Cholewka Agnieszka, Szlag Marta, Białas Brygida, Kellas-Ślęczka Sylwia, Slosarek Krzysztof
Department of Radiotherapy and Brachytherapy Planning.
Brachytherapy Department, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice, Poland.
J Contemp Brachytherapy. 2013 Dec;5(4):227-31. doi: 10.5114/jcb.2013.39365. Epub 2013 Dec 5.
This study includes four years of our clinical trials to improve implant quality in multicatheter accelerated partial breast irradiation (APBI). The progress in dosimetric and volumetric parameters of the treatment plans was evaluated. One hundred and ninety-one women, for whom treatment plans were made based on three dimensional imaging, were selected for the study. To evaluate progress made in our APBI procedure, following parameters and indices were taken into account: percentage of the target volume receiving the reference dose (PTVref), minimum dose in the target volume expressed as a percentage of reference dose (PTVmin), dose homogeneity index (DHI), and conformity index (COIN). Additionally, the plan quality index was calculated for every group as the sum of mean values of four evaluated parameters. PTVref have increased from the mean value of 83.4% at the beginning to recent 94.8%. The maximum value equals to 95.4%. The same trend can be observed with PTVmin value, which has been improved from 51.7% to 70.1%, maximally. DHI and COIN mean values present similar progress. DHI value increased from 0.53 level to 0.68, and COIN from 0.58 in 2009 to 0.74. Plan quality index has increased from 2.46 in 2009 to 3.06, recently. The implant quality is crucial for the accurate dose distribution. This paper shows the progress that was made in APBI procedure to improve implant quality. Nowadays, our implant technique is based on three-dimensional CT imaging results in acceptable dose distributions.
本研究纳入了我们为提高多导管加速部分乳腺照射（APBI）中植入物质量而进行的四年临床试验。评估了治疗计划在剂量学和体积参数方面的进展。选择了191名基于三维成像制定治疗计划的女性进行研究。为评估我们的APBI程序所取得的进展，考虑了以下参数和指标：接受参考剂量的靶体积百分比（PTVref）、靶体积中的最小剂量占参考剂量的百分比（PTVmin）、剂量均匀性指数（DHI）和适形指数（COIN）。此外，计算了每组的计划质量指数，即四个评估参数平均值的总和。PTVref从开始时的平均值83.4%增加到最近的94.8%。最大值等于95.4%。PTVmin值也呈现相同趋势，已从51.7%最大提高到70.1%。DHI和COIN的平均值也有类似进展。DHI值从0.53提高到0.68，COIN从2009年的0.58提高到0.74。计划质量指数从2009年的2.46提高到最近的3.06。植入物质量对于准确的剂量分布至关重要。本文展示了在APBI程序中为提高植入物质量所取得的进展。如今，我们的植入技术基于三维CT成像，可实现可接受的剂量分布。
