首页|腹式深吸气屏气和自由呼吸在左侧乳腺癌调强放疗中剂量学比较

腹式深吸气屏气和自由呼吸在左侧乳腺癌调强放疗中剂量学比较

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目的 探讨腹式深吸气屏气(ADIBH)和自由呼吸(FB)在左乳腺癌调强放疗(IMRT)中的剂量学差异。方法 选取2022年7月至2023年5月该院左乳腺癌术后需行辅助放疗的22例患者为研究对象。采集ADIBH和FB两种呼吸模式CT模拟定位图像,勾画计划靶区(PTV)和危及器官,设计IMRT计划,比较两种呼吸模式剂量学参数。结果 ADIBH和FB的PTV平均剂量(Dmean)、均匀性指数(HI)、适形性指数(CI)比较,差异无统计学意义(P>0。05)。与FB比较,ADIBH的心脏Dmean、V5、V10、V20、V30、V40分别下降2。95 Gy、12。21%、8。26%、6。56%、5。41%、3。48%,冠状动脉左前降支(LAD)的 Dmean、最大剂量(Dmax)、最小剂量(Dmin)、V40 分别下降 15。99 Gy、16。10 Gy、0。82 Gy、13。73%,差异有统计学意义(P<0。05)。与 FB 比较,ADIBH 的同一层面心脏受照剂量和体积明显降低。Pearson相关性分析显示,ADIBH的心脏Dmean与LAD Dmean呈正相关(r=0。72),FB的心脏Dmean与LAD Dmean也呈正相关(r=0。69)。与FB比较,ADIBH的左肺Dmean下降0。99 Gy,差异有统计学意义(P<0。05);但两种呼吸模式左肺V5、右肺Dmean、右乳Dmean比较,差异无统计学意义(P>0。05)。结论 ADIBH可有效降低心脏和LAD的剂量,起到良好的保护作用。
Dosimetric comparison between abdominal deep inspiration breath hold and free breath in intensity modulated radiotherapy for left breast cancer
Objective To explore the dosimetric differences between abdominal deep inspiration breath hold(ADIBH)mode and free breath(FB)mode in intensity modulated radiation therapy(IMRT)for left breast cancer.Methods From July 2022 to May 2023,a total of 22 patients who needed adjuvant radiation therapy after left breast cancer surgery in the hospital were selected as the research objects.The simulated computed tomography(CT)positioning images of ADIBH and FB modes were collected,the planned target volume(PTV)and endangered organs were outlined,the IMRT plan was designed,and the dosimetric param-eters of the two modes were compared.Results There was no significant difference in the mean dose(Dmean),homogeneity index(HI)and conformity index(CI)of PTV between the ADIBH and the FB modes(P>0.05).Compared with the FB mode,the heart Dmean,V5,V10,V20,V30 and V40 in the ADIBH mode decreased by 2.95 Gy,12.21%,8.26%,6.56%,5.41%and 3.48%,respectively,and the left anterior descending(LAD)coronary artery Dmean,maximum dose(Dmax),minimum dose(Dmin)and V40 decreased by 15.99 Gy,16.10 Gy,0.82 Gy and 13.73%,respectively,with statistical significance(P<0.05).Compared with the FB mode,the dose and volume of heart irradiation in the ADIBH mode at the same level were significantly reduced.Pearson correlation analysis showed that there was a positive correlation between heart Dmean and LAD Dmean in the ADIBH mode(r=0.72),and between heart Dmean and LAD Dmean in the FB mode(r=0.69).Compared with the FB mode,the left lung Dmean of the ADIBH mode decreased by 0.99 Gy,and the difference was statistically significant(P<0.05).However,there was no significant difference in left lung V5,right lung Dmean and right breast Dmean between the two breathing modes(P>0.05).Conclusion ADIBH mode can effectively reduce the dose to the heart and LAD,and play a good protective role.

breast cancerradiation therapyabdomina deep inspiration breath holdfree breathradia-tion dose

张炎、滕芸、唐罗勇、徐宝芹、林啸东、胡望远

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温州医科大学附属金华医院放疗科,浙江金华 321015

乳腺癌 放射治疗 腹式深吸气屏气 自由呼吸 辐射剂量

浙江省金华市科技局重点项目

2022-3-119

2024

重庆医学
重庆市卫生信息中心,重庆市医学会

重庆医学

CSTPCD
影响因子:1.797
ISSN:1671-8348
年,卷(期):2024.53(4)
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