适度深吸气呼吸控制状态下全乳腺正向调强外照射的剂量学研究  

Dosimetry of moderate deep inspiration breath hold achieved using an active breathing control device in the target of forward whole-breast intensity-modulated radiotherapy after breast conserving surgery in breast cancer

作　　者：何振宇[1] 迟锋[1] 李凤岩[1] 王俊杰[2] 吴三纲[1] 管迅行[1] 

机构地区：[1]华南肿瘤学国家重点实验室中山大学肿瘤防治中心放疗科,广东广州510060 [2]河南省新乡市中心医院肿瘤内科,河南新乡453000

出　　处：《中华肿瘤防治杂志》2011年第16期1273-1276,共4页Chinese Journal of Cancer Prevention and Treatment

基　　金：广东省科技计划社会发展项目(2008B060600019)

摘　　要：目的:评估适度深吸气(mDIBH)呼吸控制状态下乳腺癌保留乳房术后全乳正向调强外照射的剂量学优势。方法:入组的18例乳腺癌保留乳房术患者,在自主呼吸控制技术配合下进行CT定位扫描,获得1幅自由呼吸(FB)及1幅mDIBH的图像。采用Pinnacle7.4f治疗计划系统,分别在FB的图像上和mDIBH的图像制定全乳腺正向调强外照射计划,比较2个计划的正常组织和靶区的受照射情况。结果:FB状态下的计划靶区剂量均匀性及适形性与mDIBH状态下的计划相似(1.08±0.01 vs 1.09±0.01,P=0.776;0.59±0.08 vs 0.60±0.04,P=0.821);FB状态下患侧肺V20和V30分别为(13.07±3.93)%和(11.68±3.90)%,均较mDIBH状态下的(9.75±3.58)%和(8.12±3.23)%高,P=0.000。9例左侧乳腺癌患者在FB状态下心脏的V20和V30分别为(5.42±3.21)%和(3.70±2.84)%,均较mDIBH状态下的(2.73±1.95)%和(1.48±0.22)%高,P<0.05。结论:与FB状态相比,mDIBH呼吸控制状态下可减少乳腺癌保留乳房术后全乳腺正向调强外照射的肺和心脏受照射剂量。OBJECTIVE：To evaluate the dosimetry advantages of moderate deep inspiration breath hold（mDIBH） achieved using an active breathing control（ABC） device in the target of forward whole-breast intensity-modulated radiotherapy after breast conserving surgery in breast cancer.METHODS： 18 patients after breast conserving surgery had received primary CT-simulation assisted by ABC to get two sets of CT image on the two breathing conditions which included one set from free breath（FB）,and the other set from mDIBH.Forward whole-breast intensity-modulated radiotherapy plans were carried out in each set of CT image using Pinnacle7.4 f planning systems and the differences of two plans had been compared.RESULTS： The coverage index and habituation index of the plans in FB were similar with those in mDIBH（1.08±0.01） vs（1.09±0.01）,P=0.776;0.59±0.08 vs 0.60±0.04,P=0.821）.The V20 and V30 of Ipsilateral lung in FB were higher than those in mDIBH（13.07±3.93）% vs（9.75±3.58）%,（11.68±3.90）% vs（8.12±3.23）%,P=0.000;In the left breast cancer,The V20 and V30 of heart in FB were higher than those in mDIBH（5.42±3.21）% vs（2.73±1.95）%,（3.70±2.84）% vs（1.48±0.22）%,P0.05.CONCLUSION： Compared with FB,mDIBH achieved using an ABC device significantly reduces heart and lung doses in the target of forward whole-breast intensity-modulated radiotherapy after breast conserving surgery in breast cancer.

关 键 词：乳腺肿瘤/放射疗法 调强放射治疗 自主呼吸控制 

分 类 号：R737.9[医药卫生—肿瘤]