射束方向视图下部分切乳腺的调强方法在左乳腺癌改良根治术后放疗的剂量学研究

doi:10.13491/j.issn.1004-714X.2021.03.003

中国辐射卫生

2021, Vol. 30

Issue (3): 258-263 DOI: 10.13491/j.issn.1004-714X.2021.03.003

诊断与治疗/论著

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射束方向视图下部分切乳腺的调强方法在左乳腺癌改良根治术后放疗的剂量学研究

于晓君, 王绪刚, 李修磊

聊城市人民医院放疗科，山东聊城 252000

The dosimetric study of radiotherapy after modified radical mastectomy for left breast cancer using the beam’s eye view in intensity-modulated radiation therapy

YU Xiaojun, WANG Xugang, LI Xiulei

Department of Radiotherapy, Liaocheng Peoples Hospital, Liaocheng 252000 China

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摘要目的研究采用在射束方向视图（BEV）下部分切乳腺（BEV射野设计调强方法，B-IMRT）的调强方法进行左乳腺癌改良根治术后胸壁放疗的剂量学特点。方法对2020年5月—2020年11月在聊城市人民医院进行放疗的13例左乳腺癌改良根治术后患者，分别用BEV射野设计调强方法（B-IMRT）和切线野调强方法（T-IMRT）进行计划设计。比较2种计划在计划靶区的平均剂量、适形度指数、均匀性指数方面以及左侧肺、心脏的各项剂量体积参数上的差异。结果 B-IMRT计划较T-IMRT计划在计划靶区的适形性和均匀性上均有所改善，具有统计学差异（P < 0.05），靶区平均剂量相近。B-IMRT计划较T-IMRT计划在左侧肺的V₅、V₁₀、V₂₀、V₃₀、D_mean，心脏的V₅、V₁₀、V₃₀、D_mean剂量体积参数上均有所下降，具有统计学差异（P < 0.05）。B-IMRT计划较T-IMRT计划在患侧肺的V₅上减少了T-IMRT计划的9.23%，V₁₀上减少了13.29%，V₂₀上减少了9.54%，V₃₀上减少了8.28%，D_mean上减少了10.35%；在心脏的V₅上减少了T-IMRT计划27.62%，V₁₀上减少了29.72%，V₃₀上减少了21.45%，D_mean上减少了24.88%。结论 B-IMRT计划较T-IMRT计划在靶区剂量的适形度CI、均匀性HI上均有较好的剂量学优势（P < 0.05），而且在降低心肺的照射剂量和照射体积方面优势明显（P < 0.05）。

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	于晓君
	王绪刚
	李修磊

关键词 ：乳腺癌, 根治术, 射束方向观, 剂量

收稿日期: 2021-01-02

PACS:

R816

作者简介: 于晓君(1989-),女,山东聊城人,主管技师,从事放射治疗物理工作。E-mail:245391277@qq.com

引用本文:

于晓君, 王绪刚, 李修磊. 射束方向视图下部分切乳腺的调强方法在左乳腺癌改良根治术后放疗的剂量学研究[J]. 中国辐射卫生, 2021, 30(3): 258-263.
YU Xiaojun, WANG Xugang, LI Xiulei. The dosimetric study of radiotherapy after modified radical mastectomy for left breast cancer using the beam’s eye view in intensity-modulated radiation therapy. , 2021, 30(3): 258-263.

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http://www.zgfsws.com/CN/10.13491/j.issn.1004-714X.2021.03.003 或 http://www.zgfsws.com/CN/Y2021/V30/I3/258

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