乳腺癌保乳术后全乳预防性照射的靶区勾画范围
Target delineation of whole-breast prophylactic irradiation after breast conserving surgery
黄琳 1章斌 1黄松华 1杨力宝 1李超1
作者信息
- 1. 三明市第二医院肿瘤科,福建 三明 366000
- 折叠
摘要
目的 探讨乳腺癌保乳术后全乳预防性照射的靶区勾画范围.方法 选取149例乳腺癌患者,均进行MRI检查,记录乳腺癌病灶位置.选取其中10例左乳腺癌且采取保乳术的患者,分别进行全乳房靶区勾画和乳腺腺体靶区勾画,比较两种靶区勾画方法的剂量学参数.结果 MRI检查显示,149例患者的乳腺癌病灶均位于乳腺腺体内或乳腺腺体边缘,没有患者的乳腺癌病灶独立发生于乳腺腺体外的脂肪组织内.乳腺腺体靶区勾画的照射体积、心脏平均剂量、左肺V20均明显低于全乳房靶区勾画,差异均有统计学意义(P﹤0.01).结论 在对保乳术后患者进行全乳预防性照射时,除原发灶部位需要外扩以降低复发风险外,靶区勾画应仅限于影像学上可见的残余乳腺腺体,无需涵盖整个乳房,从而减少全乳腺照射体积,降低肺部和心脏照射剂量,对部分乳腺癌患者的长期生存有益.
Abstract
Objective To explore the target delineation of whole-breast prophylactic irradiation after breast conserv-ing surgery.Method A total of 149 patients with breast cancer were selected,all patients underwent MRI examination,and the location of breast cancer lesions were recorded.Ten patients with left breast cancer who underwent breast conserv-ing surgery were selected for whole breast target delineation and breast gland target delineation,and the dosimetric param-eters of the two target delineation methods were compared.Result MRI examination showed that the breast cancer le-sions of 149 patients were located in the breast gland or the edge,and no breast cancer lesions occurred independently in the adipose tissues outside of the breast gland.The radiation volume,mean cardiac dose,and the left lung V20 obtained by breast gland target delineation were significantly lower than those by whole breast target delineation,and the differences were statistically significant(P<0.01).Conclusion In the whole-breast prophylactic irradiation of patients after breast conserving surgery,except for the need to expand the primary site to reduce the risk of recurrence,the target delineation should be limited to the residual breast glands visible on imaging,without covering the whole breast tissues,so as to re-duce the volume of whole breast irradiation and the dose of lung and heart irradiation,which is beneficial to the long-term survival of some breast cancer patients.
关键词
乳腺癌/MRI检查/保乳术/靶区勾画Key words
breast cancer/MRI examination/breast conserving surgery/target delineation引用本文复制引用
出版年
2024
NETL
NSTL
维普
万方数据