Tolia Maria, Platoni Kalliopi, Foteineas Andreas, Kalogeridi Maria-Aggeliki, Zygogianni Anna, Tsoukalas Nikolaos, Caimi Mariangela, Margari Niki, Dilvoi Maria, Pantelakos Panagiotis, Kouvaris John, Kouloulias Vassilis
Maria Tolia, Kalliopi Platoni, Andreas Foteineas, Maria-Aggeliki Kalogeridi, Anna Zygogianni, Maria Dilvoi, Panagiotis Pantelakos, John Kouvaris, Vassilis Kouloulias, 1st and 2nd Department of Radiology, Radiation Oncology Unit, Medical School, Athens 12462, Greece.
World J Radiol. 2011 Sep 28;3(9):233-40. doi: 10.4329/wjr.v3.i9.233.
To measure the dose distribution, related to the treatment planning calculations, in the contralateral mammary gland of breast cancer patients treated with accelerated hypofractionated 3-dimensional conformal radiotherapy.
Thirty-four prospectively selected female patients with right breast cancer (pN0, negative surgical margins) were treated with breast-conserving surgery. A total dose of 42.5 Gy (2.66 Gy/fraction) was prescribed; it was requested that planning target volumes be covered by the 95% isodose line. The contralateral mammary gland was defined on CT simulation. The dose received was evaluated by dose volume histograms.
The measured contralateral breast doses were: (1) Dose maximum: 290-448 cGy [Equivalent (Eq) 337-522 cGy]; (2) Mean dose: 45-70 cGy (Eq 524-815 cGy); and (3) Median dose: 29-47 cGy (337-547 cGy) for total primary breast dose of 42.5 Gy in 16 equal fractions. The spearman rho correlation showed statistical significance between the contralateral breast volume and maximum dose (P = 0.0292), as well as mean dose (P = 0.0025) and median dose (P = 0.046) to the breast.
Minimizing the dose to the contralateral breast has to be one of the priorities of the radiation oncologist when using short schedules because of the radiosensitivity of this organ at risk. Further study is necessary to assess the long-term clinical impact of this schedule.
测量接受加速分割三维适形放疗的乳腺癌患者对侧乳腺的剂量分布，该剂量分布与治疗计划计算相关。
前瞻性选择34例右乳癌女性患者（pN0，手术切缘阴性），接受保乳手术。处方总剂量为42.5 Gy（每次分割剂量2.66 Gy）；要求计划靶体积被95%等剂量线覆盖。在CT模拟时定义对侧乳腺。通过剂量体积直方图评估所接受的剂量。
测量的对侧乳腺剂量为：（1）最大剂量：290 - 448 cGy [等效（Eq）337 - 522 cGy]；（2）平均剂量：45 - 70 cGy（Eq 524 - 815 cGy）；（3）对于16次等分割的总原发乳腺剂量42.5 Gy，中位剂量：29 - 47 cGy（337 - 547 cGy）。Spearman秩相关显示对侧乳腺体积与对侧乳腺的最大剂量（P = 0.0292）、平均剂量（P = 0.0025）和中位剂量（P = 0.046）之间具有统计学意义。
由于该危险器官的放射敏感性，在采用短疗程放疗时，将对侧乳腺的剂量降至最低必须是放射肿瘤学家的首要任务之一。有必要进一步研究评估该疗程的长期临床影响。
