在乳腺癌中比较心脏剂量的分断稳定性,其中包括三种喘息放射治疗技术
1Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada.
Clinical oncology (Royal College of Radiologists (Great Britain))
|December 20, 2024
概括
自愿深呼吸呼吸 (vDIBH) 和主动呼吸控制 (ABC) 在左侧乳腺癌放射治疗中提供了可比的平均心脏剂量 (MHD) 可重现性. 表面导向放射疗法 (SGRT) 的变化略有较大,但所有技术基本上都相似.
科学领域:
- 辐射疗法 辐射疗法
- 医学物理 医学物理
- 在瘤学瘤学.
背景情况:
- 在左侧乳腺癌放射治疗中,屏息技术对于降低心脏剂量至关重要.
- 平均心脏剂量 (MHD) 的可重复性对于有效治疗和最大限度地减少心脏毒性至关重要.
研究的目的:
- 为了比较三种常见的喘息技术中MHD的可复制性:自愿深呼吸喘息 (vDIBH),主动呼吸控制 (ABC) 和表面导向放射治疗 (SGRT).
- 确定任何技术在左侧乳腺癌放射治疗期间提供优越的MHD可再生性.
主要方法:
- 一项前性,三臂试验,涉及55名接受左侧乳腺癌放射治疗的患者.
- 使用计划CT和每周的圆束CT (CBCT) 扫描来评估MHD.
- 计算了MHD的间断变化和CBCT和计划CT累积MHD之间的差异,并在vDIBH,ABC和SGRT组进行了比较.
主要成果:
- 与vDIBH和ABC (P=0.0052和P=0.026,分别) 相比,表面导向放射疗法 (SGRT) 在MHD中显示出稍大的分数间变化 (P=0.0052和P=0.026).
- 在SGRT组中,CBCT的累积MHD低于计划CT (平均差异:-22.1cGy,P=0.013),但在vDIBH或ABC组中并非如此.
- 在CBCT的累积MHD可重现性与计划CT之间没有明显的差异在三种技术中观察到 (所有P>0.1).
结论:
- 虽然SGRT显示出更大的断片间MHD变异的趋势,但这种差异可能没有临床意义.
- 三种喘息技术 (vDIBH,ABC,SGRT) 都显示了CBCT中MHD的可比性可复制性,与计划CT相比.
- 这些发现表明vDIBH,ABC和SGRT在放射治疗期间保持可重现的心脏剂量方面具有广泛的有效性.
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