左乳癌保乳术后调强放疗计划三维剂量验证

摘要

Radiotherapy planning verification can ensure that patients receive accurate treatment.We performed Compass three-dimensional dose verification for intensity-modulated radiotherapy (IMRT) plans for 11 patients undergoing breast-conserving surgery for left breast cancer.The dose-volume histograms and Gamma values of the planning target volume (PTV) and the organsat-risk (OAR) were analyzed by comparing the parameters in Compass reconstruction plan with those in Pinnacle treatment planning system.The results showed that the deviation of D1,D95,D99,and Dmean of PTV and OAR were less than 1 Gy,and that of V5,V20 and V30 were less than 1.5％.Under the 3 mm/3％ criterion,the average Gamma value of PTV was 0.45±0.04,and the average passing rate was 92.70％±2.44％,which had a statistical significance;for OAR,the passing rate was nearly 100％.Under the 2 mm/2％ criterion,the mean passing rate of PTV was 78.61％±3.90％,and that of OAR was 97.34％±0.96％.Compass is capable of verifying the feasibility of linear accelerator in radiotherapy planning to facilitate the clinical implementation of radiotherapy plans after breast-conserving surgery for breast cancer.%放疗计划验证能够确保病人接受精准治疗,具有重要临床意义.选取11例左乳癌保乳术后患者,对其调强放疗计划做Compass三维剂量验证.通过Compass重建计划与Pinnacle治疗计划系统数据对比,分析靶区(Planning TargetVolume,PTV)和危及器官(Organs-at-Risk,OAR)的剂量体积直方图与Gamma值.PTV和OAR的D1、D95、D99、Dmean偏差小于1 Gy,V5、V20、V30偏差小于1.5％.在3 mm/3％标准下,PTV平均Gamma值为0.45±0.04,通过率均值为92.70％±2.44％,且具有统计学意义;OAR通过率接近100％.在2 mm/2％标准下,PTV通过率均值为78.61％±3.90％;OAR通过率均值为97.34％±0.96％.Compass验证了直线加速器对放疗计划的执行能力,为乳腺癌保乳术后调强放疗计划的临床应用提供了依据.