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乳腺癌改良根治术后内乳淋巴结放疗患者VMAT与IMRT计划剂量学比较
喻洁, 李卿, 曾道林, 易汉杰, 刘光金, 兰琼玉
南昌大学第二附属医院肿瘤科 江西省肿瘤临床转化研究重点实验室 330061
Dosimetric comparison between IMRT and VMAT in patients undergoing internal mammary lymph node radiotherapy after modified radical mastectomy
Yu Jie, Li Qing, Zeng Daolin, Yi Hanjie, Liu Guangjin, Lan Qiongyu
Department of Oncology, Second Affiliated Hospital of Nanchang University,Jiangxi Provincial Key Laboratory of Clinical Transformation Research,Nanchang 330061, China
Abstract：Objective To investigate the dosimetric differences in volumetric-modulated arc therapy (VMAT) and intensity-modulated radiation therapy (IMRT) in patients receiving adjuvant radiotherapy and internal lymph node irradiation after left-sided modified radical mastectomy. Methods VMAT and IMRT radiotherapy plans were established for 20 patients undergoing left-sided modified radical mastectomy. The dosimetric parameters of the target area and organs at risk were calculated by the dose volume histogram. The categorical variables were tested by χ2 or Fisher′s exact probability test. The continuous variables with normal distribution were analyzed by paired-t test or rank-sum test. Results Among the two radiotherapy techniques, the homogeneity index of IMRT was significantly higher than that of VMAT (P<0.05). The time of VMAT treatment was significantly shorter than that of IMRT (P<0.01). VMAT was superior to IMRT in V20Gy and V30Gy of the affected lung (both P<0.05). VMAT was superior to IMRT in the left anterior descending coronary artery Dmean, Dmax, and heart V30Gy, V40Gy, Dmean and Dmax(all P<0.01). The esophageal Dmean in the VMAT group was superior to that in the IMRT group (P<0.05). The V5Gy and V10Gy of the contralateral lung and the Dmax of the esophagus in the IMRT group were significantly better compared with those in the VMAT group (all P<0.05). Conclusions VMAT can significantly reduce the dose of the heart, contralateral lung, spinal cord, esophagus and other vital organs, and shorten the treatment time. For patients who need adjuvant radiotherapy and internal mammary lymph node irradiation after left-sided modified radical mastectomy, VMAT technology can better protect normal tissues than IMRT.
Yu Jie,Li Qing,Zeng Daolin et al. Dosimetric comparison between IMRT and VMAT in patients undergoing internal mammary lymph node radiotherapy after modified radical mastectomy[J]. Chinese Journal of Radiation Oncology, 2020, 29(11): 978-981.
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