摘要
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(D_(mean))、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D_(mean)、V_(5)、V_(10)、V_(20)、V_(30)、V_(40)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D_(mean)、最大剂量(D_(max))、最小剂量(D_(min))、V_(40)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D_(mean)与LAD D_(mean)呈正相关(r=0.72),FB的心脏D_(mean)与LAD D_(mean)也呈正相关(r=0.69)。与FB比较,ADIBH的左肺D_(mean)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V_(5)、右肺D_(mean)、右乳D_(mean)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。
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 parameters of the two modes were compared.Results There was no significant difference in the mean dose(D_(mean)),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 D_(mean),V_(5),V_(10),V_(20),V_(30) and V_(40) 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 D_(mean),maximum dose(D_(max)),minimum dose(D min)and V_(40) 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 D_(mean) and LAD D_(mean) in the ADIBH mode(r=0.72),and between heart D_(mean) and LAD D_(mean) in the FB mode(r=0.69).Compared with the FB mode,the left lung D_(mean) 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 V_(5),right lung D_(mean) and right breast D_(mean) 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.
作者
张炎
滕芸
唐罗勇
徐宝芹
林啸东
胡望远
ZHANG Yan;TENG Yun;TANG Luoyong;XU Baoqin;LIN Xiaodong;HU Wangyuan(Department of Radiotherapy,Affiliated Jinhua Hospital of Wenzhou Medical University,Jinhua,Zhejiang 321015,China)
出处
《重庆医学》
CAS
2024年第4期576-581,共6页
Chongqing medicine
基金
浙江省金华市科技局重点项目(2022-3-119)。
关键词
乳腺癌
放射治疗
腹式深吸气屏气
自由呼吸
辐射剂量
breast cancer
radiation therapy
abdomina deep inspiration breath hold
free breath
radiation dose
