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左侧乳房切除术患者三维适形放疗(3D-CRT)与调强放疗技术(IMRT)的剂量学比较及放疗剂量模拟

Dosimetric Comparison of Three-Dimensional Conformal Radiotherapy (3D-CRT) and Intensity Modulated Radiotherapy Techniques (IMRT) with Radiotherapy Dose Simulations for Left-Sided Mastectomy Patients.

作者信息

Aras Serhat, İkizceli Türkan, Aktan Meryem

机构信息

Department of Medical Imaging Techniques, University of Health Sciences, İstanbul, Turkey.

Department of Radiology, University of Health Sciences, İstanbul, Turkey.

出版信息

Eur J Breast Health. 2019 Apr 1;15(2):85-89. doi: 10.5152/ejbh.2019.4619. eCollection 2019 Apr.

Abstract

OBJECTIVE

To compare 3-dimensional conformal radiotherapy (3D-CRT) and intensity modulated radiotherapy (IMRT) techniques on the target tissue and critical organ doses in terms of dosimetry, during treatment planning of patient's post-mastectomy radiotherapy (PMRT) to the left chest wall.

MATERIALS AND METHODS

Twenty breast cancer patients with left-sided post-mastectomy have selected for PMRT both 3D-CRT and IMRT techniques. Dosimetric calculation of dose simulation in Eclipse treatment planning system have been performed. Organs at risk with the maximum dose, minimum dose, mean dose, D95, conformity and homogeneity indexes and total monitor unit for the Planning Target Volume were compared in terms of the critical organ doses.

RESULTS

There was no significant difference between the two treatment planning techniques in terms of maximum, minimum, mean dose and heterogeneity index (p>0.05). At low doses, the dose received at the heart was significantly lower with the 3D-CRT technique, but there was no statistically significant difference between the two techniques at the maximum and average doses in the high dose regions.

CONCLUSION

For PMRT to the left chest wall, IMRT significantly improves the conformity of plan and reduce the high-dose volumes of ipsilateral lung and heart compared to 3D-CRT, but 3D-CRT is superior in terms of low-dose volume.

摘要

目的

在左侧胸壁乳腺癌改良根治术后放疗(PMRT)患者的治疗计划中,从剂量学角度比较三维适形放疗(3D-CRT)和调强放疗(IMRT)技术对靶组织和危及器官剂量的影响。

材料与方法

选取20例左侧乳腺癌改良根治术后患者,对其进行3D-CRT和IMRT技术的PMRT。在Eclipse治疗计划系统中进行剂量模拟的剂量计算。从危及器官剂量方面比较计划靶体积的最大剂量、最小剂量、平均剂量、D95、适形度和均匀性指数以及总监测单位。

结果

两种治疗计划技术在最大剂量、最小剂量、平均剂量和异质性指数方面无显著差异(p>0.05)。在低剂量时,3D-CRT技术使心脏接受的剂量显著降低,但在高剂量区域的最大剂量和平均剂量方面,两种技术之间无统计学显著差异。

结论

对于左侧胸壁的PMRT,与3D-CRT相比,IMRT显著提高了计划的适形度并减少了同侧肺和心脏的高剂量体积,但3D-CRT在低剂量体积方面更具优势。

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