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目的:主要对胃癌三维适形放疗(3DCRT)、7野分野放疗以及强调放射治疗之间计量学差异进行比较,意在为临床应用的提高提供参考。方法:选取2012年1月-2012年12月前来我院进行救治的胃癌患者6例,以上述三种放疗技术为主分别制定不同的放疗计划,给予95%PTV45Gy的处方剂量,并采用等剂量曲线以及剂量体积直方图(DVH)对计划结果进行评价,且评价参数大致有V110%、V95%、不均匀性指数、适形指数(CI)以及正常组织受照剂量。结果:就靶区适形性以及靶区剂量分布均匀性而言,IMRT与7FRT和3DCRT比较较优,但7FRT与3DCRT相比,靶区适形性两者差异没有统计学意义;对于肝脏保护问题,IMRT均优于7FRT和3DCRT,而3DCRT又较差于7FRT的肝脏D1/3,7FRT在肝脏受到的平均剂量与3DCRT差别没有统计学意义。脊髓的最高受量主要与3DCRT有关,与7FRT和IMRT相比比较优越,且7FRT和IMRT二者间7FRT较好;肾脏受量IMRT、7FRT及3DCRT之间差异没有统计学意义。结论:7FRT的肝脏D1/3与3DCRT相比比较优越,而就HI、脊髓最高受量而言,3DCRT优于7FRT,而IMRT均优于7FRT与3DCRT。IMRT在胃癌放疗上有着放射物理的优越性。
OBJECTIVE: To compare the metrological differences between three dimensional conformal radiotherapy (3DCRT), 7 field radiotherapy and emphasizing radiotherapy for gastric cancer, which is intended to provide reference for the improvement of clinical application. Methods: Six patients with gastric cancer who came to our hospital from January 2012 to December 2012 were enrolled in this study. Different radiotherapy plans were given based on the above three radiotherapy techniques. The prescribed dose of 95% PTV45Gy was given and adopted Dose curves and dose-volume histogram (DVH) were used to evaluate the planned results. The evaluation parameters were approximately V110%, V95%, inhomogeneity index, conformal index (CI) and normal tissue exposure dose. Results: IMRT was superior to 7FRT and 3DCRT in terms of the conformality of the target zone and uniformity of dose distribution in the target zone. However, there was no significant difference in the conformality of the target zone between 7FRT and 3DCRT. For liver protection The IMRT was superior to 7FRT and 3DCRT, but the average dose of liver D1 / 3 and 7FRT with 3DCRT and 7FRT was not statistically different from that of 3DCRT. The highest dose of spinal cord was mainly related to 3DCRT, which was superior to 7FRT and IMRT, and 7FRT between 7FRT and IMRT was better. There was no significant difference between IMRT, 7FRT and 3DCRT in kidney. CONCLUSION: The hepatic D1 / 3 of 7FRT is superior to 3DCRT, while 3DCRT is superior to 7FRT in terms of HI and spinal cord maximum dose, while IMRT is superior to 7FRT and 3DCRT. IMRT radiotherapy in the treatment of gastric cancer has the superiority.