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目的比较乳腺癌保乳术后常规经典的切线野(2D)放疗、三维适形(3D-CRT)放疗、以及两适形野+两调强野的混合调强技术(3D_4F_H_IMRT)放疗三种方式,使靶区剂量分布更均匀以及对周围组织器官损伤减少差异。方法我院2011.1～2011.3收治乳腺癌保乳术后患者15人,应用以上3种照射技术设计治疗方案。2Gy/25次总剂量50Gy。根据积分剂量体积直方图比较靶区剂量和正常组织器官受量。结果常规经典的切线野(2D)、三维适形(3F-CRT)放疗剂量分布明显在靶区形成剂量热点。两适形野+两调强野的混合调强技术(3D_4F_H_IMRT),剂量分布更均匀,乳腺周围正常组织及患侧肺和心脏受照剂量更低,皮肤反应更轻。临床效果最佳。结论两适形野+两调强野的混合调强技术(3D_4F_H_IMRT),在剂量分布上更有利于乳腺癌患者放射治疗。
OBJECTIVE: To compare the effects of conventional classic tangent field (2D) radiotherapy, 3D-CRT radiotherapy and mixed intensity modulation (3D_4F_H_IMRT) with two conformal fields and two fields of strength after breast-conserving surgery , The target dose distribution more uniform and reduce the damage to the surrounding tissue and organ differences. Methods From 2011.1 to 2011.3, 15 patients were treated with breast-conserving surgery, and the above three kinds of irradiation techniques were used to design the treatment plan. 2Gy / 25 total dose of 50Gy. The target dose and normal tissue and organ dose were compared according to the integral dose histogram. Results Conventional classic tangential field (2D) and 3-D conformal (3F-CRT) radiotherapy dose distributions evidently produced dose-specific hot spots in the target area. Two conformable field + two tone field mixed intensity modulation technology (3D_4F_H_IMRT), more uniform dose distribution, normal tissue around the breast and ipsilateral lung and heart dose lower, skin reactions lighter. The best clinical results. Conclusions The hybrid intensity-modulated technique (3D_4F_H_IMRT) with two conformal fields and two intensities fields is more beneficial to the radiation therapy of breast cancer patients in dose distribution.