The Study of Different Intensity Modulated Radiotherapy Optimization Planning for Breast Cancer

乳癌強度調控放射治療計畫之最適化研究

趙家緯(Chia-Wei Chao) ； 胡彼得(Peter Woo) ； 熊敬業(Ching-Ye Hsiung) ； 馬漢光(Hon-Kwong Ma) ； 林招膨(Jao-Perng Lin) ； 賴源淳(Yuan-Chun Lai)

《台灣應用輻射與同位素雜誌》 7卷2期 (2011/06) Pp. 83-93

https://doi.org/10.29832/TJARI.201106.0005

摘要

本研究針對施予手術後放射治療的早期乳癌患者，探討不同種的強度調控放射治療計畫(Intensity modulated radiotherapy, IMRT)，找出最適化的放射治療方式。實驗收集八位已完成放射治療早期乳癌患者之電腦斷層定位影像，而病患電腦斷層定位的姿勢呈平躺且雙臂高舉到頭部。治療計畫系統使用Philip pinnacle3 version 7.6c，模擬Elekta Synergy(上標 ®)醫用直線加速器。研究四種不同的強度調控放射治療計畫，包含照野中照野強度調控放射治療(filed in field IMRT)、強度調控放射治療、切線照野強度調控放射治療(tangential IMRT)和非共平面的強度調控放射治療(non-coplaner IMRT)。計畫結果依照劑量體積直方圖、鄰近組織劑量、計畫靶體積劑量、靶劑量的順形指數(Conformity number, CN)及劑量同質性指數(Homogenate index, HI)來評估最適化的結果。FIF IMRT劑量順形指數和患側肺葉劑量保護相對其他計畫沒有很好的結果，但確實能減少傳統相切照野所產生之熱區，對其他鄰近組織也有很好的保護，IMRT劑量順形指數是所有計畫當中最好，NC-IMRT在靶劑量與其他正常組織保護上也都達成很好的結果，tangential IMRT是一個能夠給予腫瘤足夠劑量和有良好劑量順形指數且鄰近正常組織又能獲得很好的保護的治療計畫。

關鍵字

強度調控放射治療 ； 相切照野技術 ； 乳癌 ； 劑量順形指數

並列摘要

The study is aimed at exploring different types of IMRT planning to find out an optimum method of radiotherapy for the early-stage breast cancer patients who receive radiotherapy after the operation. In the experiment, the CT data of 8 early-stage breast cancer patients who have completed radiotherapy are collected and when CT is made, the patients lie down flat with their arms raising high to the head. Philip pinnacle^3 version 7.6c, emulation Elekta Synergy(superscript ®) medical linear accelerator is used as the treatment planning system. Four types of different IMRT planning are studied, including filed in field IMRT, IMRT, tangential IMRT and NC IMRT. The optimum result is evaluated on the basis of DVH, dose in adjacent tissue, dose of planning target volume, conformity number and the dose homogenate index got from the planning results. FIF IMRT dose conformity index and the dose protection of the lung lobe at affected side don't have good results compared with other plans, but it can really reduce the hot spots caused by traditional tangential fields and well protect other adjacent tissues. IMRT dose conformity index is the best of all plans. NC-IMRT also has very good results in target dose and the protection of other normal tissues. Tangential IMRT is a good treatment plan that can give enough dose to tumor with good dose conformity index while provide good protection to the adjacent normal tissues.

並列關鍵字

Intensity modulated radiotherapy ； IMRT ； Breast cancer ； Dose volume histogram ； DVH