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保乳手术后不同部位序贯或同步加量调强 hypofractionated 全乳照射的对比研究。

A comparative study on hypofractionated whole-breast irradiation with sequential or simultaneous integrated boost on different positions after breast-conserving surgery.

机构信息

Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China.

Department of Radiation Oncology, Shandong Cancer Hospital and Institute (Shandong Cancer Hospital), Shandong First Medical University and Shandong Academy of Medical Sciences, 440 Jiyan Road, Jinan, 250117, China.

出版信息

Sci Rep. 2021 Sep 9;11(1):18017. doi: 10.1038/s41598-021-97520-z.

DOI:10.1038/s41598-021-97520-z
PMID:34504253
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8429685/
Abstract

This study explored the dosimetric difference between hypofractionated whole-breast irradiation (HFWBI) with sequential boost (SEB) and simultaneous integrated boost (SIB) based on supine and prone positions to identify the superior boost mode and superior position. Thirty breast cancer patients eligible for HFWBI after breast-conserving surgery were enrolled. All patients underwent 3DCT simulation scanning in both supine and prone positions. For the SEB-HFWBI plan, the dose prescribed for the planning target volume (PTV) of whole breast (WB) was 2.67 Gy per fraction with a total of 15 fractions, followed by a sequential boost of 3.2 Gy per fraction to the PTV of tumor bed (TB) in 3 fractions. For the SIB-HFWBI plan, the dose prescribed for the PTV of WB was 2.67 Gy per fraction with a total of 15 fractions, with a simultaneously integrated boost of 3.2 Gy per fraction to the PTV of TB with a total of 15 fractions. Regardless of the position, for the PTV of TB, the conformal index (CI) in the SIB-HFWBI plans was greater than those in the SEB-HFWBI plans (T = - 8.114, - 8.114; both P < 0.05). The CI for the PTV of WB increased significantly in the prone position relative to the supine position in both two plans(Z = - 3.340, - 3.501; all P < 0.05). The study suggested that prone SIB-HFWBI might be more suitable for postoperative radiotherapy after breast-conserving surgery for early-stage breast cancer patients.

摘要

本研究旨在探讨仰卧位和俯卧位两种体位下分别行序贯推量（SEB）和同步整合推量（SIB）的全乳低分割放疗（HFWBI）的剂量学差异，以明确优势的推量模式和体位。选择 30 例接受保乳手术后行 HFWBI 的乳腺癌患者，所有患者均在仰卧位和俯卧位进行 3DCT 模拟扫描。SEB-HFWBI 计划中，全乳（WB）计划靶区（PTV）处方剂量为 2.67Gy/ 次，共 15 次，随后对肿瘤床（TB）PTV 行 3.2Gy/ 次的序贯推量，共 3 次。SIB-HFWBI 计划中，WB PTV 处方剂量为 2.67Gy/ 次，共 15 次，同时对 TB PTV 行 3.2Gy/ 次的同步整合推量，共 15 次。无论体位如何，SIB-HFWBI 计划中 TB PTV 的适形指数（CI）均大于 SEB-HFWBI 计划（T=-8.114，-8.114；均 P<0.05）。两种计划中，俯卧位 WB PTV 的 CI 均显著高于仰卧位（Z=-3.340，-3.501；均 P<0.05）。研究提示，对于早期乳腺癌保乳术后患者，俯卧位 SIB-HFWBI 可能更适合术后放疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1005/8429685/97d29fa3b700/41598_2021_97520_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1005/8429685/9016ba6f1317/41598_2021_97520_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1005/8429685/97d29fa3b700/41598_2021_97520_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1005/8429685/9016ba6f1317/41598_2021_97520_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1005/8429685/97d29fa3b700/41598_2021_97520_Fig2_HTML.jpg

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Acute radiation-induced skin toxicity in hypofractionated vs. conventional whole-breast irradiation: An objective, randomized multicenter assessment using spectrophotometry.
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Medicina (Kaunas). 2022 Jun 29;58(7):873. doi: 10.3390/medicina58070873.
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