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乳腺癌改良根治术后三种放疗技术的剂量学对比研究
苗俊杰, 徐英杰, 翟医蕊, 门阔, 王淑莲, 戴建荣
国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院放疗科 100021
Dosimetric comparison of three techniques in radiotherapy for breast cancer after modified mastectomy
Miao Junjie, Xu Yingjie, Zhai Yirui, Men Kuo, Wang Shulian, Dai Jianrong
Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Abstract：Objective To analyze and compare the dosimetric differences based on volumetric-modulated arc therapy (VMAT), fixed field intensity-modulated radiotherapy (F_IMRT), and electron irradiation combined with VMAT (E&VMAT) in radiotherapy for breast cancer after modified mastectomy, aiming to provide reference for clinical selection of treatment plan. Methods Ten patients with the left breast cancer who received radiotherapy after modified mastectomy were randomly selected. The target areas included chest wall and supraclavicular region, and the prescribed dose was 43.5Gy in 15 fractions (2.9Gy/F). Based on the Pinnacle3 planning system, the VMAT, F_IMRT and E&VMAT plans (electron beam for chest wall, VMAT for supraclavicular area) were designed for each patient. The conformity and homogeneity of the target areas, the dose of organs at risk and treatment time were compared. Results The VMAT plan could improve the dose distribution of the target areas. The conformity index and homogeneity index of the target dose were significantly better than those of the F_IMRT and E&VMAT plans (all P<0.05). The average dose, V30Gy, V20Gy, V10Gy of the left lung in the VMAT plan were significantly better than those in the F_IMRT and E&VMAT plans (all P<0.05). The V5Gy of the left lung in the VMAT plan was significantly better than that in the F_IMRT plan (P<0.05). There was no statistical difference in the V5Gy of the left lung between the VMAT and E&VMAT plans (P>0.05). The heart, right breast and right lung of the VMAT plan could meet the clinical dose limit requirements. The treatment time of the VMAT, F_IMRT and E&VMAT plans was (326±27) s,(1 082±169) s, and (562±48) s, respectively. Conclusions Compared with the F_IMRT and E&VMAT plans, the VMAT plan has better quality and shorter treatment time. VMAT plan has higher value in clinical application compared with the F_IMRT and E&VMAT plans.
Miao Junjie,Xu Yingjie,Zhai Yirui et al. Dosimetric comparison of three techniques in radiotherapy for breast cancer after modified mastectomy[J]. Chinese Journal of Radiation Oncology, 2021, 30(9): 924-929.
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