乳癌強度調控放射治療與傳統相切照野治療技術治療計畫之最適化比較

手術後放射治療的乳癌患者，由於胸壁變薄，易使鄰近正常組織接受更多的劑量，併發症也更爲嚴重。故本研究針對施予手術後放射治療之早期乳癌患者，探討使用不同種之放射治療計畫其劑量最適化結果。實驗收集四位乳癌患者之電腦斷層定位影像，配合Philip Pinnacle^3 version 7.6c治療計畫系統及Elekta Synergy(上標 ®)醫用直線加速器執行。計畫在28次分次治療給予計畫靶體積(Planning target volume, PTV)5040cGy之處方劑量。兩種治療計畫之評估，根據靶劑量順形指數、劑量同質性指數和鄰近組織之劑量體積直方圖來探討。傳統相切照野(tangential fields)技術易發生的熱區，照野中照野治療計畫(Field in field intensity modulation therapy, FIF IMRT)確實有減少熱區的結果，95%處方劑量的順形指數相對較高，臨床靶體積和計畫靶體積的D(下標 5%)和D(下標 95%)的劑量差異性也較小，劑量同質性指數也要來的好，正常組織中肱骨頭接受到的劑量明顯較低，也降低心臟、主動脈和對側肺葉的最大劑量。

關鍵字

乳癌；相切照野技術；強度調控放射治療

並列摘要

The study compare tangential field and coplanar with non-conplanar intensity modulation radiotherapy (IMRT) were evaluated dose distribution CT data for cohort of eight previous treated patients will be select for this study. The study will be performed with Philip Pinnacle^3 version 7.6c. In all patients the planning target volume will be treated to a dose of 5040 Gy in 28 fractions. No more than 1% of any of the PTVs (i.e. PTV 54 Gy or PTV Node) was allowed to receive ＞115% (D1 6 62.1 Gy or 55.2 Gy, respectively) of the prescription dose. Tangential fields easy to occurred hot spots, Field in field intensity modulation therapy (FIF IMRT) can really reduce the hot spots caused by traditional tangential fields and well protect other adjacent tissues, 95% prescription dose conformity index is relatively high, and Both D5% and D95% of CTV and PTV are relatively low. Homogenate index is relatively better. FIF IMRT plan resulted in better sparing of the humeral head, aorta and heart.

並列關鍵字

Intensity modulation radiotherapy ； Tangential field ； Breast cancer ； Dose-volume histogram

國際替代計量

乳癌強度調控放射治療與傳統相切照野治療技術治療計畫之最適化比較

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