[1]宾石珍,张俊俊,单冬勇,等.两种皮肤通量外扩方法在乳腺癌根治术后调强放疗计划中的剂量学比较[J].中国医学物理学杂志,2020,37(10):1237-1241.[doi:DOI:10.3969/j.issn.1005-202X.2020.10.005]
　BIN Shizhen,ZHANG Junjun,SHAN Dongyong,et al.Dosimetric comparison of two kinds of skin fluence expansion methods in intensity-modulated radiotherapy following radical mastectomy for breast cancer[J].Chinese Journal of Medical Physics,2020,37(10):1237-1241.[doi:DOI:10.3969/j.issn.1005-202X.2020.10.005]
点击复制

两种皮肤通量外扩方法在乳腺癌根治术后调强放疗计划中的剂量学比较()
分享到：

《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
37
期数:
2020年第10期
页码:
1237-1241
栏目:
医学放射物理
出版日期:
2020-10-29

文章信息/Info

Title:
Dosimetric comparison of two kinds of skin fluence expansion methods in intensity-modulated radiotherapy following radical mastectomy for breast cancer
文章编号:
1005-202X（2020）10-1237-05
作者:
宾石珍1; 张俊俊1; 单冬勇1; 成树林1; 张骥1; 唐甜1; 李娜2
1.中南大学湘雅三医院肿瘤科， 湖南 长沙 410013； 2.中南大学湘雅三医院放射科， 湖南 长沙 410013
Author(s):
BIN Shizhen1;  ZHANG Junjun1;  SHAN Dongyong1;  CHENG Shulin1;  ZHANG Ji1;  TANG Tian1;  LI Na2
1. Department of Oncology, the Third Xiangya Hospital of Central South University, Changsha 410013, China 2. Department of Radiology, the Third Xiangya Hospital of Central South University, Changsha 410013, China
关键词:
乳腺癌; 调强放射治疗; 皮肤通量外扩; 剂量学
Keywords:
Keywords: breast cancer intensity-modulated radiotherapy skin fluence expansion dosimetry
分类号:
R737.9；R811.1
DOI:
DOI:10.3969/j.issn.1005-202X.2020.10.005
文献标志码:
A
摘要:
目的：比较两种皮肤通量外扩方法在乳腺癌调强放疗计划中的剂量学差异。方法：对20例左乳腺癌根治术后患者的调强放疗计划分别采用瓦里安Eclipse治疗计划系统（11.0版）提供的Nearest cell（NC）和Erosion-dilation（ED）两种方法进行皮肤通量外扩，生成8FIMRT-NC和8FIMRT-ED计划。比较两组治疗计划的剂量体积直方图、靶区和危及器官的剂量分布、计划验证通过率和单次总机器跳数。结果：两种计划的通量和剂量线均已向胸壁皮肤外扩，两组计划的靶区剂量分布均达到临床处方剂量要求。PTV的最大剂量、平均剂量、大于110%处方剂量受照的体积、适形度指数、均匀性指数、梯度测量值等差异均无统计学意义。主要危及器官肺、心脏和脊髓等的剂量基本相似，差异均无统计学意义。两组计划的验证通过率差异无统计学意义，且均能应用于临床治疗。8FIMRT-ED计划比8FIMRT-NC计划的单次总机器跳数更少，分别为（1 282.35±184.84） MU和（1 302.05±195.37） MU，具有统计学意义（t=2.590, P<0.05）。结论：在乳腺癌根治术后的调强放疗临床计划中，采用NC和ED两种外扩方法均可以将皮肤通量有效外扩，且靶区剂量和危及器官受量均能满足临床治疗要求，两者剂量学无显著差异，但采用ED方法进行外扩，单次总机器跳数更少。
Abstract:
Abstract: Objective To compare the dosimetric differences between two kinds of skin fluence expansion methods in intensity-modulated radiotherapy (IMRT) plan for breast cancer. Methods Twenty patients treated by IMRT after radical mastectomy for left-sided breast cancer were randomly enrolled in the study, and Nearest cell (NC) and Erosion-expansion (ED) provided by Varian Eclipse treatment planning system (Version 11.0) were separately used for skin fluence expansion to generate 8FIMRT-NC plan and 8FIMRT-ED plan. Dose-volume histograms, dose distributions of planning target volume (PTV) and organs-at-risk (OAR), plan verification passing rates and the total monitor units (MU) per fraction were compared between two groups of plans. Results The fluence and dose lines in both groups were expanded to the chest wall skin, and the dose distribution of PTV in both groups met the prescribed dose requirements. There was no significant difference in the Dmax, Dmean, V110%, conformity index, homogeneity index, gradient measurement of PTV between two groups. The doses of the main OAR such as lungs, heart and spinal cord were basically similar, without statistical differences. The difference in plan verification passing rate between two groups was trivial, and both two groups of plans could be applied to clinical treatment. However, the total MU per fraction in 8FIMRT-ED plan was lower than that in 8FIMRT-NC plan, with statistical significance ［(1 282.35±184.84) MU vs (1 302.05±195.37) MU t=2.590, P<0.05］. Conclusion In IMRT after radical mastectomy for breast cancer, both NC and ED can effectively expand the skin fluence, and the dose of PTV and OAR can meet the clinical treatment requirements. There was no significant dosimetric difference between two methods, but the total MU per fraction was less when using ED to expand the skin fluence.

相似文献/References:

[1]柏 晗,王 丽,刘旭红,等.左乳腺5种不同主野分布IMRT计划的剂量比较分析[J].中国医学物理学杂志,2015,32(02):210.[doi:10.3969/j.issn.1005-202X.2015.02.013]
[2]史贵连,叶福丽.PTW729二维矩阵的平面剂量验证[J].中国医学物理学杂志,2015,32(02):239.[doi:10.3969/j.issn.1005-202X.2015.02.020]
[3]张晋建,黎 静,文 婷,等.Arc CHECK在乳腺癌螺旋断层放疗计划剂量验证中的应用[J].中国医学物理学杂志,2015,32(02):244.[doi:10.3969/j.issn.1005-202X.2015.02.021]
[4]戴相昆,杨丰蔚,杜 镭,等.等效均匀剂量优化法在宫颈癌调强计划中的应用[J].中国医学物理学杂志,2015,32(02):290.[doi:10.3969/j.issn.1005-202X.2015.02.033]
[5]巩汉顺,王金媛,丛小虎,等.晚期胰腺癌适形、简化调强及螺旋断层放疗的剂量学评估[J].中国医学物理学杂志,2015,32(01):8.[doi:10.3969/j.issn.1005-202X.2015.01.003]
[6]曾 彪,张九堂,席许平,等.单中心上下半野技术在胸中上段食管癌放射治疗中的剂量学分布[J].中国医学物理学杂志,2015,32(03):357.[doi:10.3969/j.issn.1005-202X.2015.03.012]
[7]史贵连,叶福丽.肺癌调强放疗计划的设计[J].中国医学物理学杂志,2015,32(03):361.[doi:10.3969/j.issn.1005-202X.2015.03.013]
[8]陈炳周,路俊哲,侯 氢.不同设计方式的调强逆向治疗计划比较[J].中国医学物理学杂志,2015,32(03):391.[doi:10.3969/j.issn.1005-202X.2015.03.020]
[9]周 钢,田 野,陆雪官,等.同步加量技术应用于脑胶质瘤术后调强放疗的剂量学研究[J].中国医学物理学杂志,2014,31(02):4727.[doi:10.3969/j.issn.1005-202X.2014.02.002]
[10]白 雪,杜向慧,王升晔,等.半野技术结合非共面照射技术在乳腺癌胸锁联合照射中的应用[J].中国医学物理学杂志,2014,31(03):4849.[doi:10.3969/j.issn.1005-202X.2014.03.001]
[11]花威,张西志,张先稳,等.RapidArc在乳腺癌术后放疗中的应用[J].中国医学物理学杂志,2013,30(02):3984.[doi:10.3969/j.issn.1005-202X.2013.02.005]
[12]段云龙,杨涛,曲宝林,等.乳腺癌保乳切线野三维适形、切线野正向调强及逆向调强放疗的剂量学评估[J].中国医学物理学杂志,2015,32(06):841.[doi:doi:10.3969/j.issn.1005-202X.2015.06.017]
　[J].Chinese Journal of Medical Physics,2015,32(10):841.[doi:doi:10.3969/j.issn.1005-202X.2015.06.017]
[13]郑荣辉,李洪胜,张秀萍,等. 乳腺癌保乳术后全乳调强瘤床加量大分割放疗[J].中国医学物理学杂志,2016,33(6):569.[doi:10.3969/j.issn.1005-202X.2016.06.006]
　[J].Chinese Journal of Medical Physics,2016,33(10):569.[doi:10.3969/j.issn.1005-202X.2016.06.006]
[14]赵彪,潘香,杨毅,等. 右乳癌保乳术后瘤床同步X线和后程电子线补量调强放疗剂量学比较[J].中国医学物理学杂志,2016,33(6):576.[doi:10.3969/j.issn.1005-202X.2016.06.008]
　[J].Chinese Journal of Medical Physics,2016,33(10):576.[doi:10.3969/j.issn.1005-202X.2016.06.008]
[15]袁细伟,周蓉蓉,张子健. 早期乳腺癌保乳术后3D-CRT与IMRT的剂量学分布及皮肤损害比较[J].中国医学物理学杂志,2017,34(6):574.[doi:DOI:10.3969/j.issn.1005-202X.2017.06.007]
　[J].Chinese Journal of Medical Physics,2017,34(10):574.[doi:DOI:10.3969/j.issn.1005-202X.2017.06.007]
[16]周琼,陈维军,王奇,等. 基于RTOG 1005早期乳腺癌调强多目标优化计划和单目标优化计划比较[J].中国医学物理学杂志,2017,34(10):993.[doi:DOI:10.3969/j.issn.1005-202X.2017.10.005]
[17]沈奕晨,王为,张松方,等. 乳腺癌螺旋断层放射治疗与调强放射治疗的剂量学研究与临床剂量实测比较[J].中国医学物理学杂志,2018,35(3):269.[doi:DOI:10.3969/j.issn.1005-202X.2018.03.005]
　SHEN Yichen,WANG Wei,ZHANG Songfang,et al. Dosimetry study and measured dose comparison of Tomotherapy and intensity-modulated radiotherapy for breast cancer[J].Chinese Journal of Medical Physics,2018,35(10):269.[doi:DOI:10.3969/j.issn.1005-202X.2018.03.005]
[18]王磊,倪昕晔,王根和,等. 乳腺癌固定野调强射野数目的研究[J].中国医学物理学杂志,2018,35(11):1269.[doi:DOI:10.3969/j.issn.1005-202X.2018.11.006]
　WANG Lei,NI Xinye,WANG Genhe,et al. Different fixed-field intensity-modulated radiotherapy plans for breast cancer: a dosimetric comparison[J].Chinese Journal of Medical Physics,2018,35(10):1269.[doi:DOI:10.3969/j.issn.1005-202X.2018.11.006]
[19]陈日新,罗展雄,秦佳宁,等.早期乳腺癌保乳术后不同剂量调强放射治疗疗效比较[J].中国医学物理学杂志,2020,37(8):993.[doi:DOI:10.3969/j.issn.1005-202X.2020.08.010]
　CHEN Rixin,LUO Zhanxiong,QIN Jianing,et al.Comparison of therapeutic effects of intensity-modulated radiotherapy with different dose schemes following breast-conserving surgery for early-stage breast cancer[J].Chinese Journal of Medical Physics,2020,37(10):993.[doi:DOI:10.3969/j.issn.1005-202X.2020.08.010]
[20]魏夏平,苏洁洪,黄小伟,等.基于Halcyon加速器的乳腺癌IMRT计划设计方法[J].中国医学物理学杂志,2022,39(7):817.[doi:DOI:10.3969/j.issn.1005-202X.2022.07.005]
　WEI Xiaping,SU Jiehong,HUANG Xiaowei,et al.IMRT planning for breast cancer based on Halcyon accelerator[J].Chinese Journal of Medical Physics,2022,39(10):817.[doi:DOI:10.3969/j.issn.1005-202X.2022.07.005]

备注/Memo

备注/Memo:
【收稿日期】2020-03-19 【基金项目】湖南省卫生健康委科研计划课题（C2019168）；湖南省自然科学基金青年项目（2019JJ50904） 【作者简介】宾石珍，硕士，主管技师，研究方向：放射治疗技术，E-mail: shizhenbin@csu.edu.cn 【通信作者】李娜，博士，助理研究员，研究方向：医学影像技术，E-mail: lina2864@foxmail.com
更新日期/Last Update: 2020-10-29