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首页> 外文期刊>Journal of Cancer Research and Therapeutics >Dual partial arc volumetric-modulated arc therapy: The game changer for accelerated hypofractionated whole-breast radiotherapy with simultaneous integrated tumor cavity boost in early breast cancer - A comparative dosimetric study with single partial arc volumetric-modulated arc therapy
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Dual partial arc volumetric-modulated arc therapy: The game changer for accelerated hypofractionated whole-breast radiotherapy with simultaneous integrated tumor cavity boost in early breast cancer - A comparative dosimetric study with single partial arc volumetric-modulated arc therapy

机译：双部分弧容积调制弧光治疗：早期乳腺癌的加速超分割全乳癌放疗与同时整合的肿瘤腔增强的游戏改变者-单部分弧容积调制弧光治疗的对比剂量研究

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Introduction: In a previous study, we demonstrated clinical and dosimetric feasibility of single partial arc volumetric modulated arc therapy (VMAT) for accelerated hypofractionated whole breast radiotherapy with simultaneous integrated boost (SIB) to lumpectomy cavity for early breast cancer. In this dosimetric study, we compared dual partial arcs versus single arc. Patients and Methods: Fifteen consecutive patients for treatment with hypofractionated accelerated radiotherapy with SIB using VMAT were planned with single partial arc in an earlier study, initial result of which is published elsewhere. The comparative dosimetric plan was created using two partial arcs. Skewness and kurtosis test, Paired Student's t-test, and Wilcoxon signed-rank test were applied for statistical analysis. P 0.05 was considered statistically significant. Results: Most planning targets are better achieved with dual arc technique. Coverage of planning target volume (PTV) whole breast (PTVsubWB)/sub and PTV lumpectomy cavity (PTVsubBOOST/sub) was significantly improved with dual partial arc without significant difference in conformity index and homogeneity index. Dual arc improved dosimetric parameter significantly. Mean dose (Dsubmean/sub) and maximum dose (Dsubmax/sub) of whole breast PTV as well as Dsubmax/sub of PTVsubBOOST/sub; ipsilateral and contralateral lung Dsubmean/sub, Dsubmax/sub, 5 Gy volume (Vsub5/sub); contralateral lung Dsubmean/sub, Dsubmax/sub, Vsub5/sub; Heart Vsub25/sub and Vsub18/sub; Dsubmean/sub of 5 mm thickness skin; Dsubmean/sub and Dsubmax/sub of ribs; and Dsubmean/sub and Dsubmax/sub of contralateral breast were improved with dual arc. Conclusion: This is first of its kind study establishing the advantage of dual partial arcs in the current context. Dual partial arcs improved dosimetry over single partial arc. Significant dose reduction can be achieved for multiple crucial organs at risk.
机译：简介：在先前的研究中，我们证明了单部分弧体积调制弧光疗法（VMAT）用于加速超分割全乳癌放疗，同时将联合增强（SIB）应用于早期乳房癌切除术腔的临床和剂量学可行性。在此剂量学研究中，我们比较了双部分弧和单弧。患者和方法：在较早的研究中，计划连续15例接受VMAT的SIB超分割加速放疗的患者采用单部分弧治疗，其初步结果发表在其他地方。比较剂量计划是使用两个局部弧创建的。偏度和峰度检验，配对学生t检验和Wilcoxon符号秩检验用于统计分析。 P <0.05被认为具有统计学意义。结果：双弧技术可以更好地实现大多数计划目标。双部分弧治疗可显着改善计划目标体积（PTV），全乳（PTV WB）和PTV肿块切除腔（PTV BOOST ）的覆盖率，而合格指数和均匀度指标。双弧大大提高了剂量参数。整个乳房PTV的平均剂量（D mean ）和最大剂量（D max ）以及PTV BOOST < / sub>;同侧和对侧肺D 平均值，D max ，5 Gy体积（V 5 ）;对侧肺D 平均值，D max ，V 5 ;心V 25 和V 18 ; D mean 厚度为5毫米的皮肤;肋骨的D mean 和D max ;双弧可改善对侧乳房的D mean 和D max 。结论：这是同类研究中的第一项，确立了当前背景下双部分弧的优势。双局部弧比单个局部弧改善了剂量学。对于处于危险中的多个关键器官，可以显着降低剂量。

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