摘要:
目的:比较胃癌术后放疗射野角度优化和传统布野方法的剂量学差异.方法:选择8例胃癌术后患者分别制定射野均分(EGA)、人工布野(MBS)、射野角度优化(BAO)调强放疗计划,对靶区和危及器官的剂量学数据进行配对t检验,比较射野角度分布差异.结果:EGA与BAO比较,肝脏Dmean(21.77%,P=0.003)、V10(31.68%,P=0.004)、V20(37.87%,P=0.006);双肾Dmean(23.83%,P=0.039)、V10(31.51%,P=0.024)、V15 (60.60%,P=0.026)、V20(70.45%,P=0.018);胃Dmean(7.25%,P=0.025)、V10(3.78%,P=0.027);双肺Dmean(10.23%,P=0.024)、V10(20.18%,P=0.035);Body-PTV Dmean(7.57%,P=0.006)、V5(10.26%,P=0.005)、V10(12.20%,P=0.010),差异有统计学意义,BAO组优于EGA组.MBS与BAO比较,双肾V15(36.54%,P=0.032)、V20(43.97%,P=0.034);胃Dmean(3.93%,P=0.035)、V10(2.86%,P=0.038),差异有统计学意义,BAO组优于MBS组.EGA与BAO计划的射野角度差异要明显大于MBS与BAO计划的差异.结论:胃癌术后放疗中,BAO计划可更好地保护危及器官.