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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Concomitant intensity modulated boost during whole breast hypofractionated radiotherapy - A feasibility and toxicity study
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Concomitant intensity modulated boost during whole breast hypofractionated radiotherapy - A feasibility and toxicity study

机译：全乳超分割放疗过程中同时进行的调强疗法-可行性和毒性研究

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Background: Breast cancer sensitivity to large fraction size may be enhanced using hypofractionated concomitant boost radiotherapy (CBRT), thereby shortening overall treatment time. This ethics approved, prospective single cohort feasibility study was designed to evaluate the dosimetry and toxicity of CBRT using an intensity-modulated radiotherapy (IMRT) technique, compared with a standard sequential boost technique (SBT). Methods: Fifteen women (11 right-sided; 4 left-sided) received 42.4 Gy to the whole breast and an additional 10.08 Gy to the tumor bed in 16 daily fractions, using IMRT and standard dose constraints. Each patient was replanned with the SBT, using mixed photon-electrons. Clinical target volume (CTV), dose evaluation volume (DEV), and organs at risk (OAR) dose distributions were compared with the SBT. Toxicity and treatment times were prospectively recorded. Results: All 15 CBRT plans achieved the desired CTV (V 49.9Gy ≥ 99%) and DEV (V 49.9Gy ≥ 95%), coverage of the boost, compared with only 10 (66.7%, p = 0.03), and 12 (80%, p = 0.125) SBT plans, respectively. Ipsilateral lung (p 0.0001), and heart (right-sided, p = 0.001; left-sided, p = 0.13) doses were lower. Grade 3 acute toxicity occurred in 1 (6.7%) patient. At 1 year, two (13.3%) additional patients had overall grade 2 late toxicity, compared with baseline. No grade 3-4 late toxicity was observed. Conclusions: CBRT using IMRT improved boost coverage and lowered OAR doses, compared with SBT. Toxicities were acceptable using a daily boost of 3.28 Gy. While resource utilization was greater, overall treatment time was reduced.
机译：背景：使用超分割伴随增强放疗（CBRT）可以增强乳腺癌对大分子肿瘤的敏感性，从而缩短总体治疗时间。这项经伦理学批准的前瞻性单队列可行性研究旨在通过强度调节放射疗法（IMRT）技术与标准连续增强技术（SBT）相比，评估CBRT的剂量学和毒性。方法：使用IMRT和标准剂量限制，对15名妇女（右侧为11;左侧为4）在16天内每天对整个乳房进行42.4 Gy的治疗，对肿瘤床再给予10.08 Gy的治疗。使用混合光子电子对每个患者进行SBT重新计划。将临床目标体积（CTV），剂量评估体积（DEV）和高危器官（OAR）剂量分布与SBT进行了比较。前瞻性记录毒性和治疗时间。结果：所有15个CBRT计划均达到了所需的CTV（V 49.9Gy≥99％）和DEV（V 49.9Gy≥95％），增强的覆盖范围，而只有10个（66.7％，p = 0.03）和12（ 80％，p = 0.125）的SBT计划。同侧肺（p <0.0001）和心脏（右侧，p = 0.001;左侧，p = 0.13）剂量较低。 1名患者（6.7％）发生3级急性毒性。与基线相比，在1年时，另外2名（13.3％）患者总体具有2级晚期毒性。没有观察到3-4级晚期毒性。结论：与SBT相比，使用IMRT的CBRT可以提高覆盖率并降低OAR剂量。每天增加3.28 Gy的毒性是可以接受的。虽然资源利用率更高，但总体治疗时间却减少了。

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