Eyachew Misganew Tegaw, G. Tadesse, G. Geraily, S. Gholami, W. Gebreamlak
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The pooled weighted mean difference (MD) with their 95% confidence intervals for each of the three OAR mean doses were determined using a random-effects meta-analysis model to assess the dose reductions. From a total of 189 studies, 1 prospective study, 15 retrospective studies, and 3 randomized control trials (RCTs) with an overall of 634 patients were included. Reduction of doses to the heart (weighted MD = -1.79 Gy; 95% CI (-2.28, -1.30); P = 0.00001), LAD (weighted MD = -8.34 Gy; 95% CI (-11.06, -5.61); P = 0.00001), and left-lung (weighted MD = -0.90 Gy; 95% CI (-1.19, -0.61); P = 0.00001) were observed using DIBH combinations relative to FB combination. 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引用次数: 0
摘要
摘要左侧乳腺癌患者放射治疗后,心脏、左前降支(LAD)冠状动脉、左肺等危险器官可能长期受到辐射剂量的影响。本研究的目的是进行一项全面的荟萃分析,并确定使用不同的RT模式联合深度吸气屏气(DIBH)相对于自由呼吸(FB)治疗左侧乳腺癌期间OARs剂量的减少。使用PubMed、Scopus、EMBASE、ProQuest、Google Scholar和Cochrane Library电子数据库检索到2021年6月6日之前的研究。选取符合条件的19项研究,采用RevMan 5.3统计软件包进行分析。使用随机效应荟萃分析模型来评估剂量减少,确定了三个OAR平均剂量的合并加权平均差(MD)及其95%置信区间。共纳入189项研究,1项前瞻性研究、15项回顾性研究和3项随机对照试验(rct),共纳入634例患者。减少心脏剂量(加权MD = -1.79 Gy;95% ci (-2.28, -1.30);P = 0.00001), LAD(加权MD = -8.34 Gy;95% ci (-11.06, -5.61);P = 0.00001),左肺(加权MD = -0.90 Gy;95% ci (-1.19, -0.61);P = 0.00001)。本研究强调,在左侧乳腺/胸壁(CW)±锁骨上(SCV)±锁骨下(ICV)±乳腺内链(IMC)淋巴结(LN)±腋窝(Ax)/肿瘤患者的治疗过程中,与FB相比,不同的放疗方式联合DIBH技术是减少OARs剂量的更好选择,有利于减少长期并发症。
Comparison of organs at risk doses between deep inspiration breath-hold and free-breathing techniques during radiotherapy of left-sided breast cancer: A Meta-Analysis
Abstract After radiotherapy (RT) of left-sided breast cancer patients, organs at risk (OARs) such as heart, left anterior descending (LAD) coronary artery, and left lung could be affected by radiation dose in the long term. The objective of this study was to perform a comprehensive meta-analysis and determine OARs dose reduction during left-sided breast cancer treatment using different RT modalities combined with deep inspiration breath-hold (DIBH) relative to free-breathing (FB). PubMed, Scopus, EMBASE, ProQuest, Google Scholar, and Cochrane Library electronic databases were used to search for studies until June 6, 2021. Nineteen eligible studies were selected and analyzed using the RevMan 5.3 statistical software package. The pooled weighted mean difference (MD) with their 95% confidence intervals for each of the three OAR mean doses were determined using a random-effects meta-analysis model to assess the dose reductions. From a total of 189 studies, 1 prospective study, 15 retrospective studies, and 3 randomized control trials (RCTs) with an overall of 634 patients were included. Reduction of doses to the heart (weighted MD = -1.79 Gy; 95% CI (-2.28, -1.30); P = 0.00001), LAD (weighted MD = -8.34 Gy; 95% CI (-11.06, -5.61); P = 0.00001), and left-lung (weighted MD = -0.90 Gy; 95% CI (-1.19, -0.61); P = 0.00001) were observed using DIBH combinations relative to FB combination. This study emphasizes that during the treatment of left-sided breast/chest wall (CW) ± supraclavicular (SCV) ± infraclavicular (ICV) ± internal mammary chain (IMC) lymph nodes (LN) ± axillary (Ax)/ cancer patients, different RT modalities combined with DIBH techniques are better options to reduce dose to OARs compared to FB, which benefits to minimize the long-term complications.
期刊介绍:
Polish Journal of Medical Physics and Engineering (PJMPE) (Online ISSN: 1898-0309; Print ISSN: 1425-4689) is an official publication of the Polish Society of Medical Physics. It is a peer-reviewed, open access scientific journal with no publication fees. The issues are published quarterly online. The Journal publishes original contribution in medical physics and biomedical engineering.