保乳术后早期乳腺癌患者序贯同步加量放疗的剂量学比较。
Dosimetric Comparison of Sequential Simultaneous-integrated Boost in Early-stage Breast Cancer Patients Treated With Breast-conserving Surgery.
机构信息
Department of Radiation Oncology, Baskent University Faculty of Medicine, Adana, Turkey
Department of Radiation Oncology, Baskent University Faculty of Medicine, Adana, Turkey.
出版信息
In Vivo. 2019 Nov-Dec;33(6):2181-2189. doi: 10.21873/invivo.11720.
Abstract
BACKGROUND/AIM: To compare simultaneous-integrated boost (SIB) versus sequential-boost (SB) delivered in the context of whole-breast irradiation (WBI) via volumetric-modulated arc therapy (VMAT) and helical-tomotherapy (HT).
MATERIALS AND METHODS
Planning target-volume (PTV) dosimetric parameters and organs at risk (OAR) were analyzed for SB plan (50 Gy plus 16 Gy boost) and SIB plan (50.4 Gy WBI and 64.4 Gy tumor bed boost) in VMAT and HT techniques.
RESULTS
Conformity and homogeneity for target-volume doses were better in HT plans compared to VMAT plans. There were no significant differences in ipsilateral lung doses between VMAT and HT plans for SB/SIB techniques, except for a significantly higher lung V5 value with VMAT-SB, and lung V13 value with HT-SIB technique. HT provided a statistically significant decrease in contralateral lung mean V5.
CONCLUSION
The SIB technique showed better target-volume dose distribution in both HT and VMAT plans, and better sparing heart in HT compared to the SB technique.
摘要
背景/目的：比较容积调强弧形治疗（VMAT）和螺旋断层放疗（HT）下全乳照射（WBI）中同步整合推量（SIB）与序贯推量（SB）的剂量学差异。
材料与方法
分析 SB 计划（50Gy 加 16Gy 推量）和 SIB 计划（50.4Gy WBI 和 64.4Gy 肿瘤床推量）在 VMAT 和 HT 技术中的计划靶区（PTV）剂量学参数和危及器官（OAR）。
结果
与 VMAT 计划相比，HT 计划在靶区剂量的适形性和均匀性方面更好。对于 SB/SIB 技术，VMAT 和 HT 计划之间同侧肺剂量没有显著差异，除了 VMAT-SB 的肺 V5 值显著较高，以及 HT-SIB 技术的肺 V13 值较高。HT 可显著降低对侧肺平均 V5。
结论
与 SB 技术相比，SIB 技术在 HT 和 VMAT 计划中均显示出更好的靶区剂量分布，且 HT 对心脏的保护更好。
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