Zhang Kunpeng, He Ruixin, Tang Fenwen, Zhou Luping, Zhang Xiaozhi, Li Jinsheng, Wei Zhiwei, Li Yi
Department of Radiotherapy, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Our United Corporation, Xi'an, China.
Front Oncol. 2024 Aug 21;14:1397273. doi: 10.3389/fonc.2024.1397273. eCollection 2024.
Radiotherapy is a primary therapeutic approach for breast cancer following breast-conserving surgery. The TaiChiB dual-modality radiotherapy system combining X-ray and focused γ-ray, offers a new approach to reduce the radiation dose of organs at risk (OARs) and has the potential to mitigate the adverse effects of radiotherapy. Currently, there are few studies on the dosimetric characteristics of the TaiChiB dual-modality system for actual treatment plans for specific diseases. The purpose of this work is to study the dosimetric advantages of dual-modal systems for right breast patients after breast-conserving surgery.
Treatment plans for 20 patients with right breast cancer were generated for a linear accelerator (LINAC) based system and the TaiChiB dual-modality system, respectively. Volumetric modulated arc therapy plans with simultaneous integrated boost (VMAT-SIB) were made for the LINAC. Focused γ-ray was used to deliver the boost dose with the dual-modality system. The dosimetric parameters of the target and OARs were evaluated and compared between the treatment plans generated for the two systems.
The TaiChiB dual-modality plans exhibit a higher conformal index (CI) and lower gradient index (GI) for the PGTV and PTV compared with the LINAC-based VMAT-SIB plans. Compared to VMAT-SIB plans, the PTV Dmax, PTV Dmean, PTV V110, PGTV Dmax, and PGTV Dmean of the TaiChiB dual-modality plans are significantly lower. Meanwhile, the dose to OARs, such as the Dmean of the heart, the V5 of liver, the Dmean of ipsilateral lung, the V30 of ipsilateral lung, the V20 of ipsilateral lung, the V5 of ipsilateral lung, the Dmean of contralateral lung, Dmax of contralateral breast and the Dmean of contralateral breast are significantly reduced.
Our study demonstrates the dosimetric advantages of the novel TaiChiB dual-modality radiotherapy system for the treatment of right-sided breast cancer. Overall, for the TaiChiB dual-modality radiotherapy system, the radiation dose outside the target region decreases rapidly, thereby minimizing radiation exposure to neighboring organs and ensuring the conformity of the target area. Our research confirms the potential of the TaiChiB dual-modality system for future radiotherapy.
放射治疗是保乳手术后乳腺癌的主要治疗方法。太极B双模态放射治疗系统结合了X射线和聚焦γ射线，为降低危及器官（OARs）的辐射剂量提供了一种新方法，并且有可能减轻放射治疗的不良反应。目前，针对特定疾病的实际治疗计划，关于太极B双模态系统剂量学特征的研究较少。本研究的目的是探讨双模态系统对保乳手术后右乳患者的剂量学优势。
分别为基于直线加速器（LINAC）的系统和太极B双模态系统生成20例右乳腺癌患者的治疗计划。为LINAC制定了容积调强弧形放疗计划并同步推量（VMAT-SIB）。双模态系统使用聚焦γ射线进行推量。评估并比较了两种系统生成的治疗计划中靶区和OARs的剂量学参数。
与基于LINAC的VMAT-SIB计划相比，太极B双模态计划在PGTV和PTV方面表现出更高的适形指数（CI）和更低的梯度指数（GI）。与VMAT-SIB计划相比，太极B双模态计划的PTV Dmax、PTV Dmean、PTV V110、PGTV Dmax和PGTV Dmean显著更低。同时，心脏Dmean、肝脏V5、同侧肺Dmean、同侧肺V30、同侧肺V20、同侧肺V5、对侧肺Dmean、对侧乳腺Dmax和对侧乳腺Dmean等OARs的剂量显著降低。
我们的研究证明了新型太极B双模态放射治疗系统在治疗右侧乳腺癌方面的剂量学优势。总体而言，对于太极B双模态放射治疗系统，靶区外的辐射剂量迅速降低，从而将对邻近器官的辐射暴露降至最低，并确保靶区的适形性。我们的研究证实了太极B双模态系统在未来放射治疗中的潜力。
