左胸の放射線ポータルの内側にある心臓の容量に対する呼吸器の操作の影響
M H Chen1, M L Chuang, B A Bornstein
1Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Mass 02215, USA. mchen@bidmc.harvard.edu
Circulation
|December 13, 1997
まとめ
シンプルな呼吸運動は,乳がん患者の心臓放射線被曝を減らすことができます. インスピラトリー・マニュバーは,放射線場における心臓の容量を減少させ,生存者の長期的な心臓リスクを下げる可能性がある.
科学分野:
- 腫瘍学 腫瘍学
- 心臓病学 心臓病学
- 放射線療法による放射線治療です.
背景:
- 心臓の遅い合併症は,放射線治療を受けた乳がんの生存者にとって懸念事項です.
- 放射線による心臓損傷は,放射線ポータル内の心臓組織の容量と関連しています.
- 呼吸器の操作は,乳房の治療を損なうことなく,放射線被曝を減らすために心臓の位置を変化させる可能性があります.
研究 の 目的:
- 左胸の放射線フィールド内の心臓の容量に対する呼吸器の操作の影響を評価する.
- 放射線療法中の心臓の曝露を最小限に抑えることができるかどうかを判断するために.
主な方法:
- 14人の健康な女性ボランティアに心筋MRIが行われました.
- シミュレートされた左胸の放射線フィールド内の心臓の体積は,正常な呼吸,深いインスピレーション,強制的な吐息の間に測定されました.
- 測定は,心臓全体を覆う1cm厚さの連続した切片を用いて行われました.
主要な成果:
- 心臓は92パーセントの被験者の放射線ポータルに含まれており,潮末の体積 (中位20.9cm3) であった.
- インスピレーションにより,ポータルの心臓の体積が有意に減少した (中位減少10.7cm3,-40.2%,P<.001).
- エクスピレーションにより,ポータルの心臓の体積が増加しました (平均増加4.0cm3,21.5%,P<.001).
結論:
- 心臓の一部は,通常,左胸の放射線フィールドに含まれています.
- インスピレーションマニュバーは,放射線ポータル内の心臓の容量を効果的に減らす.
- このテクニックは,心臓の関わりを最小限に抑え,死亡リスクを低減しながら,乳房放射線用量を保存することができます.
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