深吸气屏气技术在左侧乳腺癌保乳术后动态容积旋转调强放疗中的剂量学分析  

Dosimetric analysis of deep inspiration breath-hold technique with volumetric modulated arc therapy for left breast cancer patients after breast-conserving surgery

作　　者：柴林燕[1] 周灿 蒙渡[1] 王科峰 李茸[1] 王尧 何瑞欣 张晓智[1] CHAI Linyan;ZHOU Can;MENG Du;WANG Kefeng;LI Rong;WANG Yao;HE Ruixin;ZHANG Xiaozhi(Department of Radiotherapy;Department of Breast Surgery,the First Affiliated Hospital of Xi'an Jiaotong University,Shaanxi Xi'an 710061,China;Department of Endocrinology,the Rehabilitation Hospital of Shaanxi,Shaanxi Xi'an 710061,China)

机构地区：[1]西安交通大学第一附属医院放疗科,陕西西安710061 [2]西安交通大学第一附属医院乳腺外科,陕西西安710061 [3]陕西省康复医院内分泌科,陕西西安710061

出　　处：《现代肿瘤医学》2021年第21期3830-3833,共4页Journal of Modern Oncology

基　　金：陕西省科技厅重点研发计划(编号:2019SF-145)。

摘　　要：目的:比较深吸气屏气(deep inspiration breath-hold,DIBH)和自由呼吸(free breathing,FB)两种呼吸模式在左侧乳腺癌保乳术后动态容积旋转调强(volumetric modulated arc therapy,VMAT)放疗中的剂量学差异,探寻左侧乳腺癌保乳术后放疗最佳呼吸模式。方法:选取11例左侧乳腺癌保乳术后女性患者,分别在DIBH-CT和FB-CT图像上设计切线弧t-VMAT计划。结果:DIBH呼吸模式下心脏V_(5)、V_(10)、V_(20)、V_(30)、D mean、左冠状动脉前降支D mean、左肺D mean、右肺V_(5)、D mean及右侧乳腺V_(5)、D mean均低于FB呼吸模式,且差异均有统计学意义(P均<0.05),其中心脏、左冠状动脉前降支LAD及左肺平均剂量分别下降26.2%、47.7%和11.8%。结论:DIBH呼吸模式显著降低了心脏及左冠状动脉前降支等危及器官的受照剂量,采用t-VMAT计划缩短了深吸气屏气技术的治疗时间,提高了患者舒适度,更好的保证治疗顺利进行。Objective:Deep inspiration breath-hold(DIBH)was compared with free breathing(FB)in dosimetric analysis of left breast cancer after breast conserving surgery with volumetric modulated arc therapy(VMAI),to explore the optimal breathing mode for left breast cancer patients after conserving surgery.Methods:Eleven women with left breast cancer after breast conserving surgery were included.We designed t-VMAT plans for DIBH-CT and FB-CT respectively.The dose differences of organs at risk was compared between the two plans.Results:Compared with FB mode,the average heart V_(5),V_(10),V_(20),V_(30),D mean,left anterior descending coronary artery D mean,left lung D mean,right lung V_(5),D mean and right breast V_(5),D mean were all lower in DIBH mode and difference between the two groups has statistical significance(P<0.05).The average dose of heart,LAD and left-lung reduced 26.2%,47.7%and 11.8%respectively.Conclusion:DIBH technology for left breast cancer significantly reduced the dose of heart and left anterior descending coronary artery and the VMAT technology can shorten the treatment time greatly.This combination technology can provide a comfortable treatment and ensure the treatment goes smoothly.

关 键 词：乳腺癌 深吸气屏气 自由呼吸 容积旋转调强放疗 

分 类 号：R737.9[医药卫生—肿瘤]