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首页> 外文期刊>Medical Physics >Tracking the dynamic seroma cavity using fiducial markers in patients treated with accelerated partial breast irradiation using 3D conformal radiotherapy
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Tracking the dynamic seroma cavity using fiducial markers in patients treated with accelerated partial breast irradiation using 3D conformal radiotherapy

机译：采用3D全成形放射治疗的加速部分乳房辐射治疗的患者的基准标记跟踪动态血清瘤腔

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Purpose: The purpose of the present study was to perform an analysis of the changes in the dynamic seroma cavity based on fiducial markers in early stage breast cancer patients treated with accelerated partial breast irradiation (APBI) using three-dimensional conformal external beam radiotherapy (3D-CRT). Methods: A prospective, single arm trial was designed to investigate the utility of gold fiducial markers in image guided APBI using 3D-CRT. At the time of lumpectomy, four to six suture-type gold fiducial markers were sutured to the walls of the cavity. Patients were treated with a fractionation scheme consisting of 15 fractions with a fractional dose of 333 cGy. Treatment design and planning followed NSABP/RTOG B-39 guidelines. During radiation treatment, daily kV imaging was performed and the markers were localized and tracked. The change in distance between fiducial markers was analyzed based on the planning CT and daily kV images. Results: Thirty-four patients were simulated at an average of 28 days after surgery, and started the treatment on an average of 39 days after surgery. The average intermarker distance (AiMD) between fiducial markers was strongly correlated to seroma volume. The average reduction in AiMD was 19.1% (range 0.0%-41.4%) and 10.8% (range 0.0%-35.6%) for all the patients between simulation and completion of radiotherapy, and between simulation and beginning of radiotherapy, respectively. The change of AiMD fits an exponential function with a half-life of seroma shrinkage. The average half-life for seroma shrinkage was 15 days. After accounting for the reduction which started to occur after surgery through CT simulation and treatment, radiation was found to have minimal impact on the distance change over the treatment course. Conclusions: Using the marker distance change as a surrogate for seroma volume, it appears that the seroma cavity experiences an exponential reduction in size. The change in seroma size has implications in the size of the CTV, PTV, and percent of normal breast tissue irradiated when using 3D-CRT. ? 2013 American Association of Physicists in Medicine.
机译：目的：本研究的目的是根据使用三维保形外梁放射治疗的促进部分乳腺辐射（APBI）治疗的早期乳腺癌患者的基于基于乳腺癌患者的基于基于乳腺癌患者的动态血环腔的变化分析-crt）。方法：旨在使用3D-CRT调查图像引导APBI中的金基准标记的效用。在乳房切除术时，缝合四到六六型金基准标记物被缝合到腔的壁上。患者用分馏方案进行处理，该分馏方案由15分数组成，分数为333个CGY。治疗设计和规划遵循NSABP / RTOG B-39指南。在辐射处理期间，进行每日KV成像，并将标记物定位和跟踪。基于规划CT和每日kV图像分析基准标记之间的距离的变化。结果：三十四名患者平均在手术后28天模拟，并在手术后平均每平39天开始治疗。基准标记物之间的平均接口距离（AIMD）与血清瘤体积强烈相关。所有患者的仿真和完井之间的所有患者分别为19.1％（范围0.0％-41.4％）和10.8％（范围0.0％-35.6％）和放疗和放疗的仿真和放疗开始之间的所有患者的10.8％（范围0.0％-35.6％）。 AIMD的变化适合具有血清瘤收缩的半衰期的指数函数。血清瘤收缩的平均半衰期为15天。在通过CT模拟和处理后开始进行手术后开始发生的减少后，发现辐射对治疗过程中的距离变化产生最小的影响。结论：使用标记距离变化作为血清瘤体积的替代品，似乎血型腔体现了指数尺寸的指数。血清瘤大小的变化在使用3D-CRT时，在CTV，PTV和正常乳房组织的百分比中具有影响。还是2013年美国物理学家的医学协会。

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