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[目的]优化全乳腺放疗时野中野调强技术的设计方法。[方法]选取乳腺癌保乳术后患者10例,用野中野调强技术设计全乳腺放疗计划,每例患者分别用完全正向法(正向法)、完全正向加楔形板补偿法(正楔法)和正向加逆向直接射野优化(DMPO)法(正逆法)设计三个治疗计划并进行对比。[结果]只有正逆法的计划靶区(PTV)剂量分布能达到目标要求(平均剂量5000cGy,均匀性为±5%),其覆盖99%靶区体积的剂量为4753±28cGy,接受高于5250cGy剂量的靶区体积为0.2%,剂量不均匀性指数为1.092±0.005,均明显优于正向法和正楔法(P<0.05)。三种方法中同侧肺、左心室和对侧乳房的受量无明显差异。[结论]正向加DMPO的正逆法得到的剂量分布最好,正向加楔形板法产生的照射野最为简单。
[Objective] To optimize the design method of Nakano field intensity adjustment technique in the whole breast radiotherapy. [Method] Ten patients with breast conserving surgery after breast-conserving surgery were selected. The whole-breast radiotherapy program was designed by using wild-field technique. Each patient was treated with complete forward method (positive method), complete plus wedge plate compensation method Positive wedge method) and forward and reverse direct field optimization (DMPO) method (forward and reverse method) to design and compare the three treatment plans. [Results] Only the target dose (PTV) dose distribution of forward and reverse method could achieve the target requirement (average dose of 5000cGy, uniformity of ± 5%), the dose covering 99% of target volume was 4753 ± 28cGy, The target volume of 5250cGy dose was 0.2%, and the dose inhomogeneity index was 1.092 ± 0.005, which was significantly better than that of the positive and positive wedge methods (P <0.05). Three methods in the ipsilateral lung, left ventricle and contralateral breast by the amount of no significant difference. [Conclusion] The positive and negative DMPO plus positive and negative methods had the best dose distribution, and the radiation field produced by the wedge-shaped plate method was the most simple.