乳腺癌根治术后胸壁放疗技术的选择

目的:探讨乳腺癌根治术后胸壁放射治疗的最合理方式。方法:对20例乳腺癌根治术后患者采用三维适形放疗(3D-CRT)和调强放疗(IMRT)2种技术,同时设计胸壁治疗计划,通过三维治疗计划系统(3D-TPS),用剂量-体积直方图(DVH)比较2种治疗计划中照射野的数目、肿瘤靶体积的剂量、适形指数(CI)、剂量不均匀指数(HI)及心、肺、肝等重要组织器官的照射量。结果:IMRT技术靶区的适形度、剂量分布均匀,心、肺、肝正常组织器官的照射量分别为0.21、1.19、2.75、9.797、.68 Gy,优于3D-CRT,二者差异有统计学意义(P<0.01)。2种治疗技术中肿瘤靶区内剂量分布基本相似,差异无统计学意义。结论:IMRT可以提高靶区内剂量分布的均匀性,减少胸壁出现高剂量区;能减少心、肺、肝等器官的照射容积和受照剂量。

The selection of radiotherapy on chest wall of patients with breast carcinoma after radical mastectomy

Objective: To evaluate the rational way of radiotherapy onchest wall after mastectomy. Methods: Twenty patients after mastectomy with breast cancer respectively received two different methods of planning including intensity modulated radiaton therapy (IMRT) and three-dimensional conformal radiation therapy (3D-CRT) according to three-dimensional radiation treatment planning system (3D-TPS). Dose-volume histogram (DVH) was used to assess the total number monitor units, target volume distribution, conformity index (CI), heterogeneity index (HI), dose of normal organs: lung, heart and liver. Results: (Using) IMRT, target conformity, target heterogeneity and the doses of normal tissue such as lung, heart, liver are respectively 0.21, 1.19, 2.75, 9.79, 7.68 Gy. These are superior to those using 3D-CRT. But target volume distribution does not differ significantly between two ways. Conclusion: Compared with 3D-CRT, Target volume dosimetric distribution of IMRT is more precise. The IMRT plans increased the target heterogenetity and decrease the radiation volumes and doses of normal tissue.