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在乳房切除术后胸壁强度调节的放射治疗中,胸部运动的强有力的治疗计划方法

Yuya Miyasaka¹, Takuya Ono¹, Hongbo Chai¹

¹Department of Heavy Particle Medical Science, Yamagata University Graduate School of Medical Science, Yamagata, Japan.

Journal of applied clinical medical physics

|November 29, 2023

概括

强度调节放射治疗 (IMRT) 在胸壁乳房切除术后放射治疗 (PMRT) 中的稳健规划 (RP) 有效地管理呼吸运动. 虽然RP显示了与计划目标体积 (PTV) 计划相比较的瘤覆盖率,但它稍微增加了风险器官剂量,需要仔细的临床考虑.

科学领域:

辐射瘤学辐射瘤学
医学物理医学物理
癌症治疗治疗癌症治疗

背景情况:

胸壁切除术后的放射治疗 (PMRT) 需要考虑呼吸运动.
呼吸道运动会影响辐射剂量分布和目标覆盖率.
强度调节辐射疗法 (IMRT) 是PMRT的一种常见技术.

研究的目的:

评估在PMRT中IMRT的稳定性规划 (RP) 的有效性.
评估RP减轻胸壁呼吸运动影响的能力.
为了比较RP与传统的规划目标量 (PTV) 计划和虚拟博卢斯 (VP) 计划.

主要方法:

分析了20名PMRT患者 (10个左侧,10个右侧胸壁).
创建并比较了三个计划:PTV计划 (PP),虚拟博卢斯计划 (VP) 和强大的计划 (RP).
作为设置不确定性,RP将呼吸运动纳入;用模拟的胸壁运动重新计算剂量.

主要成果:

RP显示了与PP相比的瘤剂量覆盖率.
与RP相比,VP显示了较高的PTV Dmax和较低的PTV V95% (p < 0.001).
与PP相比,RP的肺V20Gy和Dmean显著更高,对胸壁运动的敏感性降低.

结论:

在PMRT中,RP对呼吸运动具有强大作用,提供与PP相比的瘤剂量.
与VP相比,RP提供了优越的瘤覆盖.
在RP中,风险器官的剂量略有增加,需要仔细的临床考虑.

关键词:

在IMRT中,IMRT是IMRT.在PMRT中使用PMRT.呼吸运动是呼吸的运动.强大的优化优化.设置错误可能是设置错误.

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