直肠癌术后盆腔三维适形放疗、简化调强技术和适形调强放疗的三维剂量学比较分析［摘要］目的比较三维适形放疗、简化调强放疗和适形调强放疗在直肠癌术后放疗中的三维剂量学差异。方法选择2008年1月〜2013年1月在本院进行直肠癌术后放疗口无放疗禁忌证患者342例，分别使用三维适形放疗、简化调强放疗以及适形调强放疗方案，按照国际标准评价方法比较3种放疗方案的靶区平均剂量、靶区适形指数、剂量不均性指数及子野机器跳数。结果靶区平均剂量：三维适形放疗比简化调强放疗、适形调强放疗剂量要高，差异有统计学意义（P0.05）。靶区适形指数：三维适形放疗指数最低（P0.05）。剂量不均性指数：适形调强放疗最高，简化调强放疗最低，3种方案差异有统计学意义（P0.05）。结论3种化疗方案屮，简化调强技术性价比最好，值得临床推广应用。［关键词］三维适形放疗；简化调强放疗；适形调强放疗；直肠癌术后［中图分类号］R735.3+7［文献标识码］A［文章编号］1674-4721（2015）05（b）-0060-03Comparativeanalysisofthreedimensionaldosimetryforthreedimensionalconformalradiotherapy,simplifiedintensity-modulatedtechniqueandintensity-modulatedconformalradiotherapyofpelviccavityafterrectaicarcinomaoperationLIUKe-jiaDepartmentofRadiotherapy,theFirstPeople'sHospitalofTianmenCityinHubeiProvince,Tianmen431700,China[Abstract]ObjectiveTocomparethediffereneeofthreedimensionaldosimetryforhreedimensionalconformalradiotherapy,simplifiedintensity-modulatedtechniqueandintensity-modulatedconformalradiotherapyinpostoperativeradiotherapyofrectalcarcinoma.Methods342patientswithoutcontraindicationofradiotherapywhoreceivedradiotherapyafterrectaicarcinomaoperationinourhospitalfromJanuary2008toJanuary2013wereselected.Theyweregiventhreedifferentschemesofthreedimensionalconfonnalradiotherapy,simplifiedintensity-modulatedradiotherapyandintensity-modulatedconformalradiotherapyrespectively.Meandosageintargetregion,conformalindexintargetregion,anddoseheterogeneityindexandmachineunit(MU)ofsegmentofthreekindsofradiotherapyplanwascomparedrespectively.ResultsAsformeandosageintargetregion,dosageofthree-dimensionalconformalradiotherapywashigherthanthatofsimplifiedintensity-modulatedradiotherapyandintensity-modulatedconformalradiotherapy,andtherewasastatisticaldifferenee(P0.05).Asforconfornialindexintargetregion,indexofthreedimensionalconformalradiotherapywasthelowest,andthediffereneewasstatisticallysignificant(P0・05).Asfordoseheterogeneityindex,indexofintensity-modulatedconformalradiotherapywasthehighest,andtheindexofsimplifiedintensity-modulatedradiotherapywasthe1owestandtherewasastatisticaldifferenceamongthreekindsofmethod(P0.05).ConclusionAmongthreeschemesofradiotherapy,costperformanceofsimplifiedintensity-modulatedtechniqueisthebest,anditisworthyofclinicalpromotionandapplication.[Keywords]Threedimensionalconformalradiotherapy；Simplifiedintensity-modulatedtechnique；Intensity-modulatedconformalradiotherapy；Afterrectalcarcinoma直肠癌是我国最常见的消化道恶性肿瘤之一，发病位置在齿状线与乙状结肠交界处，其位置深入盆腔，解剖结构复杂，术后复发率较高，术后放疗成为根治直肠癌、降低复发率的关键[1-2]o目前临床上常用的盆腔放疗有三维适形放疗、简化调强放疗和适形调强放疗3种。本文回顾性总结了本院2008〜2013的342例直肠癌术后放疗患者的三维剂量学，以便为后续临床工作的开展提供理论依据。1资料与方法1.1一般资料选择2008年1月〜2013年1月在本院进行直肠癌术后放疗的患者342例，术后病理结果均为直肠癌，无放疗禁忌证。其中男性患者192例，女性患者150例，年龄37-71岁，平均(45.68±16.33)岁,KPS评分$70分，分期为n~m期。1.2方法...