Wang Wei, Wang Jinzhi, Qiu Pengfei, Sun Tao, Zhang Yingjie, Shao Qian, Xu Min, Liu Xijun, Li Jianbin
Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China.
Breast Cancer Center, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China.
Front Oncol. 2020 Apr 9;10:456. doi: 10.3389/fonc.2020.00456. eCollection 2020.
To investigate the effect of anatomic and technical parameters on the incidental internal mammary lymph node (IMN) irradiation (IIMNI) dose among postmastectomy patients. We retrospectively delineated the IMN on planning CT images from 138 patients who had undergone postmastectomy radiotherapy (PMRT). We analyzed the IIMNI dose coverage and its relationship with anatomic and technical parameters. The IIMNI mean dose was 32.85 ± 9.49 Gy, and 10 of 138 patients (7.25%) treated with PMRT received ≥45 Gy. In univariate analysis, the body weight, body mass index, body surface area, thoracic transverse diameter (D), ratio of D to the thoracic anteroposterior diameter (D)(R), planning target volume of IMN (PTV) included in PTV (IMNin) and the ratio of IMNin to PTV (R) and PTV posterior border were the parameters affecting IIMNI dose. In multivariate analysis, body weight, R, and R were correlative factors that affected IIMNI dose. For patients who underwent PMRT without IMN irradiation (IMNI), there was a wide variety in IIMNI doses. A minority of patients had adequate IIMNI dose coverage, and the higher IIMNI doses were associated with the less body weights and more R.
为研究解剖学和技术参数对乳房切除术后患者术中内乳淋巴结（IMN）照射（IIMNI）剂量的影响。我们回顾性地在138例接受乳房切除术后放疗（PMRT）患者的计划CT图像上勾画IMN。我们分析了IIMNI剂量覆盖情况及其与解剖学和技术参数的关系。IIMNI平均剂量为32.85±9.49 Gy，138例接受PMRT治疗的患者中有10例（7.25%）接受的剂量≥45 Gy。单因素分析中，体重、体重指数、体表面积、胸廓横径（D）、D与胸廓前后径之比（R）、计划靶体积（PTV）中包含的IMN计划靶体积（PTV）（IMNin）以及IMNin与PTV之比（R）和PTV后边界是影响IIMNI剂量的参数。多因素分析中，体重、R和R是影响IIMNI剂量的相关因素。对于未进行IMN照射（IMNI）而接受PMRT的患者，IIMNI剂量差异很大。少数患者有足够的IIMNI剂量覆盖，较高的IIMNI剂量与较低的体重和较高的R相关。
