【摘 要】
：
目的:对12例三维适形或调强治疗的肺癌病例进行回顾性肺NTCP分析,加深对肺癌三维适形及调强治疗认识.为同等条件下不同治疗方案的正常组织并发症概率(NTCP)物理学的优选,提供一定依据.方法:引用第三方NTCP计算实例,验证NTCP软件计算办法和可行性.而后对12例肺癌病例(4例为三维适形治疗,8例为调强治疗)进行NTCP计算和统计学分析.结果:调强治疗病例患肺NTCP,双肺NTCP与三维适形治疗
【机 构】
：
北京第二炮兵总医院放疗科 北京肿瘤医院
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目的:对12例三维适形或调强治疗的肺癌病例进行回顾性肺NTCP分析,加深对肺癌三维适形及调强治疗认识.为同等条件下不同治疗方案的正常组织并发症概率(NTCP)物理学的优选,提供一定依据.
方法:引用第三方NTCP计算实例,验证NTCP软件计算办法和可行性.而后对12例肺癌病例(4例为三维适形治疗,8例为调强治疗)进行NTCP计算和统计学分析.
结果:调强治疗病例患肺NTCP,双肺NTCP与三维适形治疗病例有显著差异(调强治疗＞三维适形);调强治疗病例患侧肺有效体积,健侧肺有效体积,双肺有效体积之和与三维适形治疗病例有显著差异(调强治疗＞三维适形).对三维适形或调强治疗来说同等条件下降低双肺受累有效体积,可以降低双肺NTCP.
结论:肺癌调强治疗本身就是一项放疗优化技术,但其投照技术产生的剂量体积直方图(DVH)物理效应有别于适形放疗方案,致使调强治疗病人患肺NTCP普遍高于三维适形病人.不同的投照方案,会产生不同的DVH.鉴于此,可以借助NTCP便捷计算技术对肺癌病人的调强治疗或三维适形计划进行二次评估,以较低的肺NTCP达到预期的治疗目的.对肺癌的调强治疗尤为重要.
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