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左侧乳腺癌三维适形放射治疗中肺剂量的评估:一项模体研究

Evaluation of the Lung Dose in Three-dimensional Conformal Radiation Therapy of Left-Sided Breast Cancer: A Phantom Study.

作者信息

Abdemanafi Mahsa, Tavakoli Mohammad Bagher, Akhavan Ali, Abedi Iraj

机构信息

Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Department of Radiotherapy Oncology, Seyed Alshohada Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

J Med Signals Sens. 2020 Feb 6;10(1):48-52. doi: 10.4103/jmss.JMSS_1_19. eCollection 2020 Jan-Mar.

Abstract

BACKGROUND

Three-dimensional 3D-CRT: conformal radiation therapy is a selective modality in many radiotherapy centers for the treatment of breast cancer. One of the most common side effects of this method is radiation lung injury. Considering such an injury, lung dose deserves to be studied in depth.

METHODS

Computed tomography scan of a node-positive left-sided breast cancer woman was used for generating a thorax phantom. Ten thermoluminescent dosimeters (TLDs) were distributed evenly in the left lung of the phantom, and the phantom was scanned. The optimal plan, including supraclavicular and tangential fields, was created by the treatment planning system (TPS). The results of TLD dose measurements at the selected points in the phantom were compared to TPS dose calculations.

RESULTS

Lung doses calculated by TPS are significantly different from those measured by the TLDs ( = 0.007). The minimum and maximum differences were -0.91% and 4.46%, respectively. TLDs that were on the inner margin of the lung and breast tissue showed higher dose differences than the TLDs in the lung.

CONCLUSION

The results of this study showed that TPS generally overestimated doses compared to TLD measurements due to incorrect beam modeling caused by contaminated electrons in the lung.

摘要

背景

三维适形放疗(3D-CRT)是许多放疗中心治疗乳腺癌的一种选择性方式。这种方法最常见的副作用之一是放射性肺损伤。考虑到这种损伤,肺剂量值得深入研究。

方法

使用一名左侧淋巴结阳性乳腺癌女性的计算机断层扫描来生成胸部体模。十个热释光剂量计(TLD)均匀分布在体模的左肺中,并对体模进行扫描。由治疗计划系统(TPS)创建包括锁骨上野和切线野的优化计划。将体模中选定点处的TLD剂量测量结果与TPS剂量计算结果进行比较。

结果

TPS计算的肺剂量与TLD测量的剂量有显著差异(P = 0.007)。最小和最大差异分别为-0.91%和4.46%。位于肺和乳腺组织内缘的TLD显示出比肺内TLD更高的剂量差异。

结论

本研究结果表明,由于肺内受污染电子导致的束流建模不正确,与TLD测量相比,TPS通常高估了剂量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/529c/7038741/f004be0c5727/JMSS-10-48-g001.jpg

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