混合放射技术与3d-crt治疗左侧全性乳腺癌的比较

Nina Pavlovic, T. Miladinović, D. Stojanović, A. Miladinović, M. Jeremic
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摘要

为了确定左侧乳腺癌患者的最佳治疗技术,我们比较了混合调强放射治疗(hIMRT)和传统三维适形放射治疗(3D-CRT)的方案。计算了ptv和OARs的剂量学指标。分析了靶体的剂量覆盖率、均匀性指数、一致性指数和关键结构的剂量体积。该研究选择了2019年至2020年期间在克拉古耶瓦茨大学临床中心随机选择接受治疗的7名患者作为样本。根据相同的图像和轮廓,使用ECLIPSE治疗计划系统为每位患者制定两种技术的治疗计划。混合IMRT技术包括两个静态的相对切向场和四个优化的IMRT场(剂量比70:30)。对于3D-CRT规划,使用了一个带楔形的半光束阻挡切向场的等中心。所有治疗方案均以6 MV光子束生成。与3D-CRT相比,混合IMRT计划的给药剂量达到计划靶体积(PTV)的95% (D95),异质性HI和符合性CI更好。对心脏、肺和对侧乳房等关键器官的保护略差于3D-CRT。
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HYBRID IMRT RADIATION TECHNIQUE COMPARISON WITH 3D-CRT FOR LEFT-SIDED WHOLE BREAST CANCER
To identify the best treatment technique for patients with left-sided breast cancer, we compared plans obtained with a hybrid intensity-modulated radiation therapy (hIMRT) and conventional three- dimensional conformal radiation therapy (3D-CRT). Dosimetric indices for PTVs and OARs were calculated. Also, the dose coverage, homogeneity index, conformity index of the target, and the dose volumes of critical structures were analyzed. A sample of seven patients who were selected randomly treated in University Clinical Center Kragujevac between 2019 and 2020 was selected for the study. Therapy plans for both techniques were made with an ECLIPSE treatment planning system for each patient based on the same images and contours. The hybrid IMRT technique consists of two static opposed tangential fields and four optimized IMRT fields (dose ratio 70:30). For 3D-CRT planning, one isocenter with half-beam blocked tangential fields with wedges was used. All treatment plans were generated with 6 MV photon beam. Hybrid IMRT plans compared to the 3D-CRT resulted in better dose delivered to 95% (D95) of the planning target volume (PTV) and better heterogeneity HI and conformity CI. Protection for critical organs such as the heart, lungs, and contralateral breast is slightly worse than those obtained by 3D-CRT.
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