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目的:比较新疆地区食管鳞癌患者采用三维适形放疗(3DCRT)、适形调强放疗(IMRT)剂量分布及危及器官剂量学的差异。方法:收集我院2011年10月-2012年7月间收治的13例食管癌进行放射治疗,分别行三维适形(3DCRT)和适形调强(IMRT)计划设计,比较两种放疗计划剂量学及危及器官参数。结果:在相同处方剂量下,IMRT计划100%、95%等剂量曲线所覆盖的PTV体积百分比均高于3DCRT计划(P=0.00),IMRT靶区适形度(CI)和不均匀指数(HI)更接近1。IMRT计划肺的V20、V30、V15及MLD均低于3DCRT计划(P<0.05)。IMRT同时脊髓最大所受剂量(D max),心脏V40及心脏平均剂量(D mean)均低于3DCRT,差异均有统计学意义(P<0.05)。结论:胸上段食管癌采用IMRT放疗,可以获得更好地靶区内剂量分布及适形度,同时又降低肺、脊髓、心脏的受照剂量,有利于提高肿瘤局控率,减少放疗毒副反应。
OBJECTIVE: To compare the dose distribution of three-dimensional conformal radiotherapy (3DCRT), conformal IMRT (IMRT) and organ dose-dosimetry in patients with esophageal squamous cell carcinoma in Xinjiang. Methods: Thirteen patients with esophageal cancer who were treated in our hospital from October 2011 to July 2012 were enrolled in this study. Three-dimensional conformal 3DCRT and IMRT planning were performed respectively. Learn and endanger organ parameters. Results: Under the same prescription dose, the volume percentage of PTV covered by 100% and 95% isodose curves in IMRT plan was higher than those in 3DCRT plan (P = 0.00), IMRT target area conformality (CI) and inhomogeneity index ) Is closer to 1. The lung V20, V30, V15 and MLD in the IMRT plan were lower than those in the 3DCRT plan (P <0.05). The maximum spinal cord exposure dose (D max), heart V40 and mean cardiac dose (D mean) of IMRT were both lower than those of 3DCRT. The difference was statistically significant (P <0.05). Conclusion: IMRT radiotherapy in upper thoracic esophageal cancer can achieve better dose distribution and conformality in the target area, meanwhile reduce dose of lung, spinal cord and heart, which is beneficial to increase the control rate of tumor and reduce the toxicity of radiotherapy reaction.