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。
