摘要
目的:研究以容积旋转调强放疗(volume modulated arc therapy,VMAT)技术为基础的混合布野的方法 HVMAT(hybrid-VMAT)在左侧乳腺癌胸锁联合放疗中的可行性。方法:选取左侧乳腺癌胸锁联合放疗患者21例,分别使用dMLC(dynamic multi-leave collimator)、VMAT和HVMAT方法进行计划设计,并分别命名为dMLC计划、VMAT计划与HVMAT计划。比较3种计划在计划靶区(planning target volume,PTV)、危及器官剂量分布上的差异。使用SPSS27.0软件进行统计学分析。结果 :3种计划间PTV剂量分布差异均具有统计学意义(P<0.05)。与dMLC计划相比,HVMAT计划的D_(98)、CI较大,Dmean较小,差异具有统计学意义(P<0.05);与VMAT计划相比,HVMAT计划的D_2、HI、D_(mean)更小,差异具有统计学意义(P<0.05)。与dMLC计划相比,HVMAT计划的左肺V_(30)更低,与VMAT计划相比,HVMAT计划的V_(10)和V_5更低,差异均具有统计学意义(P<0.05)。HVMAT计划的右肺V_5和D_(mean)介于dMLC计划和VMAT计划之间,HVMAT计划的心脏V30和Dmean最低。3种计划间脊髓D_(max)的差异无统计学意义。结论:HVMAT应用于左侧乳腺癌胸锁联合放疗不仅可提供更优的靶区剂量分布,还可进一步降低危及器官剂量。
Objective To investigate the feasibility of hybrid-VMAT(HVMAT)mixed field distribution based on volume modulated arc therapy(VMAT)technique in combined sternoclavicular radiotherapy for left-sided breast cancer.Methods Twenty-one left-sided breast cancer patients undergoing combined sternoclavicular radiotherapy had the plans designed with dynamic multi-leave collimator(dMLC),VMAT and HVMAT,and the plans obtained were named dMLC plan,VMAT plan and HVMAT plan,respectively.The three plans were compared in terms of the planning target volume(PTV)and dose distribution to organs at risk.SPSS 27.0 software was used for statistical analysis.Results The differences in PTV dose distribution among the 3 plans were statistically significant(P<0.05).HVMAT plan had significantly higher values of D98 and CI while lower value for Dmean when compared with dMLC plan(P<0.05);HVMAT plan had significantly lower values of D2,HI and Dmean when compared with VMAT plan(P<0.05).HVMAT plan had left lung V30 lower than that of dMLC plan and V10 and V5 lower than those of VMAT plan,and all the differences were statistically significant(P<0.05).Right lung V5 and Dmean of HVMAT plan were intermediate between those of dMLC and VMAT plans;HVMAT plan had the lowest cardiac V30 and Dmean in the three plans.There were no significant differences between the three plans in term of spinal cord Dmax.Conclusion The involvement of HVMAT combined sternoclavicular radiotherapy for left-sided breast cancer contributes to enhancing target dose distribution and reducing the dose distribution to organs at risk.
作者
刘灏
LIU Hao(Department of Radiation Oncology,Wanbei Coal Electricity Group General Hospital,the Third Hospital Affiliated to Bengbu Medical College,Suzhou 234000,Anhui Province,China)
出处
《医疗卫生装备》
CAS
2023年第6期42-46,共5页
Chinese Medical Equipment Journal
关键词
混合布野
乳腺癌
胸锁联合放疗
dMLC
VMAT
剂量分布
mixed field distribution
breast cancer
combined sternoclavicular radiotherapy
dynamic multi-leave collimator
volume modulated arc therapy
dose distribution
