Hejazi Peyman, Tirtash Maede Jafari, Khoshnazar Alireza Khoshbin
Department of Medical Physics, Semnan University of Medical Sciences, Semnan, Iran.
Department of Radiotherapy, Mirdamad Oncology and Radiotherapy Center, Gorgan, Iran.
Breast Cancer (Dove Med Press). 2019 Nov 14;11:303-307. doi: 10.2147/BCTT.S227686. eCollection 2019.
Accelerated partial breast irradiation (APBI) is a method in which just bed of lumpectomy with a margin of 1-2 cm is irradiated. Regarding advantages of APBI to whole-brain radiation therapy (WBRT) and limitations for performing other techniques, we compare external beam radiation therapy (EBRT) with three-dimensional conformal radiation therapy (3DCRT), as a type of APBI technique.
Dosimetric parameters including uniformity index (UI), conformity index (CI), and homogeneity index (HI) beside heart and lung doses were assessed and compared in two techniques. CT images of 24 patients with left-sided breast cancer after lumpectomy were selected. Patients were categorized into three groups based on the volume of breast, respectively, ≤ 1000 cc, 1000-1500 cc, and ≥ 1500 cc. CI, HI, UI and DVH were calculated by DosiSoftIsogray treatment planning software.
Results show the value of UI in APBI method is more than EBRT method significantly (p=0.004). Moreover, that CI in APBI method was more than EBRT (p=0.0000) and nearer to 1. There was no significant difference between HI values between APBI and EBRT methods. As the volume of breast gets bigger, HI values rise, meaning worse homogeneity.
APBI method may be a good method for minimizing side effect and minimizing treatment periods.
加速部分乳腺照射(APBI)是一种仅对切除边缘1 - 2厘米的肿块切除床进行照射的方法。鉴于APBI相对于全脑放射治疗(WBRT)的优势以及实施其他技术的局限性,我们将外照射放疗(EBRT)与作为一种APBI技术的三维适形放疗(3DCRT)进行比较。
评估并比较两种技术的剂量学参数,包括均匀性指数(UI)、适形指数(CI)、均匀性指数(HI)以及心脏和肺部剂量。选择24例左侧乳腺癌肿块切除术后患者的CT图像。根据乳房体积将患者分为三组,分别为≤1000立方厘米、1000 - 1500立方厘米和≥1500立方厘米。CI、HI、UI和剂量体积直方图(DVH)由DosiSoftIsogray治疗计划软件计算得出。
结果显示APBI方法中UI的值显著高于EBRT方法(p = 0.004)。此外,APBI方法中的CI高于EBRT(p = 0.0000)且更接近1。APBI和EBRT方法之间的HI值没有显著差异。随着乳房体积增大,HI值升高,意味着均匀性变差。
APBI方法可能是一种使副作用最小化和治疗周期最短化的好方法。