基于解剖学的多变量模型预测提升覆盖范围 剂量升级的同时综合提升放射治疗在早期乳腺癌中的稳定性
Mengyuan Wang1, Changyou Zhong2, Xiao Luo1
1Central Hospital of Guangdong Provincial Nongken, Zhanjiang, China.
Technology in cancer research & treatment
|October 21, 2025
概括
设置错误显著影响左侧乳腺癌患者接受同时综合增强 (SIB) 的放射治疗覆盖率. 较大的误差 (≥2.0°:2.0mm) 损害了目标体积剂量,需要根据瘤解剖学和误差大小进行风险分层.
科学领域:
- 辐射瘤学 辐射瘤学
- 医学物理 医学物理
- 在瘤学瘤学.
背景情况:
- 乳腺癌放射治疗需要精确的准,以最大限度地控制瘤并最大限度地减少副作用.
- 同时集成增强 (SIB) 技术为瘤床提供更高的剂量,同时照射整个乳房.
- 放射治疗中的设置错误可能会影响到计划目标体积 (PTVboost) 的剂量覆盖.
研究的目的:
- 评估设置错误对SIB.治疗的早期左侧乳腺癌患者的增强目标体积 (PTVboost) 覆盖率的剂量测量影响.
- 在各种设置错误条件下识别影响PTVboost覆盖范围的解剖因素.
主要方法:
- 对35名接受全乳房放射治疗和SIB治疗的患者进行了回顾性分析.
- 模拟转换-旋转合的设置错误 (1.0°-3.0°旋转与1.0-3.0 mm转换).
- 对PTVboost覆盖范围的D95和V95的评估和多变量分析,将覆盖范围与PTVboost体积 (V_boost),距离异心 (D_iso) 和表面深度 (S_Depth) 相对应.
主要成果:
- 轻微的设置错误 (1.0°:1.0mm) 维持了PTVboost的覆盖率 (D95,V95 ≥95%).
- 增加的误差 (2.0°:2.0mm) 导致覆盖范围显著减少 (大约. 80% 的病例<95% D95/V95).
- 主要错误 (3.0°:3.0mm) 导致通用覆盖失败 (<95% D95/V95).
- V_boost,D_iso和S_Depth被确定为目标覆盖率的重要预测指标.
结论:
- 增加的D_iso,减少的V_boost和更短的S_Depth.对PTVboost剂量覆盖有协同的影响.
- 结合瘤解剖学和设置错误大小的多变量模型可以分层覆盖风险类别.
- 准确的患者设置对于维持乳腺癌SIB放射治疗的目标覆盖率至关重要.
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