Suppr超能文献

高剂量率近距离放射治疗联合三维适形放疗与调强放疗在累及内乳链的左侧乳腺癌患者中的应用:剂量学和技术参数的比较分析

HDR brachytherapy combined with 3-D conformal vs. IMRT in left-sided breast cancer patients including internal mammary chain: comparative analysis of dosimetric and technical parameters.

作者信息

Kinhikar Rajesh Ashok, Deshpande Sudesh Sharad, Mahantshetty Umesh, Sarin Rajiv, Shrivastava Shyam Kishore, Deshpande Deepak Dattatraya

机构信息

Department of Medical Physics, Tata Memorial Hospital, Mumbai 400012.

出版信息

J Appl Clin Med Phys. 2005 Summer;6(3):1-12. doi: 10.1120/jacmp.v6i3.2027. Epub 2005 Aug 12.

Abstract

Treatment of the internal mammary chain (IMC) with radiation therapy (RT) for patients with breast cancer remains a controversial issue. Different treatment techniques have been proposed, including oblique electrons, electron-photon combination, and partially wide tangents (PWTs). However, the residual heart dose can remain significant mainly for left-sided lesions. With PWTs and intensity-modulated radiotherapy (IMRT), respiratory movement and errors in IMC localization remain a problem. The goal of this paper is to evaluate the impact of IMC brachytherapy (IMCBT) combined with 3D conformal radiotherapy (3DCRT) planning on heart, lung, and contralateral breast doses compared with IMRT. All plans including IMCBT plus 3DCRT were done on PLATO; IMRT plans were generated using the Cadplan-Helios inverse treatment-planning software module with the "sliding window" technique. Dose-volume histograms (DVHs) were calculated for all volumes of interest. Conformity and homogeneity index was also calculated for the planning target volume (PTV). Dose distribution in the surrounding normal tissue was evaluated. The mean conformity of the PTV was found to be 1.06 with IMCBT plus 3DCRT and 1.12 with IMRT. The mean homogeneity (HI95/107) was found to be 1.4 with IMCBT plus 3DCRT and 3.32 with IMRT. Using the IMCBT plus 3DCRT technique, the mean dose to the heart, contralateral breast, ipsilateral lung, and contralateral lung decreased with values of 32%, 6.76%, 20% and 5.52%, respectively, compared with IMRT. This novel technique of IMCBT plus 3DCRT can potentially reduce the dose to the heart and lungs. In addition, it rivals IMRT because of its unique advantages in localization, obviating the need for respiratory gating and maximum sparing of heart and other structures.

摘要

对于乳腺癌患者,采用放射治疗(RT)处理内乳链(IMC)仍是一个存在争议的问题。已提出了不同的治疗技术,包括斜向电子线、电子 - 光子联合以及部分宽切线野(PWTs)。然而,主要对于左侧病变,心脏的残留剂量可能仍然较高。使用PWTs和调强放射治疗(IMRT)时,呼吸运动以及IMC定位误差仍是问题。本文的目的是评估与IMRT相比,IMC近距离放射治疗(IMCBT)联合三维适形放射治疗(3DCRT)计划对心脏、肺和对侧乳腺剂量的影响。所有包括IMCBT加3DCRT的计划均在PLATO上完成;IMRT计划使用具有“滑动窗口”技术的Cadplan - Helios逆向治疗计划软件模块生成。为所有感兴趣的体积计算剂量体积直方图(DVH)。还为计划靶体积(PTV)计算了适形度和均匀性指数。评估了周围正常组织中的剂量分布。发现IMCBT加3DCRT时PTV的平均适形度为1.06,IMRT时为1.12。发现IMCBT加3DCRT时平均均匀性(HI95/107)为1.4,IMRT时为3.32。与IMRT相比,使用IMCBT加3DCRT技术时,心脏、对侧乳腺、同侧肺和对侧肺的平均剂量分别降低了32%、6.76%、20%和5.52%。这种IMCBT加3DCRT的新技术可能会降低心脏和肺部的剂量。此外,由于其在定位方面的独特优势,无需呼吸门控且能最大程度地保护心脏和其他结构,它可与IMRT相媲美。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fcae/5723489/1df1e3cb6e5d/ACM2-6-001-g001.jpg

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验