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基于4DCT探讨金属夹、血清肿及两者结合勾画靶区对EB-PBI剂量学参数影响
国兵,李建彬,王玮,李奉祥,郭延娈,李彦康,刘同海
250117 济南大学山东医学科学院医学与生命科学学院 山东省肿瘤医院放疗科
Dosimetric effects of target volume delineation with metal clip and seroma, alone or in combination, on external-beam partial breast irradiation:a study based on four-dimensional computed tomography
Department of Radiation Oncology,Shandong Cancer Hospital,Medicine and Life Sciences College of Shandong Academy of Medical Sciences,Ji’nan University,Ji’nan 250117,China
Abstract：Objective To evaluate the dosimetric effects of target volume delineation with metal clip and seroma, alone or in combination, on external-beam partial breast irradiation (EB-PBI) based on four-dimensional computed tomography (4DCT). Methods Twenty female patients undergoing EB-PBI from 2009 to 2013 were enrolled as subjects. The gross tumor volumes (GTVS), GTVC, GTVS, and GTVC+S, were delineated on 4DCT images at 10 phases using metal clip, seroma, and both of them, respectively. The GTVS on 4DCT images at 10 phases were fused to generate the internal gross tumor volumes (IGTVS), IGTVC, IGTVS, and IGTVC+S. The planning target volumes (PTVS), PTVC, PTVS, and PTVC+S, were obtained via expansion of margin by 15 mm. The three-dimensional conformal radiotherapy plans were made by one physician based on PTVC, PTVS, and PTVC+S on end-inhalation images. The target volume, homogeneity index (HI), conformity index (CI), and doses to organs at risk were compared between the three groups. Results The C+S group had the largest IGTV, PTV, and the ratio of PTV to diseased breast volume, which was followed by the C group and the S group (all P<0.05). The S group had significantly lower doses to the ipsilateral normal breast and lung than the C group and the C+S group (all P<0.05). There were no significant differences in HI or CI between the three groups (all P>0.05). Conclusions The volume variation caused by target volume delineation on 4DCT images based on different references has little impact on dose distribution in target volume. However, it has substantial impact on radiation doses to the ipsilateral normal breast and lung.
Guo Bing,Li Jianbin,Wang Wei et al. Dosimetric effects of target volume delineation with metal clip and seroma, alone or in combination, on external-beam partial breast irradiation:a study based on four-dimensional computed tomography[J]. Chinese Journal of Radiation Oncology, 2016, 25(9): 975-979.
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2016, Vol. 25 
