[1]申正文,李师,谭霞,等.乳腺癌根治术后放疗靶区外放边界的分析及验证[J].中国医学物理学杂志,2021,38(7):804-808.[doi:DOI:10.3969/j.issn.1005-202X.2021.07.003]
　SHEN Zhengwen,LI Shi,TAN Xia,et al.Analysis and verification of target margin for post-mastectomy radiotherapy for breast cancer[J].Chinese Journal of Medical Physics,2021,38(7):804-808.[doi:DOI:10.3969/j.issn.1005-202X.2021.07.003]
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乳腺癌根治术后放疗靶区外放边界的分析及验证()
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《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
38卷
期数:
2021年第7期
页码:
804-808
栏目:
医学放射物理
出版日期:
2021-07-26

文章信息/Info

Title:
Analysis and verification of target margin for post-mastectomy radiotherapy for breast cancer
文章编号:
1005-202X（2021）07-0804-05
作者:
申正文; 李师; 谭霞; 田秀梅; 罗焕丽; 靳富; 万跃
重庆大学附属肿瘤医院肿瘤放射治疗中心， 重庆 400030
Author(s):
SHEN Zhengwen;  LI Shi;  TAN Xia;  TIAN Xiumei;  LUO Huanli;  JIN Fu;  WAN Yue
Department of Radiation Oncology, Chongqing University Cancer Hospital, Chongqing 400030, China
关键词:
乳腺癌; 术后放疗; 锥形束CT; 摆位误差; 外放边界; 剂量影响
Keywords:
Keywords: breast cancer post-mastectomy radiotherapy cone-beam computed tomography setup error margin dosimetric effect
分类号:
R318；R811
DOI:
DOI:10.3969/j.issn.1005-202X.2021.07.003
文献标志码:
A
摘要:
目的：回顾性分析乳腺癌根治术后放疗中的摆位误差，由此计算CTV外扩至PTV的外放边界，并通过模拟摆位误差验证此外放边界是否合适。方法：选取接受乳腺癌根治术后放疗的患者40例，其中左乳腺癌患者20例，右乳腺癌患者20例。根据治疗期间采集的CBCT图像确定摆位误差，计算出外扩边界。在TPS中模拟摆位误差，比较在此外扩边界下的剂量学差异。结果：全组患者左右、头脚、腹背方向的摆位误差分别为（2.09±2.48）、（2.57±2.52）和（2.88±2.54） mm；CTV外扩至PTV的边界分别为6.24、7.99、7.17 mm。在此外放边界下模拟摆位误差，CTV的各项剂量学指标无统计学差异，PTV的D95、D98、Dmax、Dmin有统计学差异，健侧乳腺Dmax、Dmean和脊髓Dmax有统计学差异,其他危及器官剂量学指标无统计学差异。在左右和腹背方向模拟摆位误差3 mm时，计划的γ通过率<95%。结论：摆位误差对PTV、脊髓、健侧乳腺的剂量影响较大。与头脚方向相比，剂量分布受左右和腹背方向摆位误差的影响更大。当摆位误差超过3 mm时需要对其进行修正。
Abstract:
Abstract: Objective To calculate the CTV-PTV margins based on the retrospective analysis on the setup errors of post-mastectomy radiotherapy for breast cancer, and to simulate the setup errors for verifying whether the margin is appropriate. Methods Forty breast cancer patients, including 20 patients with left-sided breast cancer and 20 patients with right-sided breast cancer, who received post-mastectomy radiotherapy were enrolled. According to the CBCT images collected during the treatment, the setup errors were determined, and the margins were calculated. The setup errors were simulated in TPS for comparing the dosimetric differences under the target margins. Results The setup errors in left-right, superior-inferior and anterior-posterior directions were (2.09±2.48), (2.57±2.52) and (2.88±2.54) mm, respectively, and the CTV-PTV margins were 6.24, 7.99 and 7.17 mm, respectively. There were statistically significant differences in D95, D98, Dmax and Dmin of PTV, Dmax and Dmean of the unaffected breast and Dmax of spinal cord, but not in the dosimetric parameters of CTV and no statistically significant difference was found in the dosimetric parameters of other organs-at-risk. When the setup errors in left-right and anterior-posterior directions were 3 mm, Gamma passing rate was less than 95%. Conclusion Setup errors have great dosimetric effects on PTV, spinal cord and unaffected breast. The dose distribution is more affected by the setup errors from left-right and anterior-posterior directions compared with superior-inferior direction. When the setup error is larger than 3 mm, it should be corrected.

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备注/Memo

备注/Memo:
【收稿日期】2021-03-15 【基金项目】国家自然科学基金（11805025）；重庆市科委社会民生项目（cstc2018jscx-msybX0153） 【作者简介】申正文，研究方向：放疗质控，E-mail: smuszw@163.com 【通信作者】田秀梅，研究方向：放射物理，E-mail: txm805988970@126.com
更新日期/Last Update: 2021-07-26