在接受PMRT/IMRT的左乳腺癌患者中,深呼吸的选择标准和方法
Yingying Zhou1, Jinfeng Xu1, Fumin Xu2
1Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
自由呼吸平均心脏剂量 (FB-MHD) 的4 Gy值有效地识别了左乳癌患者,他们受益于深呼吸呼吸 (DIBH). 心脏到胸部的欧几里德距离 (CCED) 可以在CT模拟过程中预测FB-MHD.
科学领域:
- 辐射瘤学 辐射瘤学
- 医学物理 医学物理
背景情况:
- 深呼吸呼吸 (DIBH) 在左乳腺癌放射治疗中降低心脏剂量.
- 准确的患者选择对于最大化DIBH益处至关重要.
研究的目的:
- 评估4 Gy自由呼吸平均心脏剂量 (FB-MHD) 作为DIBH适应性的值.
- 为快速FB-MHD评估确定解剖学预测因子.
主要方法:
- 在23名患者中比较了FB和DIBH计划;按FB-MHD (≥4 Gy vs. <4 Gy) 分类.
- 评估剂量差异,正常组织并发症概率 (NTCP) 和DIBH益处.
- 在30名FB患者中分析了解剖学指标 (CCED,CCG,CCC),以预测高风险心脏剂量.
主要成果:
- 与FB计划相比,DIBH计划显著减少了心脏剂量.
- 高风险组 (FB-MHD ≥4 Gy) 显示了显著更高的心脏剂量,NTCP对心脏死亡和DIBH益处.
- 心脏到胸部的欧几里德距离 (CCED) 显示出强大的预测能力 (AUC=0.83),最佳切断距离为2.5毫米.
结论:
- 4 Gy FB-MHD作为一个有效的值来选择DIBH的患者.
- 在CT模拟期间,CCED是预测左乳腺癌患者FB-MHD的可靠解剖学指标.
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