乳腺癌术后放疗H-IMRT技术与H-VMAT技术剂量学比较

doi:10.11904/j.issn.1002-3070.2021.06.005

Abstract

Abstract: Objective The aim of this study was to compare the dosimetric parameters of the mixed intensity-modulated plan(H-IMRT)and the mixed volume-modulated plan(H-VMAT)after radical mastectomy for left breast cancer(chest wall+supraclavicular+internal mammary area),and provide a certain reference for the design of complex breast cancer postoperative radiotherapy plans. Methods Twenty patients with left breast cancer who underwent radical surgery in our hospital from January 2018 to December 2020 were selected.All patients received radiotherapy on the chest wall,supra-clavicular lymph nodes,and internal mammary lymph nodes.Each patient was designed and made two radiotherapy plans:H-IMRT and H-VMAT.In the CRT field,a 2cm multi-leaf collimator(MLC)was placed in direction of the chest.The prescription dose of the target area was 50Gy,and the dose parameters of the target area and the organ at risk were compared through the dose calculation. Results The uniformity index for the target area of H-IMRT plan was(0.13±0.06),and the conformity index was(1.33±0.08).The uniformity index for the target area of H-VMAT plan was(0.12±0.04),and the conformity index is(1.24±0.07).The uniformity index and conformity index of the target area in the H-VMAT plan were higher than those in the H-IMRT plan(P＜0.05).H-IMRT plan suffered from lung V₅(48.99±2.91)% and V₂₀(24.5±1.1)%;H-VMAT plan suffered from lung V₅(45.87±3.53)% and V₂₀(20.6±1.6)%.The doses of V₅ and V₂₀ suffered from lung in H-VMAT plan were lower than those of H-IMRT plan(P＜0.05).H-IMRT plan suffered from heart V₃₀(10.44±3.62)% and V₄₀(6.59±3.53)%;H-VMAT plan suffered from heart V₃₀(5.87±1.53)% and V₄₀(4.9±2.8)%.H-VMAT plan heart V₃₀ and V₄₀ Lower than H-IMRT(P＜0.05).The doses of V₃₀ and V₄₀ suffered from the heart in the H-VMAT were better than those of H-IMRT.H-IMRT plan for heart was Dmean(7.43±1.78)Gy and H-VMAT plan was Dmean(9.7±0.7)Gy.The Dmean of the heart in the H-VMAT was slightly higher than that of H-IMRT(P＜0.05). Conclusion For the postoperative radiotherapy target area of breast cancer with internal mammary lymph nodes,H-VMAT has a better conformability than H-IMRT target area,and the exposure dose to the organs at risk is lower.

Key words: Intensity-Modulated radiotherapy, Volumetric-Modulated radiotherapy, Conventional tangent field

CLC Number:

R735.7

XU Bingchen, CAO Yangsen, LI Jian. Comparison of dosimetry between H-IMRT and H-VMAT techniques in postoperative radiotherapy of breast cancer[J]. Journal of Practical Oncology, 2021, 35(6): 511-516.

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URL: http://journal09.magtechjournal.com/Jwk3_syzlxzz/EN/10.11904/j.issn.1002-3070.2021.06.005

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Comparison of dosimetry between H-IMRT and H-VMAT techniques in postoperative radiotherapy of breast cancer

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