乳房切除术后放射治疗的体积调制电弧治疗与强度调制放疗的剂量学比较。

Samuel Adeneye, Michael Akpochafor, Nusirat Adedewe, Muhammad Habeebu, Ramotallah Jubril, Abe Adebayo, Omolola Salako, Adedayo Joseph, Inioluwa Ariyo, Eseoghene Awhariado, Rasak Lawal
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引用次数: 0

摘要

目的:放疗在乳腺癌治疗中继续发挥重要作用。本研究比较了强度调制放疗(IMRT)技术和体积调制电弧治疗(VMAT)技术在乳房切除术后接受放疗的乳腺癌患者中的剂量学差异。材料和方法:本研究纳入了2020年1月至2021年8月40例乳房切除术后患者(19例右侧乳房,21例左侧乳房),采用7-9场IMRT技术治疗,在Varian Vital beam直线加速器上使用2共面弧进行VMAT重新计划。胸壁、淋巴结及锁骨上淋巴结分15段接受42 Gy放疗。分析了计划靶体积(PTV)、危及器官(OAR)和人体整体剂量的剂量学参数。采用两个独立均值的学生t检验来分析方案之间的剂量学差异。结果:两种技术均达到临床目的。从95%的PTV覆盖率(IMRT: 712.17±233)vs (VMAT: 694.9±214)和均匀性指数(IMRT: 0.075±0.04)vs (VMAT: 0.104±0.03)来看,IMRT的剂量覆盖和均匀性优于VMAT。但在符合性指数上,无显著性差异。在OARs方面,IMRT计划的同侧肺平均剂量、V5、V10、V20、V30和V40均低于VMAT计划,差异无统计学意义(p值分别为0.141、0.416、0.954、0.443和1)。对于心脏的平均剂量,IMRT中低剂量体积V5、V10和高剂量体积V30与VMAT相比显著降低。当与对侧乳房进行剂量比较时,IMRT的平均剂量明显低于VMAT (2.9 vs 3.62, p = 0.0148)。对于MU, VMAT比IMRT显示更低的MU,差异不显著。结论:采用IMRT,观察到更好的PTV覆盖,均匀性和OAR保留。此外,VMAT比IMRT的分娩时间更短。总的来说,这两种技术都提供了临床可接受的剂量学质量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Dosimetric Comparison of Volumetric Modulated Arc Therapy and Intensity Modulated Radiotherapy in Patients Treated with Post-Mastectomy Radiotherapy.

Objective: Radiotherapy continues to play an important role in the management of breast cancer. This study compared the dosimetric differences between the techniques of intensity modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) in breast cancer patients who had radiotherapy after mastectomy.

Materials and methods: Forty post-mastectomy patients (19 right-sided breast and 21 left-sided breast) treated with the IMRT technique using 7-9 fields who were re-planned with VMAT using 2 coplanar arc on the Varian Vital beam linear accelerator between January, 2020 and August, 2021 were included in this study. The patients received 42 Gy in 15 fractions to the chest wall, lymph nodes and supraclavicular nodes. The dosimetric parameter for planning target volume (PTV), organs at risk (OAR) and the integral dose to the body were analysed. Student's t-test for two independent means was used to analyse the dosimetric differences between the plans.

Results: Clinical goals were achieved for both techniques. In terms of PTV coverage at 95% (IMRT: 712.17±233) vs (VMAT: 694.9±214) and the homogeneity index (IMRT: 0.075±0.04) vs (VMAT: 0.104±0.03), IMRT resulted in better dose coverage and homogeneity than VMAT. However, with the conformity index, no significant difference was seen. As regards the OARs, the mean doses, V5, V10, V20, V30, and V40 for the Ipsilateral-lung were lower in IMRT plans than in VMAT plans with a non-significant variation (p-values = 0.141, 0.416, 0.954, 0.443, and 1 respectively). Regarding the mean dose to the heart, low-dose volumes V5, V10, and high-dose volume V30 were significantly reduced in IMRT compared to VMAT. When comparing the dose to the contralateral breast, IMRT achieved a significantly lower mean dose than VMAT (2.9 vs 3.62, p = 0.0148). For MU, VMAT showed lower MU compared to IMRT with a non-significant difference.

Conclusion: With IMRT, better PTV coverage, homogeneity and OAR sparing were observed. Additionally, VMAT resulted in a lower delivery time than IMRT. Overall, both techniques offered dosimetric qualities that were clinically acceptable.

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