深呼吸呼吸:在乳腺癌患者的术后放射治疗期间降低心脏剂量的剂量学益处
Fabiana Accioli Miranda Degrande1, Gustavo Nader Marta2, Tatiana Midori Martins Teles Alves2
1Department of Radiation Oncology, Santa Paula Hospital, Santo Amaro, Sao Paulo, Brazil.
概括
深呼吸呼吸 (DIBH) 与自由呼吸 (FB) 相比,在左乳腺癌患者中显著降低了心脏和LAD辐射剂量. 这种技术保持了目标覆盖范围,同时提高了心脏和冠状动脉安全.
科学领域:
- 辐射瘤学 辐射瘤学
- 医学物理 医学物理
- 心血管成像 - 心血管成像
背景情况:
- 手术后放射治疗 (RT) 是乳腺癌的标准治疗方法.
- 心脏剂量是一个问题,特别是在左侧治疗.
- 深呼吸呼吸暂停 (DIBH) 可能会减少心脏在RT期间的暴露.
研究的目的:
- 为了比较DIBH与自由呼吸 (FB) 对心脏和左前垂下冠状动脉 (LAD) 的剂量影响.
- 评估左乳腺癌患者的RT规划技术.
主要方法:
- 对68名患有左侧乳腺癌的妇女进行了回顾性队列研究,这些妇女接受了术后的RT.
- 使用FB和DIBH技术进行了RT规划.
- 使用过分分的剂量处方 (15个分数中的40.05Gy).
主要成果:
- 在规划目标量 (PTV) 覆盖面上,DIBH和FB之间没有显著差异.
- DIBH计划显著降低了心脏剂量:中位数V16.8 Gy (0%vs2.56%),V8.8 Gy (0%vs3.47%) 和平均心脏剂量 (0.92 Gy vs1.97 Gy).
- DIBH显著降低了LAD剂量:D2%<42 Gy (中位数为5.8 Gy与34.87 Gy),V16.8 Gy<10% (中位数为0%与15.87%),以及平均LAD剂量 (2.92 Gy与8.13 Gy).
结论:
- DIBH始终降低了心脏和LAD辐射剂量.
- DIBH保持了左乳癌RT的目标体积覆盖率.
- DIBH是一种优秀的技术,可最大限度地减少心脏和LAD辐射暴露.
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