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目的探讨快速旋转调强(Rapid Arc)计划在乳腺癌术后放疗中的应用价值。方法选择20例左侧女性乳腺癌患者定位CT图像(10例保乳术后和10例改良根治术后),统一勾画靶区,分别设计Rapid Arc计划和5野逆向调强放疗(5F-IMRT)计划,根据剂量-直方图比较两种计划的靶区和危及器官体积-剂量关系、适形度指数(CI)、均匀性指数、机器跳数及治疗时间。结果在两种不同手术方式下,Rapid Arc计划的靶区均匀性指数数值均低于5F-IMRT计划,且机器跳数、治疗时间明显减少(P均<0.05);在改良根治术后,Rapid Arc计划中的CI、患侧肺的平均剂量、V_5、V_(10)、心脏V_5均高于5F-IMRT计划(P均<0.05);保乳术后,Rapid Arc计划中的患侧肺的V_5、心脏V_5均高于5F-IMRT计划(P均<0.05)。结论乳腺癌术后Rapid Arc计划能改善靶区均匀性,减少机器跳数,但可增加危及器官低剂量体积,且计划制定时间长。
Objective To investigate the value of rapid rotation (Rapid Arc) program in postoperative radiotherapy for breast cancer. Methods Twenty cases of breast cancer patients were selected to locate CT images (10 cases after breast-conserving surgery and 10 cases after modified radical mastectomy). The target area was designed and the Rapid Arc plan and 5-field reverse-modulated radiotherapy (5F-IMRT ) Plan to compare the target volume and organ volume-dose-related, conformality index (CI), uniformity index, machine hops and treatment time for both schedules based on dose-histogram. Results In the two different surgical modalities, the target values of the Rapid Arc program were lower than those of the 5F-IMRT plan and the number of machine hops and the treatment time were significantly decreased (all P <0.05). After the modified radical operation, Rapid The average dose of CI, ipsilateral lung, V_5, V_ (10), and heart V_5 were higher than those of 5F-IMRT (all P <0.05) V_5 and heart V_5 were higher than those of 5F-IMRT (all P <0.05). Conclusions The Rapid Arc program for postoperative breast cancer can improve the uniformity of the target area and reduce the number of machine hops. However, it can increase the volume of organs at low dose, which is planned for a long time.