深吸气屏气(DIBH)技术在左侧乳腺癌中的应用:一项制度回顾

K. Iqbal, Noreen Amjad, S. Butt, Fajar Rafi Ranjha, S. Minhas, Q. Shamsi
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摘要

目的:探讨深吸气式屏气(DIBH)在左乳腺癌放疗(RT)中的临床疗效,探讨放射剂量学和危及器官(OARs)评价。回顾性研究DIBH技术的心脏和同侧肺V30,并与自由呼吸(FB)技术进行比较。临床资料显示,随着吸入幅度值(cm)的增加,治疗场内最大心脏距离减小。材料与方法:对30例左侧乳腺及胸壁患者进行4DCT扫描。这些患者被选中进行DIBH技术,能够屏住呼吸超过20秒。这些患者的放疗计划采用现场规划技术,并使用机构指定的DIBH方案观察OAR剂量。结果:心脏平均剂量小于3Gy。而V2Gy和V10Gy分别小于30%和5%。同侧肺平均剂量为7.59 Gy。同侧肺V30小于25%,边缘±10%。研究发现,随着吸入振幅(cm)的增加,切向治疗场对心脏的影响减小。结论:DIBH是一种简便有效的治疗方法,可降低心脏的平均剂量和同侧肺的V30。由于心脏剂量的增加,最大心脏距离随着吸入基线的增加而减小。
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Deep-Inspirational Breath-Hold (DIBH) Technique in Left-Sided Breast Cancer: An Institutional Review
Purpose: The study of clinical effectiveness of deep-inspirational breath-hold (DIBH) in left breast cancer radiotherapy (RT) was aimed at focusing on dosimetry and organs at risk (OARs) evaluation. A retrospective study was conducted to assess the heart and ipsilateral lung V30 for DIBH technique and to compare with free breathing (FB) technique. Clinical data shows that by increasing the inhalation amplitude value (cm), the maximum heart distance decreases in the treatment field. Materials and Methods: Thirty left-sided breast and chest wall patients were CT scanned on 4DCT with DIBH. These patients were chosen for the DIBH technique with the ability to hold their breath for more than 20 seconds. Radiotherapy of these patients was planned using field-in-field planning technique, and OAR doses were observed using the institutionally specified DIBH protocol. Results: The mean heart dose was less than 3Gy. Whereas V2Gy and V10Gy were less than 30% and 5%. The mean ipsilateral lung dose was 7.59 Gy. Ipsilateral lung V30 was less than 25% with ±10% margins. It is found that by increasing the inhaling amplitude (cm) heart involvement in the tangential treatment field decreases. Conclusion: DIBH is an easy and highly efficient treatment technique for reducing the mean dose of the heart and V30 of ipsilateral lung. The maximum heart distance decreases as the baseline of inhalation increases due to heart doses.
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