【摘要】 目的比较1例体表大体积的神经纤维瘤不同放疗计划的剂量学分布,并分析各计划特点。方法在外生型肿瘤患者的插值治疗时CT图像基础上,分别制作两野对穿照射,两野交角加楔照射,四野照射,调强和组织间插值治疗。测量靶区剂量的D95,D50;全肺V5,V10,V20和V30;心脏V40和脊髓Dmax。结果两野对穿照射,两野交角加楔照射,四野照射,调强和组织间插值治疗的CI分别为:0.50,0.48,0.53,0.87和0.65;D95分别为(c Gy):5016,5023,5386,6036和6023;全肺V5,V10,V20和V30分别为(%):5.33,3.63,2.12和1.37;68.86,59.66,10.59和3.46;42.87,33.74,25.05和9.53;80.88,62.56,24.24和8.03;46.85,21.77,6.66和2.36;心脏V40为(%):4.45,42,8.9,18.95和16.02;脊髓Dmax(c Gy):42,1590,3531,2425和135。结论从剂量学上的表现不建议采用两野交角加楔照射,从保护肺心脏器官考虑,建议两野对穿照射;从给予靶区最大剂量角度综合考虑,建议采用组织间插值治疗方式。更多还原

【Abstract】 Objective To comparing the characteristics of dose distribution for different radiation treatment plans in a case of large-volume-neurofibromatosis. Methods For a case of neurofibromatosis,two-field radiotherapy,two-cross-field with wedge radiotherapy,four-field radiotherapy,intensity modulated radiotherapy( IMRT),Percutaneous Interstitial Brachytherapy( PIBT) were designed in the radiotherapy planning system. And the D95,D50,lung V5,V10,V20 and V30 of lung; V40 of heart and cord Dmax were counted. Results The CI of two-field radiotherapy,two-cross-field with wedge radiotherapy,four-field radiotherapy,IMRT,PIBT were: 0. 50,0. 48,0. 53,0. 87 and 0. 65; and the D95 was( c Gy) : 5016,5023,5386,6036 和 6023;lung V5,V10,V20 and V30 were( %) : 5. 33,3. 63,2. 12 and 1. 37; 68. 86,59. 66,10. 59 and 3. 46; 42. 87,33. 74,25. 05 and 9. 53; 80. 88,62. 56,24. 24 and 8. 03; 46. 85,21. 77,6. 66 and 2. 36; heart V40 was( %) : 4. 45,42,8. 9,18. 95 and16. 02; cord Dmax( c Gy) : 42,1590,3531,2425 and 135. Conclusion We do not suggest the two-cross-field with wedge radiotherapy because of no advantage in the dose distribution. The dose of heart and cord reached the minimum in two-field radiotherapy. And the PIBT should be a good choice for exposure of garget and protect of normal tissue.更多还原