剂量梯度函数在降低乳腺癌放疗中放射性肺损伤的应用。
Application of dose-gradient function in reducing radiation induced lung injury in breast cancer radiotherapy.
机构信息
Department of Radiation Oncology, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Cancer Center of Yunnan Province, Xishan District, Kunming, Yunnan, People's Republic of China.
Department of Physics and Astronomy, Yunnan University, Kunming, Yunnan.
出版信息
J Xray Sci Technol. 2024;32(2):415-426. doi: 10.3233/XST-230198.
OBJECTIVE
Try to create a dose gradient function (DGF) and test its effectiveness in reducing radiation induced lung injury in breast cancer radiotherapy.
MATERIALS AND METHODS
Radiotherapy plans of 30 patients after breast-conserving surgery were included in the study. The dose gradient function was defined as DGH=VDVp3, then the area under the DGF curve of each plan was calculated in rectangular coordinate system, and the minimum area was used as the trigger factor, and other plans were triggered to optimize for area reduction. The dosimetric parameters of target area and organs at risk in 30 cases before and after re-optimization were compared.
RESULTS
On the premise of ensuring that the target dose met the clinical requirements, the trigger factor obtained based on DGF could further reduce the V5, V10, V20, V30 and mean lung dose (MLD) of the ipsilateral lung in breast cancer radiotherapy, P < 0.01. And the D2cc and mean heart dose (MHD) of the heart were also reduced, P < 0.01. Besides, the NTCPs of the ipsilateral lung and the heart were also reduced, P < 0.01.
CONCLUSION
The trigger factor obtained based on DGF is efficient in reducing radiation induced lung injury in breast cancer radiotherapy.
目的
尝试创建剂量梯度函数（DGF），并测试其在降低乳腺癌放疗中放射性肺损伤的有效性。
材料与方法
本研究纳入了 30 例接受保乳手术后的患者的放疗计划。将剂量梯度函数定义为 DGH=VDVp3，然后在直角坐标系中计算每个计划的 DGF 曲线下面积，将最小面积用作触发因素，并触发其他计划以减少面积。比较 30 例患者在重新优化前后靶区和危及器官的剂量学参数。
结果
在保证靶区剂量满足临床要求的前提下，基于 DGF 的触发因素可进一步降低乳腺癌放疗中同侧肺的 V5、V10、V20、V30 和平均肺剂量（MLD），P＜0.01。同时，心脏的 D2cc 和平均心剂量（MHD）也降低了，P＜0.01。此外，同侧肺和心脏的 NTCPs 也降低了，P＜0.01。
结论
基于 DGF 的触发因素在降低乳腺癌放疗中放射性肺损伤方面是有效的。
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