在无法应用深吸气屏气技术时，持续气道正压通气对左侧乳房切除术后放疗期间心脏和肺部辐射剂量的影响：一例报告
The impact of continuous positive airway pressure on radiation dose to heart and lung during left-sided postmastectomy radiotherapy when deep inspiration breath hold technique is not applicable: a case report.
作者信息
Kil Whoon Jong, Pham Tabitha, Hossain Sabbir, Casaigne Juan, Jones Kellie, Khalil Mohammad
机构信息
Medicine Service, Radiation Oncology Clinic, Oklahoma City VA Health Care System, Oklahoma City, OK, USA.
University of Oklahoma Health Science Center, Oklahoma City, OK, USA.
出版信息
Radiat Oncol J. 2018 Mar;36(1):79-84. doi: 10.3857/roj.2018.00017. Epub 2018 Mar 2.
Abstract
Deep inspiration breathing hold (DIBH) compared to free-breathing (FB) during radiotherapy (RT) has significantly decreased radiation dose to heart and has been one of the techniques adopted for patients with breast cancer. However, patients who are unable to make suitable deep inspiration breath may not be eligible for DIBH, yet still need to spare the heart and lung during breast cancer RT (left-sided RT in particular). Continuous positive airway pressure (CPAP) is a positive airway pressure ventilator, which keeps the airways continuously open and subsequently inflates the thorax resembling thoracic changes from DIBH. In this report, authors applied CPAP instead of FB during left-sided breast cancer RT including internal mammary node in a patient who was unable to tolerate DIBH, and substantially decreased radiation dose the heart and lung with CPAP compared to FB.
摘要
与放疗（RT）期间自由呼吸（FB）相比，深吸气屏气（DIBH）显著降低了心脏的辐射剂量，并且一直是乳腺癌患者采用的技术之一。然而，无法进行适当深吸气的患者可能不符合DIBH的条件，但在乳腺癌放疗期间（尤其是左侧放疗）仍需要保护心脏和肺部。持续气道正压通气（CPAP）是一种气道正压通气设备，它能使气道持续开放，随后使胸腔充气，类似于DIBH时的胸部变化。在本报告中，作者在一名无法耐受DIBH的患者的左侧乳腺癌放疗（包括内乳淋巴结）期间应用了CPAP而非FB，与FB相比，CPAP显著降低了心脏和肺部的辐射剂量。
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