Wu Weiwei, Yin Hui, Liu Zhiwei, Liu Lipeng, Xiao Chengjian, Xiao Ying, Ding Jinquan, Zhang Qungui, Guo Hailiang
Center of Radiation Oncology, Ganzhou Cancer Hospital, Ganzhou, Jiangxi, China.
Medical Imaging Department, Ganzhou Cancer Hospital, Ganzhou, Jiangxi, China.
Front Oncol. 2024 Nov 21;14:1418723. doi: 10.3389/fonc.2024.1418723. eCollection 2024.
Compared the dosimetric characteristics of half-field-based VMAT and half-field-based IMRT for left breast cancer patients combined with deep inspiration breath-hold (DIBH) and free breathing (FB) techniques.
Twenty-one left breast cancer patients were included. Each patient underwent DIBH and FB CT scans, IMRT and VMAT plans in half-field beam mode for both breathing techniques, resulting in four plans: FB-IMRT (F-IMRT), FB-VMAT (F-VMAT), DIBH-IMRT (D-IMRT) and DIBH-VMAT (D-VMAT). The conformity index (CI), homogeneity index (HI), and the doses received at the heart, left anterior descending (LAD), left lung, right breast, and right lung, were compared among plans.The correlation between the difference in the volume of lung_L (ΔLVL) and the difference in the mean dose (ΔDmean) of lung_L under the DIBH and FB plans, the correlation between the difference in the heart-chest distance (ΔHCD) and the ΔDmean of the heart,LAD under the DIBH and FB plans.
The D-VMAT plan lower lung_L V5 than both the F-IMRT and F-VMAT plans (<0.05), The D-VMAT plan lower values for V10, V20, V30, and Dmean than did the other plans ( < 0.05). For the heart, the D-VMAT plan lower V5, V10, V20, and Dmean values than did the other plans ( < 0.05). The D1% and Dmax of the heart and the Dmax and Dmean of the LAD obtained with the D-VMAT plan were lower than those obtained with the F-IMRT and F-VMAT plans ( < 0.05). ΔHCD exhibited correlation with the ΔDmean of the LAD between the D-VMAT and F-IMRT plans and between the D-VMAT and F-VMAT plans (R = -0.765 and -0.774, respectively, = 0.000).
the D-VMAT plan offered enhanced protection for OARs. The integration of the DIBH technique with half-field and VMAT technology in the D-VMAT plan offers a superior dose distribution.
比较基于半野的容积调强弧形放疗（VMAT）和基于半野的调强放疗（IMRT）在左乳腺癌患者中联合深吸气屏气（DIBH）和自由呼吸（FB）技术时的剂量学特征。
纳入21例左乳腺癌患者。每位患者均接受DIBH和FB CT扫描，以及针对两种呼吸技术的半野射束模式下的IMRT和VMAT计划，从而产生四个计划：FB-IMRT（F-IMRT）、FB-VMAT（F-VMAT）、DIBH-IMRT（D-IMRT）和DIBH-VMAT（D-VMAT）。比较各计划之间的适形指数（CI）、均匀性指数（HI），以及心脏、左前降支（LAD）、左肺、右乳腺和右肺所接受的剂量。比较DIBH和FB计划下肺_L体积差异（ΔLVL）与肺_L平均剂量差异（ΔDmean）之间的相关性，以及DIBH和FB计划下心脏-胸壁距离差异（ΔHCD）与心脏、LAD的ΔDmean之间的相关性。
D-VMAT计划的肺_L V5低于F-IMRT和F-VMAT计划（<0.05），D-VMAT计划的V10、V20、V30和Dmean值低于其他计划（<0.05）。对于心脏，D-VMAT计划的V5、V10、V20和Dmean值低于其他计划（<0.05）。D-VMAT计划所获得的心脏D1%和Dmax以及LAD的Dmax和Dmean低于F-IMRT和F-VMAT计划（<0.05）。在D-VMAT与F-IMRT计划之间以及D-VMAT与F-VMAT计划之间，ΔHCD与LAD的ΔDmean存在相关性（R分别为-0.765和-0.774，P = 0.000）。
D-VMAT计划对危及器官（OARs）提供了更好的保护。D-VMAT计划中DIBH技术与半野和VMAT技术的结合提供了更优的剂量分布。
