|
|
The dosimetric study of radiotherapy after modified radical mastectomy for left breast cancer using the beam’s eye view in intensity-modulated radiation therapy |
YU Xiaojun, WANG Xugang, LI Xiulei |
Department of Radiotherapy, Liaocheng Peoples Hospital, Liaocheng 252000 China |
|
|
Abstract Objective To analyze the dosimetric features of chest wall radiotherapy after modified radical mastectomy for left breast cancer using the beam’s eye view (BEV) in intensity-modulated radiation therapy (B-IMRT).Methods A total of 13 patients treated with modified radical mastectomy for left breast cancer in the Liaocheng People’s Hospital from May 2020 to November 2020 were recruited. They were treated with postoperative radiotherapy using the plans of B-IMRT or tangential fields in intensity-modulated radiation therapy (T-IMRT). The mean dose, conformity index and homogeneity index of the target field, and dose volume parameters of left lung and heart were compared between two groups. Results Compared with those of T-IMRT group, B-IMRT significantly improved the conformity and homogeneity of the target field (P < 0.05), and their mean dose of target field was similar. In addition, V5, V10, V20, V30 and Dmean of the left-side lung, and V5, V10, V30 and Dmean of the heart in B-IMRT group were significantly reduced compared with those of T-IMRT group (P < 0.05). In comparison to those of T-IMRT, B-IMRT decreases V5, V10, V20, V30 and Dmean of the left-side lung by 9.23%, 13.29%, 9.54%, 8.28% and 10.35%, respectively, which decreases V5, V10, V30 and Dmean of the heart by 27.62%, 29.72%, 21.45% and 24.88%, respectively. Conclusion Compared with T-IMRT planning, B-IMRT presents dosimetric advantages in the conformity and homogeneity of the target field in the postoperative radiotherapy of patients treated with modified radical mastectomy for left breast cancer, especially in reducing the radiation dose and volume of the heart and lungs.
|
Received: 02 January 2021
|
|
|
|
|
[1] Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015[J]. CA Cancer J Clin, 2016, 66(2): 115-132. DOI: 10.3322/caac.21338 [2] Taylor C, Correa C, Duane FK, et al. Estimating the risks of breast cancer radiotherapy: evidence from modern radiation doses to the lungs and heart and from previous randomized trials[J]. J Clin Oncol, 2017, 35(15): 1641-1649. DOI: 10.1200/JCO.2016.72.0722 [3] Darby SC, Ewertz M, McGale P, et al. Risk of ischemic heart disease in women after radiotherapy for breast cancer[J]. N Engl J Med, 2013, 368(11): 987-998. DOI: 10.1056/NEJMoa1209825 [4] Fragkandrea I, Kouloulias V, Mavridis P, et al. Radiation induced pneumonitis following whole breast radiotherapy treatment in early breast cancer patients treated with breast conserving surgery: a single institution study[J]. Hippokratia, 2013, 17(3): 233-238 [5] 张怀文, 邓益杰, 丁生苟, 等. 左侧乳腺癌根治术后两种常用放疗计划剂量学比较[J]. 中华肿瘤防治杂志,2015,22(12):964-968. DOI: 10.16073/j.cnki.cjcpt.2015.12.013 Zhang HW, Deng YJ, Ding SG, et al. Dosimetric comparison of two common intensity modulated radiotherapy for left breast cancer receiving post-mastectomy[J]. Chin J Cancer Prev Treat, 2015, 22(12): 964-968. DOI: 10.16073/j.cnki.cjcpt.2015.12.013 [6] 张文, 施林心, 刘亚洲, 等. 三维适形调强放疗在乳腺癌根治术中的应用[J]. 中国辐射卫生,2019,28(2):190-193. DOI: 10.13491/j.issn.1004-714x.2019.02.021 Zhang W, Shi LX, Liu YZ, et al. Application of three-dimensional conformal intensity modulated radiation therapy in radical mastectomy[J]. Chin J Radiol Health, 2019, 28(2): 190-193. DOI: 10.13491/j.issn.1004-714x.2019.02.021 [7] 王澜, 李晓宁, 吕冬婕, 等. 肺低剂量区体积预测急性放射性肺炎价值探讨[J]. 中华放射肿瘤学杂志,2010,19(4):296-300. DOI: 10.3760/cma.j.issn.1004-4221.2010.04.005 Wang L, Li XN, Lv DJ, et al. Low dose volume of the lung in prediction of acute radiation pneumonitis[J]. Chin J Radiat Oncol, 2010, 19(4): 296-300. DOI: 10.3760/cma.j.issn.1004-4221.2010.04.005 [8] Chung Y, Yoon HI, Kim YB, et al. Radiation pneumonitis in breast cancer patients who received radiotherapy using the partially wide tangent technique after breast conserving surgery[J]. J Breast Cancer, 2012, 15(3): 337-343. DOI: 10.4048/jbc.2012.15.3.337 [9] Willner J, Jost A, Baier K, et al. A little to a lot or a lot to a little?An analysis of pneumonitis risk from dose-volume histogram parameters of the lung in patients with lung cancer treated with 3-D conformal radiotherapy[J]. Strahlenther Onkol, 2003, 179(8): 548-556. DOI: 10.1007/s00066-003-1078-0 [10] 陈偲晔, 王淑莲. 乳腺癌放射性心脏损伤(RIHD)的评估和预防研究进展[J]. 中华放射肿瘤学杂志,2017,26(4):474-480. DOI: 10.3760/cma.j.issn.1004-4221.2017.04.024 Chen SY, Wang SL. Research advances in the evaluation and prevention of radiation-induced heart damage in breast cancer[J]. Chin J Radiat Oncol, 2017, 26(4): 474-480. DOI: 10.3760/cma.j.issn.1004-4221.2017.04.024 [11] 黄勇. 放射性心血管疾病的研究进展[J]. 中国辐射卫生,2018,27(4):349-353. DOI: 10.13491/j.issn.1004-714x.2018.04.016 Huang Y. Research progress of radiation-induced cardiovascular diseases[J]. Chin J Radiol Health, 2018, 27(4): 349-353. DOI: 10.13491/j.issn.1004-714x.2018.04.016 [12] Gyenes G, Gagliardi G, Lax I, et al. Evaluation of irradiated heart volumes in stage I breast cancer patients treated with postoperative adjuvant radiotherapy[J]. J Clin Oncol, 1997, 15(4): 1348-1353. DOI: 10.1200/JCO.1997.15.4.1348 [13] van den Bogaard VA, Ta BD, van der Schaaf A, et al. Validation and modification of a prediction model for acute cardiac events in patients with breast cancer treated with radiotherapy based on three-dimensional dose distributions to cardiac substructures[J]. J Clin Oncol, 2017, 35(11): 1171-1178. DOI: 10.1200/JCO.2016.69.8480 [14] 林锋, 曾自力, 覃树付, 等. 直肠癌术后调强放疗不同照射野数的剂量学研究[J]. 中国辐射卫生,2019,28(2):201-205. DOI: 10.13491/j.issn.1004-714x.2019.02.024 Lin F, Zeng ZL, Qin SF, et al. Dosimetric study of different radiation field numbers in postoperative intensity modulated radiation therapy for rectal cancer[J]. Chin J Radiol Health, 2019, 28(2): 201-205. DOI: 10.13491/j.issn.1004-714x.2019.02.024
|
|
|
|