危及器官的剂量界定（PRV剂量界定）【放疗科医生必备】

危及器官的剂量界定（PRV剂量界定）

 

正常器官名称                                     限定剂量（Gy）

 

脑干 Brain stem (stem)+ 1mm(PRV)                <=54Gy

脊髓 Spinal cord (cord)+5mm(PRV)                <=40Gy或0体积剂量<=45Gy/6周

腮腺      左 L Parotid                          50%体积<30~35Gy

          右 R Parotid                          50%体积<30~35Gy

晶体      左 L Lens                            <=9 Gy

          右R Lens                            <=9 Gy

视神经    左 L Optic nerve                      <=54 Gy

          右 R Optic nerve                      <=54 Gy

视交叉       Optic chiasm                       <=54 Gy

喉、气管     Larynx、Trachea                   <=54 Gy

下颌骨    左 L Mandible                        <=60 Gy

          右 R Mandible                        <=60 Gy

颞颌关节  左 L Temporomandibular Joint (TML)     <=50 Gy                  

          右 R Temporomandibular Joint (TML)     <=50 Gy

颞叶      左 L Temporal lobe (TL)                <=54~60 Gy

          右 R Temporal lobe (TL)                <=54~60 Gy

垂体  Pitutary                                   <=54 Gy (蝶窦受侵者除外)

膀胱  Bladder                                   50%体积<50 Gy

直肠  rectum                                    50％体积<50 Gy

                                                25％体积<70 Gy

股骨颈 Femoral head                              5%体积<50 Gy

心脏 Heart      食道癌                           V40<=50%

肺癌                            40Gy(<100%),50Gy(<50%)

肾脏  Kidney                                   20Gy(双肾<50%或者当另一侧肾脏无功能时的一侧肾脏<75%)

肝脏 Liver                                       30Gy(<40%)

食管                                            60Gy(<50%)

肺   Lung                                      肺平均剂量<=13Gy,两肺V₂₀<=30%

                                                两肺V₃₀<=20%

肺癌                              20Gy(<35%)

术后胸胃                                        V₄₀<=50%(不能有高剂量点)

 

注：脊髓受照体积增加时，脊髓损伤几率会加大，当较大体积的脊髓已经接受到极限剂量时，医生应尽早避开脊髓。一般来讲，脊髓剂量不应当超过60Gy,哪怕是很小的体积。大分割或者每日剂量的增加会降低脊髓的耐受性。如果病人接受了3Gy/fx的治疗，脊髓剂量的上限应为大约40Gy.