【摘要】 目的比较乳腺癌保留乳房术后瘤床同步X射线和电子线整合补量调强放疗剂量学特点,探讨不同补量方式对全乳、心脏和同侧肺脏受照剂量的影响。方法选择10例患者,将银夹所标记的范围外扩10mm定义为肉眼靶区(GTV),全乳腺定义为临床靶区(CTV),根据ADACPinnacle36·2和Pinnacle37·0分别制定X射线和电子线瘤床整合补量放疗计划,比较两种计划的剂量学参数。结果X射线和电子线瘤床补量计划的剂量均匀性和适形性差异均无统计学意义;受照射剂量≥20Gy的患侧肺脏容积V20(lung)及受照射剂量≥GTV处方剂量的患侧肺脏容积V处方剂量(lung)-GTV差异无统计学意义,但电子线瘤床补量计划中受照射剂量≥CTV处方剂量的患侧肺脏容积V处方剂量(lung)-CTV明显高于X射线瘤床补量,差异有统计学意义(P=0·014);受照剂量≥30Gy的心脏容积V30(heart)和受照剂量≥CTV处方剂量的心脏容积V处方剂量(heart)-CTV差异均无统计学意义。结论X射线和电子线瘤床补量计划中的多数剂量学参数差异无统计学意义,但电子线瘤床补量计划中受照射剂量≥CTV处方剂量的患侧肺脏容积明显高于X射线瘤床补量。更多还原

【Abstract】 Objective To compare the dosimetric merits of photon beam and electron beam simultaneous integrated boost intensity modulated radiation therapy (SIB-IMRT) for conserved breast to explore the dose difference of photon and electron beam integrated boost for whole breast, ipsilateral lung and the heart. Methods Ten patients with breast cancer treated by conserving-breast operation were selected to study, the region marked by silver clips with extended margin of 10 mm was defined as gross target volume (GTV) and the whole breast was delineated as the clinical target volume (CTV). Photon beam and electron beam integrated boost planning were designed respectively for every patient using ADAC Pinnacle~3 planning system and the dosimetric merits were compared. Results There were not significant difference for dose uniformity and conformality between the plannings with photon beam and electron beam integrated boost. There were not significant difference for the volumes of the ipsilateral lung received ≥20 Gy and equal or more than the prescribed dose for GTV between different planning, but the volume of the lung received equal or more than prescribed dose for CTV in electron beam planning was significantly higher than that in photon beam planning(P=0.014). There were not significant difference for the volumes of the heart received ≥30 Gy and equal or more than prescribed dose for CTV in photon and electron beam planning. Conclusions There is not significant difference for most of the dosimetric parameters in photon beam and electron beam integrated boost planning, but the volume of the ipsilateral lung received equal or more than prescribed dose in electron planning is significantly higher than that in photon beam planning.;更多还原