乳腺癌保留乳房术后应用图像引导放射治疗效果探讨

Breast conserving surgery image guided radiation therapy

目的:评价乳腺癌保留乳房手术(保乳术)后调强放射治疗剂量学优势,评估图像引导技术在乳腺癌保乳术后调强放射治疗的摆位误差和计划靶体积边界。方法:6例早期乳腺癌接受保乳手术的患者,实施全乳腺图像引导调强放疗50 Gy,瘤床电子线加量10 Gy。评价乳腺靶区的剂量分布均匀性和周围正常组织的照射剂量和体积,观察临床毒性反应,统计摆位误差。结果:靶区剂量均匀,正常组织受量在允许范围内,摆位误差左右方向≤0.3 cm,其他方向≤0.5 cm。结论:乳腺癌保乳术后全乳腺调强靶区剂量均匀性好,正常组织受量小,临床毒性反应小,摆位重复性差,采用锥形束CT图像引导放疗可减少摆位误差。

Objective：Evaluation of breast conserving surgery intensity modulated radiation therapy（IMRT） dosimetric advantages of image guided assessment of breast conserving surgery in IMRT and the planning traget volume planning target volume border positioning errors.Methods：Six patients received breast-conserving surgery in early breast cancer patients,the implementation of the whole breast image guided intensity modulated radiation therapy 50 Gy,tumor bed volume electronic wire and evaluation of breast 10 Gy target dose uniformity and the surrounding normal tissue dose and volume,the clinical toxicity,statistical position error.Results：Target dose homogeneity and normal tissue by the amount of the allowed range,the direction of the left and right positioning error ≤0.3 cm,the other direction ≤0.5 cm.Conclusions：The whole breast after breast conserving IMRT target dose uniformity,normal tissues received a small dose,slight clinical toxicity,and poor reproducibility.Using cone-beam CT image-guided radiation therapy to reduce setup errors.