Clinical Cooperation Unit Molecular Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany;
Clinic and Practice of Radiation Oncology/Practice of Radiology Konstanz, Konstanz, Germany.
Anticancer Res. 2021 Apr;41(4):1909-1920. doi: 10.21873/anticanres.14957.
BACKGROUND/AIM: This comparative plan study examines a range of boost-radiation methods in adjuvant radiotherapy of breast cancer using helical intensity-modulated radiotherapy with TomoEdge-technique. Impact of hypofractionated radiation with simultaneous-integrated boost (SIB) and influence of differing assumed α/β-values were examined.
For 10 patients with left-sided breast cancer each four helical IMRT-plans with TomoEdge-technique were created: hypofractionated+SIB (H-SIB) (42.4/54.4 Gy, 16 fractions), normofractionated+SIB (N-SIB) (50.4/64.4 Gy, 28 fractions), hypofractionated+sequential-boost (H-SB) (42.4 Gy/16 fractions+16 Gy/8 fractions), normofractionated+ sequential-boost (N-SB) (50.4 Gy/28 fractions+16 Gy/8 fractions). Equivalent doses (EQD) to organs-at-risk (OAR) and irradiated mammary-gland were analysed for different assumed α/β-values.
The mean EQD to OAR was significantly lower using hypofractionated radiation-techniques. H-SIB and H-SB were not significantly different. H-SIB and N-SIB conformed significantly better to the breast planning-target volume (PTV) and boost-volume (BV) than H-SB and N-SB. Regarding BV, mean EQD was significantly higher for all α/β-values investigated when using H-SIB and N-SIB. Regarding PTV, there were no clinically relevant differences.
Relating to dosimetry, H-SIB is effective compared to standard-boost-techniques.
背景/目的：本对比计划研究使用带 TomoEdge 技术的螺旋调强放疗（helical intensity-modulated radiotherapy），考察了乳腺癌辅助放疗中一系列增强辐射方法。研究了部分分割放疗联合同步整合推量（hypofractionated radiation with simultaneous-integrated boost，SIB）的影响，以及不同假设的 α/β 值的影响。
为 10 例左侧乳腺癌患者中的每例患者，分别创建了 4 个带 TomoEdge 技术的螺旋调强放疗计划：部分分割联合 SIB（hypofractionated+SIB，H-SIB）（42.4/54.4 Gy，16 个分次）、常规分割联合 SIB（normofractionated+SIB，N-SIB）（50.4/64.4 Gy，28 个分次）、部分分割联合序贯推量（hypofractionated+sequential-boost，H-SB）（42.4 Gy/16 个分次+16 Gy/8 个分次）、常规分割联合序贯推量（normofractionated+sequential-boost，N-SB）（50.4 Gy/28 个分次+16 Gy/8 个分次）。对不同假设的 α/β 值的危及器官（organs-at-risk，OAR）和照射乳腺的等效剂量（equivalent doses，EQD）进行分析。
部分分割放疗技术的 OAR 平均 EQD 显著降低。H-SIB 和 H-SB 之间无显著差异。H-SIB 和 N-SIB 与乳腺计划靶区（PTV）和推量区（boost volume，BV）的吻合度明显优于 H-SB 和 N-SB。关于 BV，所有研究的 α/β 值下，H-SIB 和 N-SIB 的 EQD 均值明显更高。关于 PTV，无临床相关差异。
在剂量学方面，与标准推量技术相比，H-SIB 有效。
