。方法对12例食管癌患者分别做常规、3DCRT、SMLC及MIMiC-IMRT4组放疗计划,按计划靶区体积(planning targer volume,PTV)至少达到95%处方剂量的要求,比较各计划的靶区及心、肺、脊髓受照剂量。结果 (1)常规放疗95%等剂量线仅覆盖62%CTV和54%PTV,如要PTV受照95%的处方剂量,需扩大照射野,将导致心、肺受照剂量增加;(2)3DCRT与SMLC-IMRT比较,心、肺、脊髓的各剂量指标的差异无统计学意义(P>0.05);(3)肺V5、V10、平均剂量在MIM-iC-IMRT组最高,SMLC-IMRT组最低,差异有统计学意义(P<0.05)。结论常规放疗靶区覆盖差,3DCRT与SMLC-IMRT心、肺、脊髓剂量差异无统计学意义,SMLC-IMRT较MIMiC-IMRT利于肺组织保护。
Objective To compare the clinical target volume (CTV) dose of conventional radiotherapy, 3DCRT, SMLC-IMRT and MIMiC-IMRT in esophageal cancer radiotherapy Heart, lung, spinal cord protection differences, to explore the ideal model. Methods Twelve patients with esophageal cancer underwent conventional radiotherapy, 3DCRT, SMLC, and MIMiC-IMRT4 radiotherapy, respectively. The planned target volume of at least 95% of the planned dose of PTV was compared. Heart, lung, spinal dose. Results: (1) The 95% isodose line covered only 62% of CTV and 54% of PTV. If PTV was given 95% of the prescription dose, the irradiation field should be enlarged to increase the dose of heart and lung irradiation. (2) Compared with SMLC-IMRT, there was no significant difference in each dose index of heart, lung and spinal cord between 3DCRT and SMLC-IMRT (P> 0.05). (3) The average doses of lung V5 and V10 were the highest in MIM-iC- Group was the lowest, the difference was statistically significant (P <0.05). Conclusion The conventional radiotherapy coverage is poor. There is no significant difference in the dose of 3DCRT and SMLC-IMRT between heart, lung and spinal cord. SMLC-IMRT is more effective than MIMiC-IMRT in lung tissue protection.