接受放射治疗的成年女性左侧乳腺癌患者腹部和胸部深吸气屏气的心脏剂量比较：系统回顾和荟萃分析。

IF 2.5 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Radiography Pub Date : 2025-01-01 DOI:10.1016/j.radi.2024.12.013

W.Y.C. Pang , K.S. Yu , A.Y. Loke

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引用次数: 0

摘要

简介：深吸气屏气技术在减少心脏毒性和改善患者预后方面显示出希望。然而，关于腹式屏气技术的实施及其对心脏剂量的影响，目前还缺乏共识。本系统综述和荟萃分析旨在为左侧乳腺癌放射治疗期间腹部和胸部屏气在减轻心脏毒性方面的比较有效性提供见解。方法：在PubMed、Medline、Science Direct等电子数据库中进行综合文献检索，确定相关研究。对接受DIBH放射治疗的成年女性原发性左侧乳腺癌患者进行腹部和胸部屏气的剂量学比较研究。随机效应荟萃分析估计合并效应大小，采用I2统计量评估异质性。结果：共纳入4项研究，共166例患者。荟萃分析显示，与胸式屏气相比，腹式屏气对左前降支的平均剂量有统计学意义的降低（2.03Gy, 95%CI 0.58-3.47）。两种方法的平均心脏剂量无显著差异（0Gy, 95%CI -0.28-0.27）。结论：患者指导和放射治疗计划实践的变化可能影响心脏剂量减少的实现。需要进一步的研究来评估与不同DIBH技术相关的长期临床结果，并优化左乳放射治疗的治疗计划策略。实践意义：研究结果表明，实施腹部DIBH可能降低与辐射相关的心脏并发症的潜在风险。通过建立一致的指导技术标准，放射治疗师可以促进训练的统一性，提高屏气治疗的准确性和可重复性。

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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Cardiac dose comparison of abdominal and thoracic deep inspiration breath hold in adult female with left-sided breast cancer receiving radiation therapy: A systematic review and meta-analysis

Introduction

Deep inspiration breath hold technique has shown promise in reducing cardiac toxicity and improving patient outcomes. However, there is a lack of consensus regarding the implementation of abdominal breath hold technique and its impact on cardiac dose. This systematic review and meta-analysis aim to provide insights into the comparative effectiveness of abdominal and thoracic breath hold in mitigating cardiac toxicity during radiation therapy for left-sided breast cancer.

Methods

A comprehensive literature search was conducted in electronic databases (PubMed, Medline, Science Direct) to identify relevant studies. Dosimetric comparison studies between abdominal and thoracic breath hold conducted on adult female patients with primary left-sided breast cancer undergoing DIBH radiation therapy were included. Random effects meta-analyses were performed to estimate pooled effect sizes, and heterogeneity was evaluated using I² statistic.

Results

A total of four studies, encompassing 166 patients, were included in the review. Meta-analysis revealed a statistically significant reduction in the mean dose to the left anterior descending artery with abdominal breath hold compared to thoracic breath hold (2.03Gy, 95%CI 0.58–3.47). No significant difference was observed in mean heart dose between the two techniques (0Gy, 95%CI -0.28–0.27).

Conclusion

Variations in patient coaching and radiation therapy planning practices may impact the achieved cardiac dose reduction. Further studies are warranted to evaluate long-term clinical outcomes associated with different DIBH techniques and optimize treatment planning strategies in left-sided breast radiation therapy.

Implication for practice

Results of the study suggested that implementation of abdominal DIBH may reduce the potential risk of radiation-related cardiac complications. By establishing consistent standards for coaching techniques, radiation therapists can promote uniformity in training and improve the accuracy and reproducibility of breath hold treatments.

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来源期刊

Radiography RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

4.70

自引率

34.60%

发文量

169

审稿时长

63 days

期刊介绍： Radiography is an International, English language, peer-reviewed journal of diagnostic imaging and radiation therapy. Radiography is the official professional journal of the College of Radiographers and is published quarterly. Radiography aims to publish the highest quality material, both clinical and scientific, on all aspects of diagnostic imaging and radiation therapy and oncology.