Christopherson Kaitlin M, Gunther Jillian R, Fang Penny, Peterson Stacy L, Roach Karen E, Wong Pei-Fong, Mirkovic Dragan, Lim Tze Yee, Wang He, Wang Xin A, Wang Congjun, Garcia John, Dabaja Bouthaina S, Pinnix Chelsea C
Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Clin Transl Radiat Oncol. 2020 Jun 9;24:79-82. doi: 10.1016/j.ctro.2020.05.013. eCollection 2020 Sep.
We hypothesized that deep inspiration breath-hold (DIBH) and computed-tomography image-guided radiotherapy (CT-IGRT) may be beneficial to decrease dose to organs at risk (OARs), when treating the stomach with radiotherapy for lymphoma. We compared dosimetric parameters of OARs from plans generated using free-breathing (FB) versus DIBH for 10 patients with non-Hodgkin lymphoma involving the stomach treated with involved site radiotherapy. All patients had 4DCT and DIBH scans. Planning was performed with intensity modulated radiotherapy (IMRT) to 30.6 Gy in 17 fractions. Differences in target volume and dosimetric parameters were assessed using a paired two-sided -test. All heart and left ventricle parameters including mean dose, V30, V20, V10, and V5 were statistically significantly lower with DIBH. For IMRT-FB plans the average mean heart dose was 4.9 Gy compared to 2.6 Gy for the IMRT-DIBH group (p < 0.001). There was a statistically significant decrease in right kidney dose with DIBH. For lymphoma patients treated to the stomach with IMRT, DIBH provides superior OAR sparing compared to FB-based planning, most notably reducing dose to the heart and left ventricle. This strategy could be considered when treating other gastric malignancies.
我们假设，对于淋巴瘤患者进行胃部放疗时，深吸气屏气（DIBH）联合计算机断层扫描图像引导放疗（CT-IGRT）可能有助于降低危及器官（OARs）的剂量。我们比较了10例接受累及野放疗的胃非霍奇金淋巴瘤患者在自由呼吸（FB）和DIBH状态下生成的计划中OARs的剂量学参数。所有患者均进行了4DCT和DIBH扫描。采用调强放疗（IMRT）计划，分17次给予30.6 Gy剂量。使用配对双侧检验评估靶区体积和剂量学参数的差异。DIBH状态下所有心脏和左心室参数，包括平均剂量、V30、V20、V10和V5，均有统计学显著降低。对于IMRT-FB计划，平均心脏平均剂量为4.9 Gy，而IMRT-DIBH组为2.6 Gy（p < 0.001）。DIBH状态下右肾剂量有统计学显著降低。对于接受IMRT治疗胃部的淋巴瘤患者，与基于FB的计划相比，DIBH能更好地保护OARs，最显著的是降低了心脏和左心室的剂量。在治疗其他胃恶性肿瘤时可考虑采用这种策略。
