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

doi:10.3760/cma.j.cn113030-20190623-00238

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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.

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	Yu Jie
	Li Qing
	Zeng Daolin
	Yi Hanjie
	Liu Guangjin
	Lan Qiongyu

Key words： Breast neoplasm/postoperative radiotherapy Radiotherapy, volumetric-modulated Radiotherapy, intensity-modulated Dosimetry

Received: 23 June 2019

Fund:Science and Technology Research Project of Jiangxi Provincial Department of Education (20160163)

Corresponding Authors: Lan Qiongyu, Email:flylanhuacao@163.com

Cite this article:

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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http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.cn113030-20190623-00238 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2020/V29/I11/978

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