Dosimetric effects of ADIBH and FB on intensity modulated radiation therapy for left breast cancer after breast conserving surgery and modified radical surgery
Objective To investigate the dosimetric effects of two respiratory techniques[abdominal deep inspiration breath holding(ADIBH)and free breathing(FB)]on the intensity modulated radiation therapy(IMRT)for left breast cancer after breast conserving surgery and modified radical surgery.Methods ADIBH and FB during IMRT were performed in 50 patients with left breast cancer after breast conserving surgery(30 cases)or modified radical surgery(20 cases).The CT positioning images of the patients were collected,and IMRT planning was performed.The parameters of planned target area(PTV)[mean dose(Dmean),homogeneity index(HI),conformity index(CI)],and organ at risk(OAR)[volume percentage of the heart receiving 40,30,20 Gy radiation(V40,V30,V20)and Dmean,left anterior descending coronary artery(LAD Dmean,V30,V20)and the left lung(Dmean,V30,V20)]underwent the two respiratory techniques were compared.The difference in OAR dose parameters between ADIBH and FB was compared between the patients underwent breast conserving surgery and those underwent modified radical surgery.Results For the patients underwent breast conserving surgery and modified radical surgery,there were no significant differences in PTV parameters(Dmean,HI and CI)between ADIBH and FB(P＞0.05).Dosimetric parameters of LAD(Dmean,V20,V30),the heart(Dmean,V20,V30,V40)and the left lung(Dmem,V20,V30)underwent ADIBH were significantly lower than those underwent FB(P＜0.05).Compared with the modified radical surgery,the difference of LAD V20 in the patients with breast conserving surgery was changed more(P＜0.05).The difference of LAD Dmean was greater than that of heart Dmean in the patients underwent breast conserving surgery and modified radical surgery(P＜0.05).Conclusion ADIBH can reduce the radiation doses of the heart,LAD and left lung and play a role in protecting the heart and lung,in IMRT patients after left breast cancer surgery,regardless of breast conserving surgery or modified radical surgery.
Breast cancerIntensity modulated radiation therapyAbdominal deep inspiration breath holdingFree breathingHeart protection
NETL
NSTL
万方数据
