目的: 通过对前列腺癌调强和适形放疗方案的比较,选择前列腺癌最佳放疗方案。方法: 选取8例前列腺癌患者,经过增强CT模拟定位后参考盆腔磁共振结果勾画大体肿瘤体积,按统一标准外扩临床靶体积和PTV,应用三维治疗计划系统为每例患者设计调强适形放疗计划(IMRT)和三维适形放疗计划,在规定PTV至少达到95%处方剂量前提下根据剂量体积直方图比较两种计划靶区剂量分布及直肠、膀胱、股骨头等正常组织受量的差异。结果: 调强放疗的靶区适形度指数、均匀性指数、处方剂量覆盖PTV百分比较好,减少了直肠、膀胱和股骨头剂量,差异均有统计学意义(P <0.05)。结论: 前列腺癌采用IMRT是目前最佳的一种放疗方法。 |
[1] 郭应禄.泌尿外科内镜诊断治疗学[M].北京:北京大学医学出版社,2004:98-103.
[2] 殷蔚伯,余子豪.肿瘤放射治疗学[M].北京:中国协和医科大学出版社,2008:945-976.
[3] HANKS G E,HANLON A L,EPSTEIN B,et al.Dose response in prostate cancer with 8-12 years'follow-up[J] .Int J Radiat Oncol Biol Phys,2002,54:427-435.
[4] BRAGG C M,CONWAY J,ROBINSON M H.The roleofintensi-ty-modulated radiothera-Py in the treatment of parotid tumors[J] .Int J Radiat Oncol Biol Plays,2002,52(3):729-738.
[5] LIU H,WANG X,DONG L,et al.Feasibility of sparing lung and other thoracic structures with intensity-modulated radiotherapy for non-small cell lung cancer[J] .Int J Radiat Oncol Biol Phys,2004,58(4):1268-1279.
[6] CHAUVET B,OOZEER R,BEY P,et al.Radioth rapie conformationnelle des cancer de la prostate:revue générale[J] .Cancer Radiother,1999,3:393-406.
[7] DEARNALEY D,HALL E,JACKSON C,et al.Phase Ⅲ trial of conformal radiothepy following neoadjuvant hormone treatement in early prostate cancer[J] .Proc ASTRO,2002,54:228-232.
[8] 房辉,李晔雄.前列腺癌的适形和调强适形放疗[J] .癌症进展杂志,2005,3(5):449-459.
[9] 金大伟,戴建荣,李晔雄,等.前列腺癌调强放疗的治疗方案比较[J] .中华放射肿瘤学杂志,2005,14(1):47-51.
[10] ASBELL S O,MARTZ K L,SHIN K H,et al.Impact of surgical stage in evaluating the radiotherapeutic outcome in RTOG 77-06,a phase Ⅲ study for T1BN0M0(A2)And T2N0M0(B) prostate cancer[J] .Int J Radiat Oncol Biol Phys,1998,40:769-773.
[11] KUBAN D,POLLACK A,HUANG E,et al.Hazards of escalation in prostate cancer radiotherapy[J] .Int J Radiat Oncol Biol Phys,2003,57:1260-1266.
[12] FISCH B M,PICKETT B,WEINBERG V,et al.Dose of radiation received by the bulb of the penis correlates with risk of impotence after three-dimensional conformal radiotherapy for prostate cancer[J] .Adult Urology,2001,57:955-961. |