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首页> 美国卫生研究院文献>Journal of Radiation Research >Intensity-modulated radiotherapy using two static ports of tomotherapy for breast cancer after conservative surgery: dosimetric comparison with other treatment methods and 3-year clinical results
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Intensity-modulated radiotherapy using two static ports of tomotherapy for breast cancer after conservative surgery: dosimetric comparison with other treatment methods and 3-year clinical results

机译：保守手术后使用两个静态放射疗法进行乳腺癌的强度调节放疗：与其他治疗方法的剂量学比较和3年临床结果

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This study investigated the differences in dose–volume parameters for the breast and normal tissues during TomoDirectTM (TD) intensity-modulated radiation therapy (IMRT), TD-3D conformal radiotherapy (3DCRT) and 3DCRT plans, all using two beams, and analyzed treatment outcomes of two-beam TD-IMRT for breast cancer after breast-conserving surgery. Between August 2011 and January 2015, 152 patients were treated using two-beam TD-IMRT with 50 Gy/25 fractions. Among them, 20 patients with left-sided breast cancer were randomly chosen, and two-beam TD-IMRT, TD-3DCRT and 3DCRT plans were created for each patient. The homogeneity and conformity indices and various dose–volume parameters for the planning target volume and OARs were evaluated. Clinical outcomes were evaluated at 3 years. Toxicities were evaluated using the Common Terminology Criteria for Adverse Events version 4.0. TD-IMRT and TD-3DCRT showed better whole-breast coverage than 3DCRT (P < 0.001). Most of the mean values of dosimetric endpoints for OARs were better in TD-IMRT than in TD-3DCRT and 3DCRT. Overall survival rates were 97.7% and local control rates were 99.1% at 3 years. Regional control and distant metastasis control rates at 3 years were 98.6% and 96.8%, respectively. Twenty-four of the 152 patients had Grade 2 or higher acute radiation dermatitis. Four patients (4/146 = 2.7%) had Grade 2 radiation pneumonitis. There were no late adverse events of Grade 2 or higher. Two-beam TD-IMRT appeared to yield better dose distribution for whole-breast external-beam radiation therapy than TD-3DCRT and two-beam 3DCRT. The treatment appeared to provide low skin toxicity and acceptable tumor control.
机译：这项研究调查了TomoDirect TM （TD）强度调制放射治疗（IMRT），TD-3D保形放射治疗（3DCRT）和3DCRT计划期间，乳房和正常组织的剂量-体积参数的差异，均使用两束光，并分析了两束TD-IMRT保乳手术后对乳腺癌的治疗效果。在2011年8月至2015年1月之间，使用50 Gy / 25分数的两束TD-IMRT治疗了152例患者。其中，随机选择20例左侧乳腺癌患者，并为每个患者创建了两束TD-IMRT，TD-3DCRT和3DCRT计划。评估了计划目标体积和OAR的均一性和一致性指数以及各种剂量-体积参数。在3年时评估临床结局。使用《不良事件通用术语标准》 4.0版评估毒性。 TD-IMRT和TD-3DCRT显示出比3DCRT更好的全乳覆盖率（P <0.001）。 TD-IMRT中OAR的剂量学终点的大多数平均值都优于TD-3DCRT和3DCRT。 3年总生存率为97.7％，局部控制率为99.1％。 3年的区域控制率和远处转移控制率分别为98.6％和96.8％。 152名患者中有24名患有2级或更高级别的急性放射性皮炎。四名患者（4/146 = 2.7％）患有2级放射性肺炎。没有晚期或二级不良反应。两束TD-IMRT似乎比TD-3DCRT和两束3DCRT产生更好的全乳外束放射治疗剂量分布。该治疗似乎提供低皮肤毒性和可接受的肿瘤控制。

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