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目的:分析胰腺癌三维适形放疗(three dimention conform radiotherapy,3DCRT)治疗计划、5野调强放疗(5beamIMRT)治疗计划和7野调强放疗(7beamIMRT)治疗计划,确定患者选择合适的放射治疗方法。方法:对10例胰腺癌的患者分别制定3DCRT、5beamIMRT和7beamIMRT治疗计划,对其计划的靶区剂量分布和危及器官的差异进行评估。结果:V110%剂量区3DCRT剂量高于5beamIMRT和7beamIMRT,差异有统计学意义,P=0.001。7beamIMRT的CI值均大于3DCRT和5beamIMRT,其适形度最好,而3DCRT的CI值较5beamIMRT略高,适形度较5beamIMRT好,差异有统计学意义,P<0.001。7beamIMRT的HI值均低于3DCRT和5beamIMRT,差异有统计学意义,P<0.001。肝脏D1/3剂量区3DCRT高于5beamIMRT和7beamIMRT,差异有统计学意义,P=0.003。肝脏Dmean区3DCRT高于5beamIMRT和7beamIMRT,差异有统计学意义,P=0.025。脊髓Dmax区7beamIMRT高于5beamIMRT和3DCRT,差异有统计学意义,P<0.001。结论:7beamIMRT在靶区处方剂量、CI、HI、肝脏受量上优于3DCRT及5beamIMRT;3DCRT脊髓受量上优于5beamIMRT和7beamIMRT,双肾受量D1/3、D1/2上7beamIMRT要低于5beamIMRT和3DCRT;7beamIMRT所需跳数做多;7beamIMRT对于胰腺癌癌放疗具有放射物理优势。
OBJECTIVE: To analyze the plans of three dimensional conformal radiotherapy (3DCRT), 5beamIMRT and 7beamIMRT in patients with pancreatic cancer and to determine the appropriate radiotherapy method . Methods: 3DCRT, 5beamIMRT and 7beamIMRT treatment plans were made for 10 patients with pancreatic cancer, and their planned target dose distribution and organ damage-related differences were evaluated. Results: The dose of 3DCRT in V110% dose region was higher than that of 5beamIMRT and 7beamIMRT, the difference was statistically significant. The CI value of P = 0.001.7beamIMRT was greater than that of 3DCRT and 5beamIMRT, and the conformability was the best, while that of 3DCRT was slightly higher than that of 5beamIMRT , Conformality than 5beamIMRT good, the difference was statistically significant, P <0.001.7beamIMRT HI values were lower than the 3DCRT and 5beamIMRT, the difference was statistically significant, P <0.001. The 3DCRT of liver D1 / 3 dose area was higher than that of 5beamIMRT and 7beamIMRT, the difference was statistically significant (P = 0.003). The 3DCRT of liver Dmean area was higher than that of 5beamIMRT and 7beamIMRT, the difference was statistically significant, P = 0.025. Spinal cord Dmax area 7beamIMRT higher than 5beamIMRT and 3DCRT, the difference was statistically significant, P <0.001. CONCLUSION: 7beamIMRT is superior to 3DCRT and 5beamIMRT in prescription dose, CI, HI and liver volume. 3DCRT is better than 5beamIMRT and 7beamIMRT in spinal cord, and the ratio of D1 / 3 to D1 / 2 and 7beamIMRT in D1 / 2 is lower than 5beamIMRT and 3DCRT; 7beamIMRT needed to do more hops; 7beamIMRT radiotherapy for pancreatic cancer with radiological advantages.