电子线旋转治疗技术在乳腺癌术后胸壁照射中的应用

Electron Arc Therapy:Application of Chest Wall Irradiation after Mastectomy

随着肿瘤综合治疗的不断发展,乳腺癌的治疗策略发生了很大变化。但放射治疗作为一种局部治疗方法在乳腺癌综合治疗中仍占重要地位。乳腺癌术后胸壁复发占所有局部复发的44%～69%,居第一位,成为乳腺癌术后放射治疗的最重要靶区。然而,由于胸廓特殊的几何形状,传统的照射方法难以达到合理的剂量分布。电子线旋转治疗技术利用电子线的剂量分布特点、结合胸壁的形状和靶区的深度选择不同的能量,使靶区达到合理的剂量分布,同时降低心、肺受量,在胸壁照射中具有较大的优势。临床实践也证实,电子线旋转照射与常规照射技术相比具有局部控制率高、心肺毒性小、皮肤反应轻等优点,在胸壁照射中具有较高的临床应用价值。

With the development of multidisciplinary treatment for cancer, gre at changes have taken place in the therapeutic strategy of breast cancer. Howeve r, radiotherapy as a method of local management, still plays an important role i n the combined treatment of breast cancer. The recurrence in the chest wall rank s the first, accounting for 44-69% of the total local-regional relapse, ther efore, the chest wall is commonly regarded as the most important target of radio therapy after mastectomy. The traditional irradiation techniques cannot reach an ideal dose distribution due to the irregular shape of the chest wall. Electron arc therapy, by using the electron characteristics of dose distribution, combini ng the shape of thorax and the depth of target volume, make the dose distributio n of target volume more reasonable, decreases the dose of heart or lung and has more clinical benefit than traditional techniques. On the other hand, it had bee n demonstrated by some clinical research that irradiation with electron arc coul d provide a high rate of local control and generally acceptable acute and long- term toxicity, comparing with the traditional irradiation techniques.