肿瘤预防与治疗2025，Vol.38Issue(3)：216-223,8.DOI:10.3969/j.issn.1674-0904.2025.03.006
VMAT与TOMO治疗双侧乳腺癌的剂量学差异研究
Dosimetric Comparison of VMAT and TOMO in the Treatment of Bilater-al Breast Cancer
摘要
Abstract
Objective:To comparatively analyze the dosimetric differences in target volumes and organs-at-risk following bilateral breast cancer surgery using volumetric modulated arc therapy(VMAT)and helical tomotherapy(TOMO),and to investigate their respective clinical advantages.Methods:Ten patients who underwent bilateral mastectomy for breast cancer were selected,with consistent contours of target volumes and organs at risk.Treatment plans using VMAT and TOMO were designed,and their dosimetric parameters were analyzed.Results:In terms of target dose distribution,the conformity index in the TOMO group was superior to that in the VMAT group(P＞0.05),while the gradient index in the TOMO group was significantly superior to that in the VMAT group(P＜0.05).The homogeneity index was consistent between the two groups.In terms of organs at risk protection,the maxi-mum dose to the spinal cord in the TOMO group was significantly lower than that in the VMAT group.Additionally,the irra-diated volume and mean dose(Dmean)to both the lungs and liver were significantly lower in the TOMO group compared to the VMAT group.The differences were all statistically significant(P＜0.05).Regarding the dose to the heart,the TOMO group exhibited a lower Dmean compared to the VMAT group,and the doses of V5 and V10 were also lower than those in the VMAT group.However,the doses of V20 and V30 were higher than those in the VMAT group.Differences in Dmean and V5 were sta-tistically significant(P＜0.05),while the differences in V10,V20 and V30 were not statistically significant(P＞0.05).The treatment time in the VMAT group was significantly shorter than that in the TOMO group(P＜0.01).Conclusion:In the comparison of two intensity-modulated radiation therapy techniques for bilateral breast cancer,TOMO and VMAT demonstrate equally excellent conformity and homogeneity in dose distribution to the target volume.The advantage of TOMO lies in its steeper dose gradient fall-off,which provides better protection for normal tissues by reducing the dose to the lungs,heart,liver,and spinal cord.On the other hand,VMAT offers the advantage of shorter treatment time,resulting in higher treatment efficiency.关键词
螺旋断层放射治疗/剂量学/双侧乳腺癌/容积旋转调强放射治疗/铅门跟随/动态铅门Key words
Helical tomotherapy/Dosimetric medicine/Bilateral breast cancer/Volumetric modulated arc therapy/Jaw tracking technique/Dynamic jaw分类
医药卫生引用本文复制引用
王自路,王相,曹红诗,张永春,姜鹏..VMAT与TOMO治疗双侧乳腺癌的剂量学差异研究[J].肿瘤预防与治疗,2025,38(3):216-223,8.基金项目
吴阶平医学基金会临床科研专项资助基金(编号:320.6750.2022-9-22) This study was supported by grants from Wu Jieping Medical Foundation(No.320.6750.2022-9-22). （编号:320.6750.2022-9-22）
