三种不同放疗技术（VMAT、IMRT 和 3D CRT）对同步双侧乳腺癌患者治疗的心脏剂量,Hormones and Cancer

当前位置： X-MOL 学术 › Horm. Cancer › 论文详情

Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)

三种不同放疗技术（VMAT、IMRT 和 3D CRT）对同步双侧乳腺癌患者治疗的心脏剂量
Hormones and Cancer Pub Date : 2023-03-02 , DOI: 10.1007/s12672-023-00636-z
Nidal Salim _{1,

2} , Alexey Popodko ₁ , Kristina Tumanova ₁ , Alexandr Stolbovoy _{1,

2} , Irina Lagkueva ₃ , Vadim Ragimov ₃

Affiliation

目的

由于技术困难和支持最佳技术改善治疗结果的证据有限，乳腺和胸壁的同步双侧照射是一项具有挑战性的任务。我们研究并比较了三种放射治疗技术的剂量学数据，以选择最佳的一种。

方法

我们比较了 3D 适形放射治疗 (3D CRT)、强度调制放射治疗 (IMRT) 和容积调制弧治疗 (VMAT) 对 9 名同步双侧乳腺癌患者的照射，随后检查了心脏传导的剂量分布系统（窦房结、房室结和希氏束）、心肌、肺、左前降支（LADA）和右冠状动脉（RCA）。

结果

VMAT 是 SBBC 治疗最节省的技术。_尽管与_3D CRT （D 平均值分别为 2.61 ± 0.66、1.52 ±分别为 0.38 和 1.88 ± 0.70 Gy），这种差异在统计学上是微不足道的。右肺和左肺的剂量（平均 D_平均值= 12.65 ± 3.20 Gy，V _20Gy = 24.12 ± 6.25%），心肌（D_平均值= 5.33 ± 1.51 Gy，V _10Gy = 9.80 ± 3.83%，V _20Gy = 7.19 ± 3.15 %, V _25Gy = 6.20 ± 2.93%), 和 LADA (D _mean = 10.04 ± 4.92 Gy, V _20Gy= 18.17 ± 13.24% 和 V _25Gy = 15.41 ± 12.19%) 在 3D CRT 中最高。在心脏传导系统中观察到最高的 D_平均值（分别为 5.30 ± 2.23、3.15 ± 1.61 和 3.89 ± 1.85 Gy），在 RCA 中观察到类似的效果（D 平均值 = 7.48 ± 2.11 Gy _）。

结论

VMAT 是用于保护危及器官 (OAR) 的最佳且令人满意的放射治疗技术。使用 VMAT，在心肌、LADA 和肺中观察到较低的 D_平均值。3D CRT 的使用显着增加了到达肺部、心肌和 LADA 的辐射剂量，这随后会导致心血管和肺部并发症，但不会在心脏传导系统中发生。

"点击查看英文标题和摘要"

Cardiac dose in the treatment of synchronous bilateral breast cancer patients between three different radiotherapy techniques (VMAT, IMRT, and 3D CRT)

Purpose

Synchronous bilateral irradiation of both mammary glands and chest wall is a challenging task due to technical difficulties and limited evidence supporting an optimal technique to improve treatment outcomes. We studied and compared the dosimetry data of three radiotherapy techniques to select the most optimal one.

Methods

We compared three-dimensional conformal radiation treatment (3D CRT), intensity-modulated radiation therapy (IMRT), and volumetric modulated arc therapy (VMAT) during irradiation of synchronous bilateral breast cancer in nine patients followed by examination of dose distribution to the cardiac conduction system (SA node, AV node and Bundle of His), myocardium, lungs, left anterior descending artery (LADA) and right coronary artery (RCA) .

Results

VMAT is the most sparing technique for SBBC treatment. Even though doses to the SA node, AV node and Bundle of His were higher with VMAT (D_mean were 3.75 ± 0.62, 2.58 ± 0.83 and 3.03 ± 1.18 Gy respectively) compared with 3D CRT (D_mean were 2.61 ± 0.66, 1.52 ± 0.38 and 1.88 ± 0.70 Gy respectively), this difference is statistically insignificant. Doses to the right and left lung (average D_mean = 12.65 ± 3.20 Gy, V_20Gy = 24.12 ± 6.25%), myocardium (D_mean = 5.33 ± 1.51 Gy, V_10Gy = 9.80 ± 3.83%, V_20Gy = 7.19 ± 3.15%, V_25Gy = 6.20 ± 2.93%), and LADA (D_mean = 10.04 ± 4.92 Gy, V_20Gy = 18.17 ± 13.24% and V_25Gy = 15.41 ± 12.19%) were highest with 3D CRT. The highest D_mean in the cardiac conduction system (5.30 ± 2.23, 3.15 ± 1.61 and 3.89 ± 1.85 Gy respectively) was observed with IMRT, and a similar effect was noted in RCA (D_mean = 7.48 ± 2.11 Gy).

Conclusion

VMAT is the optimal and satisfactory radiation therapy technique for sparing organs at risk (OARs). With VMAT, a lower D_mean value was noted in the myocardium, LADA, and lungs. The use of 3D CRT significantly increases the dose of radiation reaching the lungs, myocardium, and LADA, which can subsequently cause cardiovascular and lung complications, but not in the cardiac conduction system.

更新日期：2023-03-02

点击分享查看原文

点击收藏

公开下载

阅读更多本刊新发论文