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目的比较早期乳腺癌保乳术后野中野三维适形放疗与双切线野三维适形放疗的剂量学差异。方法 10例早期乳腺癌保乳术后患者,分别设计双切线野三维适形放疗(双切线野组)与野中野三维适形放疗(野中野组)两组放疗计划。比较两组靶区剂量分布的均匀性、适形度以及全肺、心脏受量的差异。结果野中野组中全乳靶区剂量分布中的最大剂量(Dmax)、平均剂量(Dmean)、均匀指数(HI)、适形指数(CI)指标均优于双切线野组(P<0.05);野中野组全肺受量V5、Dmean分别为(19.19±4.83)%、(544.33±140.38)cGy,均低于双切线野组的(24.38±4.84)%、(673.38±141.89)cGy(P<0.05);野中野组心脏受量V20、V40、Dmean均低于双切线野组(P<0.05)。结论野中野三维适形放疗可有效改善早期乳腺癌保乳术后全乳靶区剂量分布的适形度和均匀性,同时不增加肺和心脏的受照剂量。
Objective To compare the dose-response differences of three-dimensional conformal radiotherapy and double-tangential field three-dimensional conformal radiotherapy of Ye Zhongye after breast-conserving surgery in early breast cancer. Methods Ten cases of breast cancer after breast-conserving surgery were treated with three-dimensional conformal radiotherapy (double tangential field group) and Yezhongye three-dimensional conformal radiotherapy group (Yezhongye group) respectively. The uniformity of dose distribution, conformality and the difference of whole lung and heart volume between the two groups were compared. Results The maximum dose (Dmax), average dose (Dmean), homogeneity index (HI) and conformal index (CI) (19.19 ± 4.83)% and (544.33 ± 140.38) cGy, respectively, which were lower than that of the bcl-2 group (24.38 ± 4.84%, 673.38 ± 141.89 cGy (P <0.05). The levels of V20, V40 and Dmean in the field group were lower than those in the bilinear group (P <0.05). Conclusion Yeh Nakano three-dimensional conformal radiotherapy can effectively improve the conformality and uniformity of the dose distribution of the whole milk after breast-conserving surgery without increasing the dose of lung and heart.