乳腺癌改良根治术后容积调强弧形治疗与调强放疗剂量比较的<i>Meta分析</i>

doi:10.3760/cma.j.cn113030-20200818-00429

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Abstract Objective To compare the dosimetric differences between volumetric-modulated arc therapy (VMAT) and intensity-modulated radiation therapy (IMRT) on planning target volume (PTV) and organ-at-risk (OAR) for breast cancer after modified radical mastectomy, aiming to provide evidence-based reference for clinical practice. Methods According to strict inclusion and exclusion criteria, literature search was performed in PubMed, Cochrane Library, FMRS, CNKI, Wanfang Data and VIP full text databases from the inception of databases up to March 2020. The controlled clinical trials of dosimetric comparison between VMAT and IMRT for breast cancer following modified radical mastectomy were selected. The meta-analysis was performed using Stata14software. Results The meta-analysis included 281 patients from 13 observational studies. Compared with IMRT, VMAT significantly increased the PTV dose coverage D95%(P<0.001) and significantly improved the PTV homogeneity index (HI,P<0.001) and conformity index (CI,P=0.004). Compared with IMRT, VMAT more effectively decreased the ipsilateral lung V20Gy (WMD=1.332,P=0.027) and contralateral lung V10Gy (P=0.003). There were no significant differences in theDmean, V5Gy, V10Gy and V30Gy of the ipsilateral lung,Dmean and V5Gy of the contralateral lung,Dmean,V10Gy and V30Gy of the heart between VMAT and IMRT (allP>0.05). Compared with VMAT, IMRT reduced the cardiac V5Gy (P=0.001). However, sensitivity analysis of included literature on cardiac V5Gy showed that the P value was reversed, indicating that the stability of the results was poor. VMAT significantly shortened the delivery time (P<0.001) and the number of monitor units (P<0.001) compared to IMRT. Conclusion Compared with IMRT, VMAT can achieves superior target dose coverage, HI and CI, better protection for the ipsilateral and contralateral lung, fewer monitor units and shorter delivery time.

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	Gao Yan
	Zhong Heli
	Li Zhuangling
	Zhang Guangwei
	Li Longxing
	Shi Yabin
	Li Xianming

Key words： Breast neoplasm/volumetric-modulated arc therapy Breast neoplasm/intensity-modulated radiotherapy Meta-analysis

Received: 18 August 2020

Fund:National Natural Science Foundation of China (61871374)

Corresponding Authors: Li Xianming, Email:lxm1828@hotmail.com

Cite this article:

Gao Yan,Zhong Heli,Li Zhuangling et al. Meta-analysis of dosimetric comparison between volumetric-modulated arc therapy and intensity-modulated radiotherapy for breast cancer after modified radical mastectomy[J]. Chinese Journal of Radiation Oncology, 2021, 30(11): 1159-1166.

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http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.cn113030-20200818-00429 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2021/V30/I11/1159

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