| 陈飞虎,潘香,吴星娆,等.左侧全乳保乳放疗心肺相关剂量分布的几何参数分析[J].中华放射医学与防护杂志,2026,46(4):376-381.Chen Feihu,Pan Xiang,Wu Xingrao,et al.Analysis of geometric parameters influencing cardiopulmonary dose distribution during whole-breast radiotherapy after left-sided breast-conserving surgery[J].Chin J Radiol Med Prot,2026,46(4):376-381 |
| 左侧全乳保乳放疗心肺相关剂量分布的几何参数分析 |
| Analysis of geometric parameters influencing cardiopulmonary dose distribution during whole-breast radiotherapy after left-sided breast-conserving surgery |
| 投稿时间：2024-12-30 |
| DOI：10.3760/cma.j.cn112271-20241230-00499 |
| 中文关键词: 几何参数|剂量-体积|相关性|左肺|心脏 |
| 英文关键词:Geometric parameters|Dose-volume metric|Correlation|Left lung|Heart |
| 基金项目:国家自然科学基金(12565027) |
| 作者 | 单位 | E-mail | | 陈飞虎 | 昆明医科大学第三附属医院 云南省肿瘤医院 北京大学肿瘤医院云南医院放射治疗科, 昆明 650118 | | | 潘香 | 昆明医科大学第三附属医院 云南省肿瘤医院 北京大学肿瘤医院云南医院放射治疗科, 昆明 650118 | | | 吴星娆 | 昆明医科大学第三附属医院 云南省肿瘤医院 北京大学肿瘤医院云南医院放射治疗科, 昆明 650118 | | | 刘旭红 | 昆明医科大学第三附属医院 云南省肿瘤医院 北京大学肿瘤医院云南医院放射治疗科, 昆明 650118 | | | 王茹 | 昆明医科大学第三附属医院 云南省肿瘤医院 北京大学肿瘤医院云南医院放射治疗科, 昆明 650118 | | | 李前艳 | 昆明医科大学第三附属医院 云南省肿瘤医院 北京大学肿瘤医院云南医院放射治疗科, 昆明 650118 | | | 谭嗣盟 | 昆明医科大学第三附属医院 云南省肿瘤医院 北京大学肿瘤医院云南医院放射治疗科, 昆明 650118 | | | 孔银武 | 昆明医科大学第三附属医院 云南省肿瘤医院 北京大学肿瘤医院云南医院放射治疗科, 昆明 650118 | | | 柏晗 | 昆明医科大学第三附属医院 云南省肿瘤医院 北京大学肿瘤医院云南医院放射治疗科, 昆明 650118
云南大学物理与天文学系, 昆明 650091 | cellbaihan@163.com |
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| 中文摘要: |
| 目的 探讨某些特定几何参数对左侧全乳保乳放疗患者左肺和心脏剂量的影响。方法 采用容积旋转调强(VMAT)技术为30例患者进行计划设计。根据靶区的解剖几何形状,为患者靶区逐层定义一个三角形ABC,通过这些三角覆盖区域与心肺靶体积有关的某些特定几何参数被定义,分别是重叠心脏与全心脏体积比(Rat-H)、重叠肺与左侧肺体积比(Rat-L)、靶区厚度(d)和靶区曲率(ρ)。探讨了这4个参数分别与心脏剂量指标(V5h、V10h、V20h、MCD)和左肺剂量指标(V5LL、V10LL、V20LL、V30LL、V40LL、MLD)之间的关系,并采用SPSS 25.0软件对这些参数进行分析。结果 心脏剂量指标(V5h、V10h、MCD)均与Rat-H存在相关性(R = 0.40~0.43,P < 0.05)且有统计学意义,左肺剂量指标(V5LL、V10LL、V20LL、V30LL、V40LL、MLD)均与Rat-L存在相关性(R = 0.44~0.57,P < 0.05)且有统计学意义,而左肺V20LL、V30LL和V40LL与d存在相关性(R = -0.50~-0.39,P < 0.05)且有统计学意义,同时左肺V30LL和V40LL与ρ存在相关性(R = -0.37、-0.46,P < 0.05)且有统计学意义。左肺的剂量-体积指标与这4种几何参数可用线性回归方程来表示。结论 左乳全乳放疗中这些特定的几何参数Rat-H、Rat-L、d和ρ均与心脏和左肺的剂量-体积相关指标具有一定的线性相关性且有统计学意义,为左乳癌保乳放疗心脏和左肺几何参数相关的剂量分布预测提供临床参考。 |
| 英文摘要: |
| Objective To investigate the effects of specific geometric parameters on the radiation dose to the left lung and heart in patients receiving whole-breast radiotherapy (WBRT) after left-sided breast-conserving surgery. Methods A total of 30 patient with left-sided breast cancer were selected in this study, with their treatment plans designed using volumetric modulated arc therapy (VMAT) technology. Based on the geometrical anatomy of the planning target volume (PTV), a triangular ABC of the target was defined layer by layer. Subsequently, certain specific geometric parameters related to cardiopulmonary target volumes were defined, including the ratio of overlapping heart to total heart volume (Rat-H), the ratio of overlapping lung to left-lung volume (Rat-L), and the thickness (d) and curvature (ρ) of the target volume. The relationships of these four parameters with the dose-volume metrics of both the heart [V5h, V10h, V20h, and mean cardiac dose (MCD)] and the left lung [V5LL, V10LL, V20LL, V30LL, V40LL, and mean lung dose (MLD)] were investigated and analyzed using the SPSS 25.0 software. Results The dose-volume metrics of the heart (V5h, V10h, and MCD) exhibited positive correlations with Rat-H, with statistical significance (R = 0.40-0.43, P < 0.05). The dose-volume metrics of the left lung (V5LL, V10LL, V20LL, V30LL, V40LL, and MLD) all showed positive correlations with Rat-L, with statistical significance (R = 0.44-0.57, P < 0.05). Among the dose-volume metrics of the left lung, V20LL, V30LL, and V40LL demonstrated negative correlations with d (R = -0.50 to -0.39, P < 0.05), with statistical significance. Meanwhile, the V30LL and V40LL demonstrated negative correlations with ρ (R = -0.37, -0.46, P < 0.05), with statistical significance. The correlations of the dose-volume metrics of the left lung and the geometric parameters could be expressed by linear regression functions. Conclusions During WBRT after left-sided breast-conserving surgery, the geometric parameters (Rat-H, Rat-L, d, and ρ) demonstrated linear correlations with the cardiopulmonary dose-volume metrics, with statistical significance. These findings provide clinical reference for predicting the cardiopulmonary dose distribution related to geometric parameters in WBRT. |
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