摘要
目的 对比自主呼吸门控系统(ABC)和Catalyst呼吸门控系统在左侧乳腺癌保乳术后的剂量学差异.方法 回顾性选取深圳市人民医院放疗科2020年11月至2021年8月收治的左侧乳腺癌保乳术后女性患者48例,分成ABC和Catalyst组,设计动态调强放疗(IMRT)计划.分析2组计划的靶区和危及器官的剂量学差异.结果 2组呼吸门控IMRT计划在胸壁靶区的D90％、D98％、Dmax、Dmean、适形指数、均匀性指数及机器跳数方面差异无统计学意义(P＞0.05).2种呼吸门控深吸气屏气(DIBH)模式IMRT计划在患侧肺、心脏方面差异无统计学意义(P＞0.05).ABC组和Catalyst组冠状动脉左前降支Dmean、Dmax、D2％依次为(1 047.72±1 401.84)vs.(454.48±206.26)、(1 619.28±809.05)vs.(1 068.53±419.63)、(1 405.85±798.30)vs.(1 016.54±592.00)cGy,Catalyst 优于 ABC 呼吸门控组,差异有统计学意义(t=-2.07、-3.18、-2.07,P＜0.05).结论 ABC和Catalyst呼吸门控系统均满足临床治疗要求,Catalyst较ABC呼吸门控可进一步降低冠状动脉左前降支受照射剂量.
Abstract
Objective To compare the dosimetric differences between active breathing coordinator(ABC)and Catalyst for respiratory gating after breast conserving surgery for left breast cancer.Methods Data of 48 female patients with left breast cancer after breast conserving surgery admitted to the Radiotherapy Department of Shenzhen People's Hospital from November 2020 to August 2021 were retrospectively selected.They were randomized to receive dynamic intensity modulated radiotherapy(IMRT)plans with ABC or Catalyst.The dosimetric differences in targets and organs at risk between the two groups were analyzed.Results Comparison of the two respiratory gating IMRT plans revealed no statistically significant differences(P＞0.05)in D90％,D98％,Dmax,Dmean,conformity index(CI),homogeneity index(HI),and monitor unit parameters in the target volume,(i.e.,chest wall),as well as the ipsilateral lung and heart under the deep inhalation breath hold(DIBH)mode.The Dmean,Dmax,and D2％of the left anterior descending coronary artery(LAD)in the Catalyst group were better than those in the ABC group[(1 047.72±1 401.84)vs.(454.48±206.26),(1 619.28±809.05)vs.(1 068.53±419.63),(1 405.85±798.30)vs.(1 016.54±592.00)cGy],with statistically significant differences(t=-2.07,-3.18,-2.07,P＜0.05).Conclusions Both ABC and Catalyst respiratory gating systems meet the requirements for clinical treatment,with the latter more effective in reducing the exposure dose of LAD.
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