PDF(Pubmed)
Abstract：
BACKGROUND: Breast cancer is the most widespread cancer in women and young women worldwide. Moving towards customised radiotherapy, balancing the use of the available technology with the best treatment modality may not be an easy task in the daily routine. This study aims to evaluate the effectiveness of introducing IQ-feasibility into clinical practice to support the decision of free-breathing (FB) versus breath-hold (BH) left-sided breast irradiations, in order to optimise the technology available and the effectiveness of the treatment.
METHODS: Thirty-five patients who received 3D radiotherapy treatment of the left breast in deep-inspiration BH were included in this retrospective study. Computed tomography scans in FB and BH were acquired for each patient; targets contoured in both imaging datasets by an experienced radiation oncologist, and organs at risk delineated using automatic segmentation software were exported to PlanIQ™ (Sun Nuclear Corp.) to generate feasibility dose volume histogram (FDVHs). The dosimetric parameter of BH versus FB FDVH, and BH clinical dataset versus BH FDVH were compared.
RESULTS: A total of 30 patients out of 35 patients analysed, presented for the BH treatments a significant reduction (p < 0.05) in the heart mean dose ([Formula: see text]), volume receiving 5 Gy ([Formula: see text]) and 20 Gy ([Formula: see text]), of 35.7%, 54.5%, and 2.1%, respectively; for the left lung, a lower reduction was registered and significant only for [Formula: see text] (21.4%, p = 0.046). For the remaining five patients, the FDVH cut-off points of heart and lung were superimposable with differences of less than 1%. Heart and left lung dosimetric parameters of the BH clinical plans are located in the difficult zone of the FDVH and differ significantly (p < 0.05) from the corresponding parameters of the FDVH curves delimiting this buffer area between the impossible and feasible zones, respectively.
CONCLUSIONS: The use of PlanIQTM as a decision-support tool for the FB versus BH treatment delivery modality allows customisation of the treatment technique using the most appropriate technology for each patient enabling accurate management of available technologies.
METHODS: Thirty-five patients who received 3D radiotherapy treatment of the left breast in deep-inspiration BH were included in this retrospective study. Computed tomography scans in FB and BH were acquired for each patient; targets contoured in both imaging datasets by an experienced radiation oncologist, and organs at risk delineated using automatic segmentation software were exported to PlanIQ™ (Sun Nuclear Corp.) to generate feasibility dose volume histogram (FDVHs). The dosimetric parameter of BH versus FB FDVH, and BH clinical dataset versus BH FDVH were compared.
RESULTS: A total of 30 patients out of 35 patients analysed, presented for the BH treatments a significant reduction (p < 0.05) in the heart mean dose ([Formula: see text]), volume receiving 5 Gy ([Formula: see text]) and 20 Gy ([Formula: see text]), of 35.7%, 54.5%, and 2.1%, respectively; for the left lung, a lower reduction was registered and significant only for [Formula: see text] (21.4%, p = 0.046). For the remaining five patients, the FDVH cut-off points of heart and lung were superimposable with differences of less than 1%. Heart and left lung dosimetric parameters of the BH clinical plans are located in the difficult zone of the FDVH and differ significantly (p < 0.05) from the corresponding parameters of the FDVH curves delimiting this buffer area between the impossible and feasible zones, respectively.
CONCLUSIONS: The use of PlanIQTM as a decision-support tool for the FB versus BH treatment delivery modality allows customisation of the treatment technique using the most appropriate technology for each patient enabling accurate management of available technologies.
摘要：
背景：乳腺癌是全世界女性和年轻女性中最普遍的癌症。走向定制放射治疗，在日常生活中，平衡现有技术的使用与最佳治疗方式可能不是一件容易的事。这项研究旨在评估将IQ可行性引入临床实践以支持自由呼吸（FB）与屏气（BH）左侧乳房照射的决定的有效性。为了优化可用的技术和治疗的有效性。
方法：这项回顾性研究包括35例接受深吸气BH左乳3D放疗的患者。为每位患者采集FB和BH中的计算机断层扫描；由经验丰富的放射肿瘤学家在两个成像数据集中绘制的目标轮廓，并将使用自动分割软件描绘的危险器官导出到PlanIQ™(SunNuclearCorp.)生成可行性剂量体积直方图(FDVHs)。BH与FBFDVH的剂量学参数，比较了BH临床数据集和BHFDVH。
结果：分析了35例患者中的30例，对于BH治疗，心脏平均剂量显着降低（p<0.05）（[公式：见正文]），接收量5Gy([公式：见正文])和20Gy([公式：见正文])，35.7%，54.5%,和2.1%，分别；对于左肺，只有[公式：见正文](21.4%，p=0.046)。其余5名患者,心脏和肺的FDVH截止点重叠，差异小于1％。BH临床计划的心脏和左肺剂量学参数位于FDVH的困难区域，并且与限定不可能区域和可行区域之间的缓冲区的FDVH曲线的相应参数显着不同（p<0.05）。分别。
结论：使用PlanIQTM作为FB与BH治疗方式的决策支持工具，可以为每位患者使用最合适的技术来定制治疗技术，从而可以对可用技术进行准确管理。
方法：这项回顾性研究包括35例接受深吸气BH左乳3D放疗的患者。为每位患者采集FB和BH中的计算机断层扫描；由经验丰富的放射肿瘤学家在两个成像数据集中绘制的目标轮廓，并将使用自动分割软件描绘的危险器官导出到PlanIQ™(SunNuclearCorp.)生成可行性剂量体积直方图(FDVHs)。BH与FBFDVH的剂量学参数，比较了BH临床数据集和BHFDVH。
结果：分析了35例患者中的30例，对于BH治疗，心脏平均剂量显着降低（p<0.05）（[公式：见正文]），接收量5Gy([公式：见正文])和20Gy([公式：见正文])，35.7%，54.5%,和2.1%，分别；对于左肺，只有[公式：见正文](21.4%，p=0.046)。其余5名患者,心脏和肺的FDVH截止点重叠，差异小于1％。BH临床计划的心脏和左肺剂量学参数位于FDVH的困难区域，并且与限定不可能区域和可行区域之间的缓冲区的FDVH曲线的相应参数显着不同（p<0.05）。分别。
结论：使用PlanIQTM作为FB与BH治疗方式的决策支持工具，可以为每位患者使用最合适的技术来定制治疗技术，从而可以对可用技术进行准确管理。
