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目的:研究比较胃癌术后放疗中三维适形和调强两种不同方法产生的计划在靶区剂量分布,正常组织受量等方面的区别,比较两种计划的优缺点,以期指导临床应用。方法:选取5个胃癌术后放疗病人,勾画完靶区后,分别运用三维适形和调强制作计划,比较靶区适形度,均匀性,正常肝组织(Liver-PTV)的(V30,Mean),双肾(V5,V15,V20,Mean),脊髓的受量。结果:三维适形计划与调强计划相比,适形度,均匀性较差;正常肝组织的V30和平均剂量调强计划略优于三维适形;双肾的V15,平均剂量两者没有明显差异,V20调强略优于适形计划,小于V5的低剂量体积调强计划要小于三维适形;脊髓受量两者没有明显差异。结论:总体来说,胃癌术后的调强计划靶区适形度,均匀性优于三维适形计划,正常组织受量与三维适形相当或者略优于三维适形,所以调强计划可以替代三维适形计划作为胃癌术后放疗的主要计划设计方法。
OBJECTIVE: To compare the difference between dose planning and target dose distribution in three different methods of three-dimensional conformaltion and intensity modulation in postoperative radiotherapy for gastric cancer, and to compare the advantages and disadvantages of the two plans in order to guide the clinical application. Methods: Five patients with postoperative radiotherapy of gastric cancer were selected and the target area was outlined. Three-dimensional conformal and intensity-modulated production plans were respectively used to compare the target conformality and homogeneity. The V30, Mean), kidneys (V5, V15, V20, Mean), the amount of spinal cord. Results: The conformality and homogeneity of the three-dimensional conformal plan were worse than those of the intensity-modulated plan. The V30 and average dose plan of the normal liver tissue were slightly better than the three-dimensional conformal plan. The two groups had no V15 and average dose Significant difference, V20 strength slightly better than conformal plan, less than V5 low dose volume intensity plan should be less than three-dimensional conformal; spinal cord by the two no significant difference. Conclusion: Generally speaking, the conformality and homogeneity of target area of IMRI is better than that of 3D conformal plan, and the amount of normal tissue is comparable to or slightly better than that of 3D conformal, so IMRT can Alternative three-dimensional conformal plan as the main planning method of postoperative radiotherapy for gastric cancer.