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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Left-sided breast cancer radiotherapy with and without breath-hold: Does IMRT reduce the cardiac dose even further?
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Left-sided breast cancer radiotherapy with and without breath-hold: Does IMRT reduce the cardiac dose even further?

机译：有屏息和无屏息的左侧乳腺癌放疗：IMRT会进一步降低心脏剂量吗？

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Purpose In radiotherapy for left-sided breast cancer, Active Breathing Control enables a decrease of cardiac and Left Anterior Descending (LAD) coronary artery dose. We compared 3D-Conformal (3D-CRT) to Intensity Modulated Radiotherapy (IMRT) treatment plans based on free-breathing (FB) and breath-hold (BH). We investigated whether IMRT enables an additional decrease of cardiac dose in radiotherapy plans with and without BH. Methods and materials Twenty patients referred for whole breast irradiation were included. The whole breast, heart and LAD-region were contoured. Four treatment plans were generated: FB-3D-CRT; FB-IMRT; BH-3D-CRT; BH-IMRT. Several doses were obtained from Dose Volume Histograms and compared. Results were compared statistically using the Wilcoxin Signed Rank Test. For heart and LAD-region, a significant dose reduction was found in BH (p < 0.01). For both BH and FB, a significant dose reduction was found using IMRT (p < 0.01). By using IMRT an average reduction of 5% was noted in the LAD-region for the volume receiving 20 Gy. In 5 cases, the LAD-region remained situated in the vicinity of the radiation portals even in BH. Nevertheless, with IMRT the LAD dose was reduced in these cases. Conclusion IMRT results in a significant additional decrease of dose in the heart and LAD-region in both breath-hold and free-breathing.
机译：目的在针对左侧乳腺癌的放射治疗中，主动呼吸控制可降低心脏和左前降（LAD）冠状动脉的剂量。我们将3D保形（3D-CRT）与基于自由呼吸（FB）和屏气（BH）的调强放疗（IMRT）治疗计划进行了比较。我们研究了IMRT是否可以在有或没有BH的放疗计划中进一步降低心脏剂量。方法和材料包括二十例接受全乳照射的患者。整个乳房，心脏和LAD区域都轮廓化。产生了四个治疗计划：FB-3D-CRT; FB-IMRT; BH-3D-CRT; BH-IMRT。从剂量体积直方图获得几种剂量并进行比较。使用Wilcoxin Signed Rank Test对结果进行统计学比较。对于心脏和LAD区域，发现BH剂量显着降低（p <0.01）。对于BH和FB，使用IMRT可以显着降低剂量（p <0.01）。通过使用IMRT，在LAD区域中接收到20 Gy的体积平均减少了5％。在5例中，即使在BH中，LAD区域仍位于辐射入口附近。然而，在这些情况下，使用IMRT可以降低LAD剂量。结论IMRT导致屏气和自由呼吸时心脏和LAD区域的剂量显着降低。

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