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基于VMAT的乳腺癌保乳术后全乳混合调强技术的建立与评价
田源,马攀,门阔,徐英杰,李明辉,宋一昕,戴建荣
100021 北京,国家癌症中心/中国医学科学院肿瘤医院北京协和医学院放疗科
Development and evaluation of whole breast irradiation with volumetric modulated arc therapy-based hybrid intensity-modulated radiotherapy after breast conserving surgery for breast cancer
Department of Radiation Oncology,National Cancer Center/Cancer Hospital,Chinese Academy of Medical Science,Peking Union Medical College,Beiijng 100021,China
Abstract：Objective To develop whole breast irradiation with volumetric-modulated arc therapy (VMAT)-based hybrid intensity-modulated radiotherapy (IMRT) after breast conserving surgery for breast cancer, and to evaluate its value in clinical application. Methods Ten patients with breast cancer undergoing breast conserving surgery were enrolled. Two radiotherapy plans were designed based on hybrid fixed-beam IMRT/IMRT technique and hybrid VMAT/IMRT technique, respectively. One group received whole breast irradiation with a prescribed dose of 50 Gy in 25 fractions. The other group received whole breast irradiation with a prescribed dose of 50 Gy in 25 fractions, as well as simultaneous integrated boost to the tumor bed with 60 Gy in 25 fractions. The dosimetric parameters and delivery efficiency were compared between the two plans using paired t test. Results For patients treated with whole breast irradiation alone, there were no significant differences in conformity index and homogeneity index of target volume between the two plans (P=0.866,0.056);however, compared with the hybrid fixed-beam IMRT/IMRT technique, the hybrid VMAT/IMRT technique significantly increased the doses to organs at risk (OARs) and the number of monitor units (MUs) in the intensity-modulated field (P=0.000-0.050,P=0.002). For patients treated with whole breast irradiation with a simultaneous integrated boost to the tumor bed;however, the hybrid VMAT/IMRT technique significantly reduced the doses to the lung and spinal cord, number of MUs in intensity-modulated field, and delivery time compared with the hybrid fixed-beam IMRT/IMRT technique (P=0.004,0.001,0.000,0.000). Conclusions For patients treated with whole breast irradiation with a simultaneous integrated boost to the tumor bed, the hybrid VMAT/IMRT technique is highly promising for clinical application due to better OAR sparing and higher delivery efficiency.
Tian Yuan,Ma Pan,Men kuo et al. Development and evaluation of whole breast irradiation with volumetric modulated arc therapy-based hybrid intensity-modulated radiotherapy after breast conserving surgery for breast cancer[J]. Chinese Journal of Radiation Oncology, 2016, 25(7): 728-732.
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2016, Vol. 25 
