肿瘤预防与治疗2024，Vol.37Issue(6)：505-511,7.DOI:10.3969/j.issn.1674-0904.2024.06.008
关于左乳癌保乳术后静态调强放疗计划内切等中心优化策略的研究
Inner Tangent Isocenter Optimization Strategy of Static Intensity Modula-ted Radiotherapy for Left Breast Cancer after Breast-Conserving Surgery
摘要
Abstract
Objective:To improve the quality of static intensity-modulated radiotherapy(IMRT)plan for patients with left breast cancer after breast-conserving surgery by comparing the dosimetric differences in targets and organs at risk be-tween the inner tangent isocenter IMRT(Iniso-IMRT)and the normal isocenter IMRT(Noriso-IMRT),in order to provide ev-idence for designing precise and personalized physics plans in clinical work.Methods:Thirty-three patients with left breast cancer after breast-conserving surgery were retrospectively and randomly selected.Noriso-IM RT and Iniso-IMRT plans were respectively designed by Monaco 6.11 treatment plan-ning system for the same patient.For Noriso-IMRT,the center of irradiation field was set as the geometric center of planning target volume(PTV),while Iniso-IMRT then moved along the papillary direction to the junction between PTV and lung tis-sue based on the setting of Noriso-IMRT.The dosimetric parameters of the two groups were compared.Results:For PTV,Iniso-IMRT was better than Noriso-IMRT in D98,homogeneity index,conformity index and monitor units,and the differences were statistically significant(P＜0.05),while there were no statistically significant differences in D50 and D2 between two groups(P＞0.05).Iniso-IMRT were significantly lower than Noriso-IMRT in V5,V10,V20,V30,V40 and Dmean of L-lung,V5,V10,V20 and Dmean of heart,D111e.in of R-lung and D2 of cord(P＜0.05).Iniso-IMRT was slightly higher than Noriso-IMRT in the Dmean of R-breast[(376.07±156.11)cGy vs(250.87±102.61)cGy],and the difference was statistically significant(P＜0.05).Conclusion:Compared with Noriso-IMRT,the design of Iniso-IMRT proposed in this paper not only benefits the target area but also significantly reduces the radiation dose of L-lung,R-lung and Heart,while the slight increase of radiation dose in the R-breast is within an acceptable range,which is valuable for medical physicists and oncologists.关键词
等中心/左乳癌保乳术后/静态调强放疗/优化策略Key words
Isocenter/Left breast cancer after breast conserving surgery/Static intensity modulated radiotherapy/Op-timized strategy分类
医药卫生引用本文复制引用
袁美芳,赵彪,孙朝细,蒲琴,李静..关于左乳癌保乳术后静态调强放疗计划内切等中心优化策略的研究[J].肿瘤预防与治疗,2024,37(6):505-511,7.基金项目
This study was supported by National Natural Science Foundation of China(No.32360114). 国家自然科学基金—地区科学基金项目(编号:32360114) （No.32360114）
