Adeneye Samuel, Akpochafor Michael, Adegboyega Bolanle, Alabi Adewumi, Adedewe Nusirat, Joseph Adedayo, Fatiregun Omolara, Omojola Akintayo, Adebayo Abe, Oluwadara Esther
Department of Radiation Biology, Division of Radiotherapy and Radiodiagnosis, College of Medicine, University of Lagos/NSIA-LUTH Cancer Centre, Lagos, Nigeria.
Department of Radiotherapy, Lagos University Teaching Hospital, Lagos, Nigeria.
Eur J Breast Health. 2021 Jun 24;17(3):247-252. doi: 10.4274/ejbh.galenos.2021.6357. eCollection 2021 Jul.
This study aimed to evaluate the dosimetric properties of treatment plans obtained from three-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy techniques (IMRT) plans for left chest wall breast cancer patients.
A total of 20 patients with left-sided chest wall radiotherapy were randomly selected with the dose prescriptions: 42 Gy and 45 Gy in 15 and 18 fractions, respectively. Treatment plans were obtained using 3D-CRT and IMRT for each patient. Five to seven beams were used for IMRT, while tangential beams were used for 3D-CRT. Planning target volume, D ( ), D ( ), D, Homogeneity and Conformity Indices (HI and CI) were obtained. Similarly, mean doses to organs at risk (OAR), V, V, V, V were generated from the dose-volume histogram and compared.
IMRT showed a significant improvement in HI compared to 3D-CRT (p<0.0001). Although there was no significant difference in sparing of the left lung between both plans for high-dose volumes (V20: 18.2 vs 30.55, p<0.0001), (V25: 11.17 vs 28.12, p<0.0001). IMRT however showed supremacy to 3D-CRT with high-dose volumes for the heart, including V20 (4.44 vs 10.29, p = 0.02), V25 (2.08 vs 8.94, p = 0.002). 3D-CRT was better than IMRT in low-dose volumes for left lung (V5: 92.23 vs 56.60, p<0.001; V10: 60.98 vs 47.20, p = 0.04) and heart (V5: 57.45 vs 30.39, p = 0.004).
IMRT showed better homogeneity and sparing of high-dose volumes to OAR than 3D-CRT. On the other hand, 3D-CRT showed a reduction of low-dose volumes to OARs than IMRT.
本研究旨在评估三维适形放疗（3D-CRT）和调强放疗技术（IMRT）计划应用于左胸壁乳腺癌患者时的剂量学特性。
随机选取20例左侧胸壁放疗患者，剂量处方分别为：42 Gy分15次和45 Gy分18次。为每位患者分别制定3D-CRT和IMRT治疗计划。IMRT使用5至7个射野，而3D-CRT使用切线野。获取计划靶体积、D（ ）、D（ ）、D、均匀性指数和适形指数（HI和CI）。同样，从剂量体积直方图生成危及器官（OAR）的平均剂量、V、V、V、V，并进行比较。
与3D-CRT相比，IMRT的HI有显著改善（p<0.0001）。尽管两种计划在高剂量体积下对左肺的保护方面无显著差异（V20：18.2对30.55，p<0.0001），（V25：11.17对28.12，p<0.0001）。然而，在心脏的高剂量体积方面，IMRT优于3D-CRT，包括V20（4.44对10.29，p = 0.02），V25（2.08对8.94，p = 0.002）。在左肺（V5：92.23对56.60，p<0.001；V10：60.98对47.20，p = 0.04）和心脏（V5：57.45对30.39，p = 0.004）的低剂量体积方面，3D-CRT优于IMRT。
与3D-CRT相比，IMRT显示出更好的均匀性以及对OAR高剂量体积的保护。另一方面，3D-CRT显示出对OAR低剂量体积的减少优于IMRT。
