【摘要】 目的通过观察三维适形放疗和三维调强放疗对乳腺癌根治术后患者心肺受量的比较,为临床选择放疗方案提供参考依据。方法乳腺癌改良根治术后患者68例,随机分为对照组及观察组各34例,对照组进行三维适形放疗,观察组进行三维调强放疗,对比两组靶区剂量学指标、心肺受量和放疗不良反应。结果观察组患者PTV剂量V95%略高于对照组,但无统计学差异(P> 0. 05)。观察组V105%、V110%、V115%和均匀性指数HI显著低于对照组(P<0. 05)。观察组适形性指数CI较对照组显著增高(P <0. 05)。观察组患侧肺脏指数V5、V10、V20、V30、V40、V50、心脏指数V30、V40、V50和对侧乳腺平均剂量均显著低于对照组(P <0. 05)。观察组放疗不良反应发生率低于对照组(P<0. 05)。结论与三维适形放疗相比,三维调强放疗对乳腺癌改良根治术后患者的靶区剂量分布更均匀,心肺受量更少,三维调强放疗的不良反应发生率更低,提示三维调强放疗有效性和安全性均优于三维适形放疗。更多还原

【Abstract】 Objective To observe the cardiopulmonary dosimetry between three dimensional conformal radiotherapy and three dimensional intensity modulated radiotherapy on patients after radical resection of breast cancer,and to provide a reference for clinical selection of radiotherapy schemes. Methods 68 patients with improved radical resection of breast cancer were randomly divided into the control group and the observation group with 34 cases each group. The control group received three-dimensional conformal radiotherapy,and the observation group received three-dimensional intensity-modulated radiotherapy. Dosimetry,cardiopulmonary dosimetry and adverse reactions to radiotherapy were compared between the 2 groups. Results The PTV V95%dose of patients in the observation group was slightly higher than that of the control group,but there was no statistical difference( P > 0. 05). The V105%,V110%,V115% and homogeneity index( HI) in the observation group were significantly lower than those of the control group( P < 0. 05). Conformal index( CI) in the observation group was significantly higher than that of the control group( P < 0. 05). The lung index V5,V10,V20,V30,V40,V50,heart index V30,V40,V50 and the mean dose of contralateral breast in the observation group was significantly lower than that of the control group( P < 0. 05). The effective rates of the observation group and the control group were 88. 2% and 76. 5% respectively,there had statistically significant differences( P< 0. 05). The incidence of adverse reactions to radiotherapy in the observation group was lower than that of the control group( P< 0. 05). Conclusion Compared with three-dimensional conformal radiotherapy,in patients after radical resection of breast cancer three-dimensional intensity modulated radiotherapy has more uniform dose distribution in the target area,less dose to the heart and lung,and lower incidence of adverse reactions to three-dimensional intensity modulated radiotherapy,suggesting that the effectiveness and safety of three-dimensional intensity modulated radiotherapy are better than that of three-dimensional conformal radiotherapy.更多还原