PDF(Pubmed)
Abstract：
Deep-inspiration breath-hold (DIBH) reduces the radiation dose to the heart and lungs during breast radiotherapy in cancer. However, there is not enough discussion about suitable breathing methods for DIBH. Therefore, we investigated the radiation doses and organ and body surface displacement in abdominal DIBH (A-DIBH) and thoracic DIBH (T-DIBH). Free-breathing, A-DIBH, and T-DIBH computed tomography images of 100 patients were used. After contouring the targets, heart, and lungs, radiotherapy plans were created. We investigated the heart and lung doses, the associations between the heart and left lung displacements, and the thorax and abdominal surface displacements. No significant differences were observed in the target dose indices. However, the heart and lung doses were significantly lower in A-DIBH than in T-DIBH for all the indices; the mean heart and lung doses were 1.69 and 3.48 Gy, and 1.91 and 3.55 Gy in A-DIBH and T-DIBH, respectively. The inferior displacement of the heart and the left lung was more significant in A-DIBH. Therefore, inferior expansion of the heart and lungs may be responsible for the respective dose reductions. The abdominal surface displaced more than the thoracic surface in both A-DIBH and T-DIBH, and thoracic surface displacement was greater in T-DIBH than in A-DIBH. Moreover, A-DIBH can be identified because abdominal surface displacement was greater in A-DIBH than in T-DIBH. In conclusion, A-DIBH and T-DIBH could be distinguished by comparing the abdominal and thoracic surfaces of A-DIBH and T-DIBH, thereby ensuring the implementation of A-DIBH and reducing the heart and lung doses.
摘要：
深吸气屏气（DIBH）可减少乳腺癌放疗期间对心脏和肺部的辐射剂量。然而,关于DIBH的合适呼吸方法没有足够的讨论。因此,我们调查了腹部DIBH（A-DIBH）和胸部DIBH（T-DIBH）的辐射剂量以及器官和体表位移。自由呼吸,A-DIBH,使用了100例患者的T-DIBH计算机断层扫描图像。勾勒出目标轮廓后,心,和肺，制定了放疗计划。我们调查了心脏和肺的剂量,心脏和左肺位移之间的关联，以及胸部和腹部表面位移。在目标剂量指数中没有观察到显著差异。然而,对于所有指标，A-DIBH的心脏和肺剂量均显着低于T-DIBH；平均心脏和肺剂量分别为1.69和3.48Gy，A-DIBH和T-DIBH中的1.91和3.55Gy，分别。在A-DIBH中，心脏和左肺的下移位更为显着。因此,心脏和肺的下扩张可能是各自剂量减少的原因。在A-DIBH和T-DIBH中，腹部表面的位移大于胸部表面，T-DIBH的胸廓表面位移大于A-DIBH。此外，可以识别A-DIBH，因为A-DIBH的腹部表面位移大于T-DIBH。总之,A-DIBH和T-DIBH可以通过比较A-DIBH和T-DIBH的腹部和胸部表面来区分，从而确保A-DIBH的实施并减少心肺剂量。
