对于患有左侧乳腺癌的患者来说,深呼吸的呼吸技术:剂量测量分析,临床评估和预测
Jing Shen1, Kun Zhang1, Xiangyin Meng1
1Department of Radiation Oncology, Peking Union Medical College Hospital. Chinese Academy of Medical Sciences & Peking Union Medical College, NO.1 Shuaifuyuan Wangfujing, Dongcheng District, Beijing 100730, People's Republic of China.
Technology in cancer research & treatment
|April 11, 2025
概括
深呼吸喘息 (DIBH) 在乳腺癌患者中显著降低心脏辐射剂量. 平均心脏剂量低于2 Gy可能表明心脏损伤风险较低,可能减少对DIBH的需要.
科学领域:
- 在瘤学瘤学.
- 辐射疗法 辐射疗法
- 心脏病学 心脏病学
背景情况:
- 乳腺放射治疗增加了心脏病的风险.
- 深呼吸呼吸 (DIBH) 降低了心脏辐射剂量,但未得到充分利用.
- 确定DIBH的最佳候选人对于患者选择至关重要.
研究的目的:
- 在自由呼吸 (FB) 和DIBH之间比较剂量参数.
- 监测心肌酶以检测心脏损伤.
- 确定心脏损伤的预测因子,以指导DIBH患者的选择.
主要方法:
- 58名乳腺癌患者的前性队列研究.
- 在FB和DIBH状态中进行CT扫描以进行剂量测量比较.
- 放射后心肌酶监测与相关性和ROC分析.
主要成果:
- 与FB相比,DIBH显著降低了心脏平均剂量 (MHD) (1.65 Gy vs 3.81 Gy).与FB相比,DIBH显著降低了心脏平均剂量 (MHD).
- 心脏V40,V30,V25,V10和V5体积在DIBH时显著减少.
- 15.51%的患者显示心肌酶升高;MHD预测升高,MHD值为2 Gy,显示>0.7的灵敏度和特异性.
结论:
- 与FB相比,DIBH显著减少了心脏和LAD辐射暴露.
- 心脏酶监测有助于早期检测辐射引起的心脏损伤.
- 一个MHD<2 Gy表明降低亚临床心脏损伤风险,可能使DIBH不必要和提高效率.
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