微创医学

【摘要】目的比较飞利浦Pinnacle3 9.10计划系统自动计划和手工计划设计乳腺癌放疗计划时的剂量分布特点，为乳腺癌的放疗计划优选方案提供依据。方法选取26例右乳腺癌改良根治术患者，在飞利浦Pinnacle3 9.10计划系统上分别用手工计划（对照组）和自动计划（观察组）方法设计出治疗计划，根据剂量体积直方图，评价靶区的V95%、V100%、V110%、均匀性指数（HI）、适形性指数（CI）、危及器官（OAR）受量等指标的优良率。结果观察组的均匀性指数和适形度指数明显优于对照组，差异有统计学意义(P＜0.05)。两组的V95%、V100%剂量参数比较，差异无统计学意义（P＞0.05）；两组V110%剂量参数比较，差异有统计学意义(P＜0.05)。观察组的患侧肺、全肺受照量明显低于对照组，差异有统计学意义(P＜0.05)。两组心脏、脊髓受量比较，差异无统计学意义（P＞0.05）。结论右乳腺癌改良根治术的自动计划在提高靶区的均匀性和适形性及降低肺接受的高剂量的体积上显著优于手工计划。

【Abstract】 ObjectiveTo compare the dose distribution feature between the autoplanning and manual planning of Philips Pinnacle3 9.10 planning system in the design of radiotherapy planning for breast cancer, thus to provide the basis for optimal radiotherapy plan screening of breast cancer. MethodsTwentysix patients receiving rightside modified radical mastectomy were enrolled. The therapeutic plans were designed using manual planning (control group) and autoplanning (observation group) of philips Pinnacle3 9.10 planning system separately. According to the dose volume histogram, the excellent rates of indicators were evaluated, including V95 %, V100 % and V110 % of the targets, homogeneity index (HI), conformal index (CI) and exposure dose of organ at risk(OAR). ResultsHI and CI of the observation group were superior to those of the control group (P＜0.05). There were no statistical differences in the dose parameters of V95% and V100% between the two groups (P＞0.05). There was statistical difference in the dose parameter of V110% between the two groups (P＜0.05). The exposure doses of affected lung and both lungs were lower in the observation group compared to the control group (P＜0.05). There were no statistical differences in the exposure doses of heart and spinal cord between the two groups (P＞0.05). ConclusionThe autoplanning for rightside modified radical mastectomy can improve the homogeneity and conformance of the targets and decrease the exposure of lung volume to highdose irradiation ,which is superior to the manual planning