Comparative analysis of radiotherapy modalities and techniques for left breast cancer: dose coverage, setup accuracy, with patient-specific selection criteria for applying deep inspiration breath hold.

IF 1.7 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Radiological Physics and Technology Pub Date : 2025-03-04 DOI:10.1007/s12194-025-00891-5

Masud Parvej, Cristina Cappelletto, Angela Caroli, Lorenzo Vinante, Annalisa Drigo, Paola Chiovati

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引用次数: 0

Abstract

To compare dosimetric outcomes between Free Breath (FB) and Deep Inspiration Breath Hold (DIBH) across different radiotherapy modalities, establish patient selection criteria for DIBH, and optimizing the setup margin (SM) in left breast cancer treatment. 26 patients with left breast cancer were studied at CRO, Aviano in Italy. FB and DIBH simulations were done using CT with a real-time position management system. 3DCRT and IMRT plans were prepared for both simulations of each patient. The setup margin was measured by Van Herk's formula and compared with residual uncertainties. The dose coverage of PTV and spare OARs were better with DIBH. The distance of more than 1.6 cm between (Left Anterior Descending artery) LAD and PTV was no significantly different for FB and DIBH. The setup margin by Van Herk's formula was calculated as 0.9 cm for DIBH_IMRT. The average duration of DIBH per respiration was 19 ± 4 s. So, holding one breath at least 19 s would be the criteria for choosing a patient to apply DIBH. DIBH enhances PTV dose coverage and OAR sparing in both 3DCRT and IMRT. When the distance between the LAD and PTV exceeds 1.6 cm, the application of DIBH depends on the availability of a LINAC with RPM and the patient's breathholding ability.

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比较自由呼吸（FB）和深吸气屏气（DIBH）在不同放疗模式下的剂量测定结果，确定深吸气屏气的患者选择标准，优化左乳腺癌治疗的设置间隙（SM）。意大利阿维亚诺的 CRO 对 26 名左乳腺癌患者进行了研究。使用带有实时位置管理系统的 CT 进行了 FB 和 DIBH 模拟。为每位患者的两次模拟准备了 3DCRT 和 IMRT 计划。根据 Van Herk 公式测量了设置余量，并与残余不确定性进行了比较。DIBH 的 PTV 和备用 OAR 的剂量覆盖率更高。FB 和 DIBH 的 LAD（左前降支动脉）与 PTV 之间的距离超过 1.6 厘米没有明显差异。根据 Van Herk 公式计算，DIBH_IMRT 的设置边缘为 0.9 厘米。每次呼吸的平均DIBH持续时间为19±4秒。因此，憋气至少19秒是选择患者应用DIBH的标准。在3DCRT和IMRT中，DIBH都能增强PTV的剂量覆盖和OAR的清除。当 LAD 与 PTV 之间的距离超过 1.6 厘米时，DIBH 的应用取决于是否有带 RPM 的 LINAC 以及患者的屏气能力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Radiological Physics and Technology RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

3.00

自引率

12.50%

发文量

期刊介绍： The purpose of the journal Radiological Physics and Technology is to provide a forum for sharing new knowledge related to research and development in radiological science and technology, including medical physics and radiological technology in diagnostic radiology, nuclear medicine, and radiation therapy among many other radiological disciplines, as well as to contribute to progress and improvement in medical practice and patient health care.