乳腺癌改良根治术后不同补偿物放疗调强计划的比较

Comparison of intensity modulated radiotherapy plans with different compensators after modified radical mastectomy of breast cancer

目的探讨乳腺癌改良根治术后使用3D打印不均匀厚度补偿物、3D打印均匀厚度补偿物及普通补偿物所做放疗计划的差异。方法选取就诊于徐州医科大学附属连云港医院的15例乳腺癌改良根治术后患者,分别使用3种不同补偿物放疗,比较3组计划的靶区和危及器官的剂量学及体积学参数差异。结果3组计划中,3D打印不均匀补偿物均匀性指数(HI)为0.10±0.03,3D打印均匀补偿物为0.11±0.04,普通补偿物为0.15±0.05,F=13.819,P<0.001;适形性指数(CI)分别为0.75±0.07、0.75±0.07和0.68±0.08,F=25.674,P<0.001;3D打印补偿物最大间隙深度为(0.44±0.16)cm,小于普通补偿物的(1.55±0.39)cm,t=-9.113,P<0.001。但2种3D打印补偿物之间差异无统计学意义,P>0.05。结论3D打印补偿物个性化程度高,在患者的贴合度、靶区剂量的均匀性、适形性方面具有优势,在乳腺癌改良根治术后放疗中有较大临床应用价值。

Objective To explore the difference of radiotherapy plans made by using 3Dprinted non-uniform thickness compensation,3Dprinted uniform thickness compensation and general compensation after modified radical mastectomy for breast cancer.Methods Totally fifteen patients with breast cancer after modified radical mastectomy who were treated in Affiliated Lianyungang Hospital of Xuzhou Medical University were selected,and three different compensators were used for radiotherapy respectively.The differences in dosimetry and volumetric parameters between the planned target areas and the endangered organs of the three groups were compared.Results In the three groups of plans,the homogeneity index(HI)value of uneven compensation for 3Dprinting was 0.10±0.03,the uniform compensation for 3Dprinting was 0.11±0.04,and the ordinary compensation was 0.15±0.05,F=13.819,P<0.001.The conformity index(CI)values were 0.75±0.07,0.75±0.07,and 0.68±0.08,respectively,F=25.674,P<0.001.The maximum gap depth of 3Dprinting compensation was(0.44±0.16)cm,which was lower than(1.55±0.39)cm of ordinary compensation,t=-9.113,P<0.001.However,there was no statistically significant difference between the two 3Dprinting compensators(P>0.05).Conclusion The 3Dprinting compensators are highly personalized,and have advantages in patient fit,target dose uniformity,and conformability.They have great clinical application value in post modified radical surgery radiotherapy for breast cancer.