| Li Dingjie,Ding Danhong,Wei Shengtao,Chen Wenyuan,Li Tian,Cai Jing,Ge Hong.A new approach to spare organs at risk for breast cancer radiotherapy-half field segmented VMAT delivery technique[J].Chinese Journal of Radiological Medicine and Protection,2021,41(5):340-345 |
| A new approach to spare organs at risk for breast cancer radiotherapy-half field segmented VMAT delivery technique |
| Received:September 21, 2020 |
| DOI：10.3760/cma.j.issn.0254-5098.2021.05.004 |
| KeyWords:Breast neoplasms Volumetric modulated arc therapy Half field delivery Organs at risk |
| FundProject: |
| Author Name | Affiliation | E-mail | | Li Dingjie | Department of Radiation Oncology, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China | | | Ding Danhong | Department of Radiation Oncology, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China | | | Wei Shengtao | Department of Radiation Oncology, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China | | | Chen Wenyuan | Yanling County Central Hospital, Xuchang City, Xuchang 461200, China | | | Li Tian | Department of Health Technology and Informatics, Hong Kong Polytechnic University, Hong Kong SAR 999077, China | | | Cai Jing | Department of Health Technology and Informatics, Hong Kong Polytechnic University, Hong Kong SAR 999077, China | | | Ge Hong | Department of Radiation Oncology, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China | gehong666@126.com |
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| Abstract:: |
| Objective To explore a new technology that can protect the lungs and heart better by utilizing the dose distribution attributes of the half-field and the characteristics of the VMAT (volumetric modulated arc therapy) technology. Methods A three-dimensional water tank was used to measure the dose of symmetrical field and half field edge and analyze them comparatively. A total of 50 patients with left breast cancer receiving the postoperative radiotherapy were selected. Among them, 25 patients were performed conserving surgery and 25 patients were performed radical mastectomy. After the operation, all the patients received the prescription dose of 50 Gy in 25 fractions. Based on the Eclipse system, the symmetrical field continuous arc VMAT technology and the semi-field segmented arc VMAT technology were used to design the plan. Besides, the dose suitability data and the treatment efficiency of target areas and organs at risk were compared and analyzed. Results The radiation size of half-field did not increase with the increased depth in the water mode. The symmetric field gradually enlarged due to the angle of tensor factor, increased to about 2 cm at the depth of 30 cm, and the delivery dose in the half-field was lower than that in the symmetric field. The closer the field edge is, the more obvious it is. Compared with the symmetric field continuous arc plan, the half-field segmental arc VMAT plan significantly improved the delivery dose of the lungs and heart (t=-4.11,-4.42,P=0.00), in which the mean values of V5, V30, and Dmean for the whole structure of the heart were reduced by 52.5%, 65.5%, and 47%, respectively. The left anterior descending coronary artery, which was closely related to the target area, had a decrease of more than 20%. The mean values of V5, V10, V20, and Dmean of the affected lung were reduced by 21.6%, 24.8%,25.0%, and 23.2%, respectively. The mean values of the doses of other endangered healthy organs, and the execution time of half-field segment arc plan were also better than the continuous arc plan. Conclusions For breast cancer radiotherapy, the combination of half-field and VMAT can give full play to the advantages of half-field and VMAT, and significantly reduce the irradiated dose of the heart, affected lung, and healthy side of the breast. |
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