左侧乳腺癌深吸气屏气放疗：两个时期中心肺剂量的变化。
Left-sided Breast Cancer Irradiation With Deep Inspiration Breath-hold: Changes in Heart and Lung Dose in Two Periods.
机构信息
Clinic for Radiation Therapy and Special Oncology, Hannover Medical School, Hannover, Germany
Clinic for Radiation Therapy and Special Oncology, Hannover Medical School, Hannover, Germany.
出版信息
In Vivo. 2022 Jan-Feb;36(1):314-324. doi: 10.21873/invivo.12704.
Abstract
BACKGROUND/AIM: Post-operative radiotherapy for breast cancer can increase cardiac disease in a dose-dependent manner. In this study we show the reduction of dose to heart and left anterior descending artery (LAD) which can be achieved by using "Deep inspiration breath-hold" (DIBH) technique.
PATIENTS AND METHODS
Tangential 3D-planned radiation was delivered to 357 patients with left-sided breast cancer, 159 of them with the DIBH technique. A distinction was made according to fractionation scheme.
RESULTS
The mean heart dose was significantly reduced by DIBH from 2.64 Gy to 1.39 Gy (p<0.001). The mean dose to the LAD was significantly reduced from 5.68 Gy to 3.88 Gy (p<0.001). Mean dose and volume receiving 5, 10 and 15 Gy of ipsilateral lung were higher with both hypofractionated schedule and conventional fractionation in the DIBH group.
CONCLUSION
DIBH in left-sided breast irradiation is an effective method of reducing the radiogenic heart dose.
摘要
背景/目的：乳腺癌术后放疗会导致心脏疾病，且剂量依赖性明显。本研究旨在展示“深吸气屏气”（DIBH）技术可降低心脏和左前降支（LAD）的剂量。
患者与方法
357 例左侧乳腺癌患者接受了切线 3D 计划放疗，其中 159 例采用了 DIBH 技术。根据分割方案进行了区分。
结果
DIBH 可显著降低心脏剂量，从 2.64Gy 降至 1.39Gy（p<0.001）。LAD 平均剂量从 5.68Gy 降至 3.88Gy（p<0.001）。同侧肺 5、10 和 15Gy 的平均剂量和体积在 DIBH 组中，无论是在低分割方案还是常规分割方案中均较高。
结论
左侧乳腺癌放疗中 DIBH 是降低放射性心脏剂量的有效方法。
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3
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CA Cancer J Clin. 2021 Jan;71(1):7-33. doi: 10.3322/caac.21654. Epub 2021 Jan 12.
4
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