摘要
Abstract
Objective:To explore the safety of patients undergoing large-segment radiotherapy after radical surgery of left breast cancer,and to evaluated the effect of hypofractionated radiotherapy on the dose to the heart and its substructures.Methods:From August 2023 to September 2024,a total of 20 patients who met the inclusion criteria postmastectomy for left breast cancer were enrolled in the Department of Oncology,The First Affiliated Hospital of Gannan Medical University.According to the radiotherapy method,they were divided into large-segment radiotherapy(43.5 Gy/15 times)group and conventional split radiotherapy(50 Gy/25 times)group,with 10 cases each.Comparison of the minimum dose(Dmin),maximum dose(Dmax),mean dose(Dmean)of the total heart,left atrium,left ventricle,left anterior descending coronary artery,right atrium,right ventricle,right coronary artery of the two groups of patients(Dmin),maximum dose(Dmax),average dose(Dmean),and relative volume fractions V5 Gy,V10 Gy,V30 Gy,V40 Gy(left atrium and right atrium did not record relative volume fractions).Comparison of Dmean in healthy breast and ipsilateral lung Dmin,Dmax,Dmean,V5 Gy,V10 Gy,V20 Gy,V30 Gy,V40 Gy in 2 groups of patients.Results:Compared with the conventional segmented radiotherapy group,the Dmax in the whole heart,Dmax,Dmean,V5 Gy,V10 Gy in the left ventricle and V40 Gy in the left anterior descending branch of the coronary artery were significantly reduced,and the differences were statistically significant(P＜0.05).The Dmean in the healthy breasts of the large segmented radiotherapy group was higher than that in the conventional segmented radiotherapy group,but the difference was not statistically significant(P＞0.05).The Dmean,V20 Gy and V40 Gy in the ipsilateral lungs of large segmented radiotherapy group were significantly lower than those in the conventional segmented radiotherapy group,and the differences were statistically significant(P＜0.05);There was no significant difference between the ipsilateral lung Dmin,Dmax,V5 Gy,V10 Gy and V30 Gy in the large segmented radiotherapy group compared with the conventional segmented radiotherapy group(P＞0.05).Conclusion:Hypofractionated radiotherapy can reduce the dose to the heart compared to conventional fractionated radiotherapy,but either of the methods requires precise outlining of cardiac substructures and individual dose limitation to better protect the heart.关键词
乳腺癌/大分割放疗/心脏亚结构Key words
Breast cancer/Hypofractionated radiotherapy/Heart substructures分类
医药卫生
