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

doi:10.3760/cma.j.issn.1004-4221.2016.09.016

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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 (GTV_S), GTV_C, GTV_S, and GTV_C+S, were delineated on 4DCT images at 10 phases using metal clip, seroma, and both of them, respectively. The GTV_S on 4DCT images at 10 phases were fused to generate the internal gross tumor volumes (IGTV_S), IGTV_C, IGTV_S, and IGTV_C+S. The planning target volumes (PTV_S), PTV_C, PTV_S, and PTV_C+S, were obtained via expansion of margin by 15 mm. The three-dimensional conformal radiotherapy plans were made by one physician based on PTV_C, PTV_S, and PTV_C+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.

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	Guo Bing
	Li Jianbin
	Wang Wei
	Li Fengxiang
	GuoYanluan
	Li Yankang
	Liu Tonghai

Key words： External-beam partial breast irradiation Tmography X-ray computed four-dimensional Surgical clips Seroma Target determination

Received: 16 April 2015

Corresponding Authors: Li Jianbin,Email:lijianbin@msn.com

Cite this article:

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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http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.issn.1004-4221.2016.09.016 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2016/V25/I9/975

[1] Njeh CF,Saunders MW,Langton CM.Accelerated partial breast irradiation using external beam conformal radiation therapy:a review[J].Crit Rev Oncol Hematol,2012,81(1):1-20.DOI:10.1016/j.critrevonc.2011.01.011.
[2] Kirby AM,Coles CE,Yarnold JR.Target volume definition for external beam partial breast radiotherapy:clinical,pathological and technical studies informing current approaches[J].Radiother Oncol,2010,94(3):255-263.DOI:10.1016/j.radonc.2009.12.010.
[3] Guo B,Li JB,Wang W,et al. Interobserver variability in the delineation of the tumour bed using seroma and surgical clips based on 4DCT scan for external-beam partial breast irradiation[J].Radiat Oncol,2015,10(1):66.DOI:10.1186/s13014-015-0370-3.
[4] 丁昀,李建彬,王玮,等.四维CT测得部分乳腺外照射者基于金属夹与血清肿确定术腔体积及位置关系比较研究[J].中华放射肿瘤学杂志,2013,22(5):361-364.DOI:10.3760/cma.j.issn.1004-4221.2013.05.006.
Ding Y,Li JB,Wang W,et al. Volume and location of lumpectomy cavity delineated by metal clips and/or seroma on 4DCT for external-beam partial breast irradiation:a comparative study[J].Chin J Radiat Oncol,2013,22(5):361-364.DOI:10.3760/cma.j.issn.1004-4221.2013.05.006.
[5] 徐敏,李建彬,范廷勇,等.早期乳腺癌保乳术后部分乳腺三维适形外照射的远期观察[J].中华放射肿瘤学杂志,2012,21(5):439-442.DOI:10.3760/cma.j.issn.1004-4221.2012.05.014.
Xu M,Li JB,Fan TY,et al. Feasibility,efficacy and cosmetic effect of three-dimensional conformal external beam partial breast irradiation for the selected early stage breast cancer patients after breast-conserving surgery[J].Chin J Radiat Oncol,2012,21(5):439-442.DOI:10.3760/cma.j.issn.1004-4221.2012.05.014.
[6] 徐敏,李建彬,于志强,等.勾画标准培训对乳腺癌保乳术后放疗靶区勾画的作用[J].中华放射肿瘤学杂志,2012,21(6):534-538.DOI:10.3760/cma.j.issn.1004-4221.2012.06.015.
Xu M,Li JB,Yu ZQ,et al. The influence of delineating criteria training on the delineation of tumor bed and whole breast target after breast-conserving surgery[J].Chin J Radiat Oncol,2012,21(6):534-538.DOI:10.3760/cma.j.issn.1004-4221.2012.06.015.
[7] 王玮,李建彬,邢军,等.保乳术后放疗四维CT呼气末术腔勾画影响因素分析[J].中华放射肿瘤学杂志,2013,22(5):357-360.DOI:10.3760/cma.j.issn.1004-4221.2013.05.005.
Wang W,Li JB,Xing J,et al. Analysis of influential factors for variability in delineation of lumpectomy cavity based on 4DCT in end-exhalation phase[J].Chin J Radiat Oncol,2013,22(5):357-360.DOI:10.3760/cma.j.issn.1004-4221.2013.05.005.
[8] Yang TJ,Tao RD,Elkhuizen PHM,et al. Tumor bed delineation for external beam accelerated partial breast irradiation:a systematic review[J].Radiother Oncol,2013,108(2):181-189.DOI:10.1016/j.radonc.2013.05.028.
[9] Kumar R,Sharma SC,Kapoor R,et al. Dosimetric evaluation of 3Dconformal acceleratedpartial-breast irradiation vs.whole-breast irradiation:a comparative study[J].Int J Appl Basic Med Res,2012,2(1):52-57.DOI:10.4103/2229-516X.96810.
[10] Gatti M,Ponzone R,Bresciani S,et al. Accelerated partial breast irradiation using 3D conformal radiotherapy:toxicity and cosmetic outcome[J].Breast,2013,22(6):1136-1141.DOI:10.1016/j.breast.2013.07.042.
[11] 张琳,李建彬,卢洁,等.时间和勾画者对保乳术后ABC辅助部分乳腺外照射靶区勾画的影响[J].中华放射肿瘤学杂志,2007,16(4):292-293.DOI:10.3760/j.issn:1004-4221.2007.04.019.
Zhang L,Li JB,Lu J,et al. Effects of time and outline on the target delineation of ABC after breast conserving surgery[J].Chin J Radiat Oncol,2007,16(4):292-293.DOI:10.3760/j.issn:1004-4221.2007.04.019.
[12] Ding Y,Li JB,Wang W,et al. A comparative study on the volume and localization of the internal gross target volume defined using the seroma and surgical clips based on 4DCT scan for external-beam partial breast irradiation after breast conserving surgery[J].Radiat Oncol,2014,9:76.DOI:10.1186/1748-717X-9-76.
[13] Wang W,Li JB,Hu HG,et al. Correlation between target motion and the dosimetric variance of breast and organ at risk during whole breast radiotherapy using 4DCT[J].Radiat Oncol,2013,8:111.DOI:10.1186/1748-717X-8-111.
[14] Recht A,Ancukiewicz M,Alm El-Din MA,et al. Lung dose-volume parameters and the risk of pneumonitis for patients treated with accelerated partial-breast irradiation using three-dimensional conformal radiotherapy[J].J Clin Oncol,2009,27(24):3887-3893.DOI:10.1200/JCO.2008.20.0121.
[15] 付和谊,卢冰,徐冰清,等.Ⅲ+Ⅳ期非小细胞肺癌三维适形放疗正常肺V₅、V₁₀预测放射性肺损伤前瞻性临床研究[J].中华放射肿瘤学杂志,2009,18(6):439-442.DOI:10.3760/cma.j.issn.1004-4221.2009.06.439.
Fu HY,Lu B,Xu BQ,et al. Prospective study of lung V₅ and V₁₀ in predicting radiation-induced lung injury in advanced non-small-cell lung cancer treated with three-dimensional conformal radiation therapy[J].Chin J Radiat Oncol,2009,18(6):439-442.DOI:10.3760/cma.j.issn.1004-4221.2009.06.439.
[16] Goyal S,Daroui P,Khan AJ,et al. Three-year outcomes of a once daily fractionation scheme for accelerated partial breast irradiation (APBI) using 3-D conformal radiotherapy (3D-CRT)[J].Cancer Med,2013,2(6):964-971.DOI:10.1002/cam4.157.
[17] Cox BW,Horst KC,Thornton S,et al. Impact of increasing margin around the lumpectomy cavity to define the planning target volume for 3D conformal external beam accelerated partial breast irradiation[J].Med Dosim,2007,32(4):254-262.DOI:10.1016/j.meddos.2007.02.003.