在个性化乳房照射中预防心脏毒性
Edy Ippolito1, Carlo Greco1, Maristella Marrocco1
1Radiation Oncology, Campus Bio-Medico University Rome, 00128 Rome, Italy.
Cancers
|November 14, 2023
概括
与自由呼吸相比,深呼吸呼吸 (DIBH) 在乳腺癌患者中显著降低了心脏辐射剂量. 建议所有患者使用这种技术,以尽量减少心脏暴露.
科学领域:
- 辐射瘤学 辐射瘤学
- 医学物理 医学物理
- 癌症护理中的心血管健康
背景情况:
- 评估深呼吸喘息 (DIBH) 与标准放射治疗技术相比的好处.
- 在乳房照射期间,确定影响左前下降动脉 (LAD) 剂量的患者特定因素.
研究的目的:
- 评估DIBH对左侧乳腺癌患者的剂量优势.
- 为了确定DIBH和自由呼吸 (FB) 放射治疗计划中LAD剂量的预测因素.
主要方法:
- 对197名左侧乳腺癌患者进行分析,这些患者有DIBH和FB放射治疗计划.
- 接收器操作特征 (ROC) 分析以确定预测LAD剂量值的参数.
- 计算曲线下的面积 (AUC) 和参数组合的测试后概率.
主要成果:
- 与FB相比,DIBH计划显著降低了LAD最大剂量31.7% (3.5 Gy与4.8 Gy相比) 和平均剂量28.1% (8.2 Gy与12.8 Gy相比).
- 最小的LAD距离与触角开放场是LAD剂量最强的预测指标.
- 肺部体积,心脏体积和乳房分离也被确定为预测参数.
结论:
- 在所有患者中,DIBH在降低LAD剂量方面具有明显的剂量优势.
- DIBH应该是左侧乳腺癌的首选放射治疗技术,以保护心脏.
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