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目的:探讨危及器官的不同定义对左侧乳腺癌逆向调强放疗计划的影响。方法:各20例改良根治术和保乳术的左侧乳腺癌患者纳入本研究,放疗前均行增强定位CT薄层扫描。当靶区包括内乳区时,比较将全心(A组)和全心+冠状动脉左前降支(LAD)(B组)作为危及器官时计划靶区(PTV)和各危及器官(OAR)的剂量-体积的变化。结果:2组计划的PTV、双侧肺的剂量-体积无明显差异,但B组的心脏和LAD的部分剂量-体积参数明显低于A组,而患侧肺的部分剂量-体积参数却高于A组,差异均具有统计学意义(P<0.05)。结论:为更好地保护心脏、LAD,左侧乳腺癌放疗内乳区时应增加LAD作为独立的危及器官。
OBJECTIVE: To investigate the impact of different definitions of endangered organs on the reverse-modulated radiotherapy program for left breast cancer. Methods: Twenty cases of left breast cancer with modified radical mastectomy and conservative surgery were enrolled in this study, and enhanced CT scanning was performed before radiotherapy. When the target region included the internal mammary region, the whole heart (group A) and total heart + coronary artery left anterior descending (LAD) (group B) were compared as the target organ at risk (PTV) and each organ at risk (OAR) The dose-volume change. Results: There was no significant difference in dose-volume between the two groups of PTV and bilateral lungs, but the dose-volume parameters of heart and LAD in group B were significantly lower than those in group A, while the dose-volume parameters of ipsilateral lung were high In group A, the differences were statistically significant (P <0.05). Conclusion: In order to better protect the heart, LAD, left breast cancer radiotherapy within the breast area should increase LAD as an independent organ at risk.