摘要
Abstract
Objective: To compare dosimetric difference and acute adverse reactions between 3 different radiotherapy plan in pa⁃tients who received modified radical mastectomy for breast cancer. Methods:30 cases of modified radical mastectomy of breast cancer pa⁃tients were left after the design of volumetric modulated arc (VMAT), intensity-modulated (IMRT) and three-dimensional conformal radiother⁃apy (3D-CRT), were randomly divided into VMAT, IMRT and 3D-CRT group, each group of 10 cases, radiotherapy according to the prescrip⁃tion dose of 50 Gy The dose volume histogram (DVH) analysis was used to evaluate the dose parameters of planning target volume (PTV) , the treatment time in each time. V5, V10, V20, Dmean in left lung, V30, V40, and Dmeanof heart were compared between 3 groups. Acute radiation skin reaction, lung injury was evaluated. The changes of cardiac TroponinI was used to evaluate cardiac injury.Results:All of the evaluation indexes except for HI of 3D-CRT PTVwere inferior to VMAT and IMRT (P2, 3<0.01).In VMAT and IMRT plans, the only differences have sta⁃tistical significance were Dmean and V95(P1<0.05), and the Dmean of VMAT plans was more close to the prescription dose and the coverage rate of V95%was as high as 98.53%, In the fraciton times of treatment, the time of VMATwas shortest (P1, 2, 3<0.01). Organs at risk (OAR):The ipsilateral lung V20, cardiac V30, V40, Dmean inVMAT and IMRT were lower than that in 3D-CRT (both P2,3<0.05). The incidence of skin reac⁃tion, and cardiac injury in VMAT and IMRT was lower than that in 3D-CRT (P2,3<0.05). There were no differences in radiation-induced lung injury between 3groups (P>0.05).Conclusion:The dose distribution and uniformity in VMAT and IMRT were better than that in 3D-CRT, and VMAT has obvious advantage in target volume dose coverage and fraction treatment time than other 2 groups, VMAT and IMRT can effec⁃tively reduce the high dose area volume and average dose of OAR, reduce the incidence of acute adverse reactions such as skin damage, heart damage and so on.关键词
乳腺癌/改良根治术/放射治疗/剂量学/放射损伤Key words
breast cancer/modified radical mastectomy/radiation therapy/dosimetry/radiation injury
