| 赵峰,陆中杰,姚国荣,等.深吸气屏气技术在左侧乳腺癌保乳术后放疗中的应用[J].中华放射医学与防护杂志,2017,37(11):821-825.Zhao Feng,Lu Zhongjie,Yao Guorong,et al.Application of deep inspiration breath hold in postoperative radiotherapy for left-side breast cancer[J].Chin J Radiol Med Prot,2017,37(11):821-825 |
| 深吸气屏气技术在左侧乳腺癌保乳术后放疗中的应用 |
| Application of deep inspiration breath hold in postoperative radiotherapy for left-side breast cancer |
| 投稿时间：2017-05-13 修订日期：2017-05-13 |
| DOI：10.3760/cma.j.issn.0254-5098.2017.11.004 |
| 中文关键词: 乳腺癌 放射治疗 深吸气屏气 危及器官 辐射剂量 |
| 英文关键词:Breast cancer Radiotherapy Deep inspiration breath hold Organs at risk Radiation dose |
| 基金项目:浙江省自然科学基金（LQ15H180001） |
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| 中文摘要: |
| 目的 比较3种呼吸模式在左侧乳腺癌保乳术后全乳放疗中的剂量学差异，以探索能最大程度地减少靶区周围重要组织器官照射体积和剂量的呼吸模式。方法 前瞻性选取18例左侧早期乳腺癌保乳术后需行放疗的患者，采集自由呼吸（FB）、胸式深吸气屏气（T-DIBH）及腹式深吸气屏气（A-DIBH）3种呼吸模式下的CT图像，随后行适形放疗计划设计，比较3种呼吸模式下的剂量学参数，包括剂量-体积直方图、靶区平均剂量及靶区剂量均匀指数、危及器官平均剂量等。结果 3种呼吸模式下，计划靶区体积、计划靶区平均剂量及计划靶区剂量均匀指数等差异均无统计学意义（P>0.05）；FB、T-DIBH及A-DIBH3种模式下的危及器官受量在心脏Dmean分别为（3.21±1.02）、（1.74±0.51）及（1.31±0.41） Gy，差异有统计学意义（W=171，P<0.05）；冠状动脉左前降支（LAD）Dmean分别为（34.61±13.51）、（14.38±10.20）及（9.21±6.53） Gy，差异有统计学意义（W=171，P<0.05）；左侧肺Dmean分别为（8.31±2.75）、（7.46±1.96）及（6.89±1.79） Gy，差异有统计学意义（W=171，P<0.05）。结论 两种深吸气屏气技术（T-DIBH或A-DIBH）可显著降低心脏、LAD及左肺等危及器官的照射剂量，且不影响放疗靶区剂量；而A-DIBH比T-DIBH在降低各危及器官的照射剂量方面更具优势。 |
| 英文摘要: |
| Objective To investigate the dosimetric differences among three types of breath hold mode (free breath:FB, thoracic deep inspiration breath hold:T-DIBH, abdomen deep inspiration breath hold:A-DIBH) and to explore the optimal breath hold method in the postoperative radiotherapy of left-side breast cancer patients with minimum dose to normal tissues and organs at risk. Methods A total of eighteen patients with left-side breast cancer patients who underwent postoperative radiotherapy were enrolled in this study. Three CT simulation scans with three different breath hold method (FB, T-DIBH, and A-DIBH) were performed for each patient. Dosimetric differences were compared among plans generated on these three different CT image sets. Results There was no significant difference in the volume, mean dose, and homogeneity of planning target volume (PTV) among plans generated from three different image sets (P>0.05). The mean heart dose, mean LAD dose and mean ipsilateral lung dose in plans generated from CT image sets with FB, T-DIBH and A-DIBH were (3.21±1.02), (1.74±0.51),(1.31±0.41) Gy (W=171, P<0.05), (34.61±13.51), (14.38±10.20), (9.21±6.53) Gy (W=171, P<0.05), and (8.31±2.75), (7.46±1.96), (6.89±1.79) Gy (W=171, P<0.05), respectively. Conclusions Compared with plans with FB, plans with DIBH (T-DIBH and A-DIBH) achieved lower cardiac, LAD and pulmonary doses. A-DIBH achieved a better normal dose reduction than T-DIBH. |
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