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保乳手术后中国乳腺癌患者仰卧位与俯卧位行体外部分乳房照射。

External-beam partial breast irradiation in a supine versus prone position after breast-conserving surgery for Chinese breast cancer patients.

机构信息

School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Jinan, Shandong province, China.

Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Shandong Academy of Medical Sciences, Jinan, Shandong province, China.

出版信息

Sci Rep. 2018 Oct 18;8(1):15354. doi: 10.1038/s41598-018-33741-z.

Abstract

To investigate the differences in target volumes and dosimetric parameters between the supine and prone positions for external-beam partial breast irradiation (EB-PBI) after breast-conserving surgery (BCS) for Chinese breast cancer patients, thirty breast cancer patients who underwent three-dimensional conformal radiation therapy (3DCRT) EB-PBI after BCS were enrolled. Supine and prone scan sets were acquired during free breathing for all patients. Target volumes and organs at risk (OARs) including the heart, ipsilateral lung and bilateral breast were contoured by the same radiation oncologist. For each patient, supine and prone EB-PBI plans were generated based on the same planning criteria. The clinical target volume (CTV) and planning target volume (PTV) in the prone position were significantly greater than those in the supine position (P = 0.003, 0.004, respectively). A 0.95 Gy reduction in the mean dose (D) to the heart (P = 0.000) was apparent in the supine position compared to the prone position. The D to the ipsilateral lung was significantly lower in the prone position than in the supine position (1.59 Gy vs. 1.72 Gy, P = 0.029). Therefore, for Chinese breast cancer patients, carrying out 3DCRT EB-PBI in the prone position during free breathing is feasible.

摘要

为了研究中国乳腺癌患者保乳手术后外照射部分乳房照射(EB-PBI)中仰卧位和俯卧位之间靶区体积和剂量学参数的差异,我们招募了 30 名接受三维适形放疗(3DCRT)EB-PBI 的乳腺癌患者。所有患者均在自由呼吸时采集仰卧位和俯卧位扫描。由同一位放射肿瘤学家勾画靶区和危及器官(OARs),包括心脏、同侧肺和双侧乳房。对于每位患者,根据相同的计划标准生成仰卧位和俯卧位 EB-PBI 计划。俯卧位的临床靶区(CTV)和计划靶区(PTV)明显大于仰卧位(P = 0.003,0.004)。与俯卧位相比,仰卧位心脏的平均剂量(D)降低了 0.95Gy(P = 0.000)。与仰卧位相比,俯卧位同侧肺的 D 明显降低(1.59Gy 比 1.72Gy,P = 0.029)。因此,对于中国乳腺癌患者,在自由呼吸时进行 3DCRT EB-PBI 俯卧位是可行的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ff98/6193958/686811adc9a4/41598_2018_33741_Fig1_HTML.jpg

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