中国医学装备2024，Vol.21Issue(7)：23-28,6.DOI:10.3969/j.issn.1672-8270.2024.07.003
自主呼吸控制技术在左侧乳腺癌放疗中对心脏及其亚结构的保护研究
Study on the protection of ABC technique for heart and its substructures in radiotherapy for left breast cancer
摘要
Abstract
Objective:To investigate the protection of Active Breathing Coordinator(ABC)technique for heart and its substructures in radiotherapy for left breast cancer.Methods:A total of 50 patients with left breast cancer who underwent radiotherapy in our department were retrospectively selected,and treatment plans with intensity modulated radiotherapy(IMRT)were designed on the images of ABC combined with deep inspiration breath hold(ABC-DIBH)computed tomography(CT)and free-breathing(FB)CT,respectively.The dose parameters of the organ at risks(OARs)of heart and its substructures,including left ventricle(LV),left atrium(LA),right ventricle(RV),right atrium(RA),left main coronary artery(LMCA),left anterior descending coronary artery(LAD),left circumflex coronary artery(LCX)and right coronary artery(RCA),were compared between the two conditions.Results:Compared with FB,the dose of 2%volume(D2),the mean dose(Dmean),the percent volumes covered by different doses(V30,V20,V10,V5)decreased respectively 32.91%(absolute reduction of 1279.11 cGy),36.12%(195.94cGy),58.95%(2.8%),54.32%(3.58%),50.14%(5.56%)and 46.22%(9.67%)of heart under ABC-DIBH condition,and the differences were significant(t=10.28,12.81,9.16,10.28,12.82,12.24,P＜0.01),respectively.In addition,the Dmean values of LV,LA,RV,RA,LMCA,LAD,LCX and RCA decreased by 37.64%(absolute reduction was 285.92 cGy),15.38%(23.68 cGy),34.12%(118.93cGy),9.72%(12.52 cGy),22.17%(47.99 cGy),31.81%(820.63 cGy),16.51%(34.72 cGy)and 14.86%(34.11cGy)under ABC-DIBH condition,respectively,the differences were significant(t=9.50,3.71,6.20,8.65,3.18,10.92,4.26,6.71,P＜0.05).Conclusion:ABC technique can greatly reduce the received doses of heart and its substructures by extending the distance between the heart and the target region with DIBH,thus can form a very effective protection for the heart and its substructures.In addition,it can eliminate the dynamic variation of target location of breast cancer caused by respiratory,and avoid a series of problems,such as target missing,overexposure on normal tissue,and dose deviation.关键词
呼吸运动管理/自主呼吸控制系统/左侧乳腺癌/心脏亚结构/调强放射治疗Key words
Respiratory movement management/Active breathing coordinator/Left breast cancer/Cardiac substructure/Intensity modulated radiotherapy(IMRT)分类
医药卫生引用本文复制引用
陈洪涛,陈伟思,朴莹,郑芳,史亚滨,杨东,李子煌..自主呼吸控制技术在左侧乳腺癌放疗中对心脏及其亚结构的保护研究[J].中国医学装备,2024,21(7):23-28,6.基金项目
海南省卫生计生行业科研项目(19A200096) Hainan provincial health family planning industry research projects(19A200096) （19A200096）
