Arms positioning in post-mastectomy proton radiation: Feasibility and development of a new arms down contouring atlas.
Arms positioning in post-mastectomy proton radiation: Feasibility and development of a new arms down contouring atlas.
复制标题
DOI：
10.1016/j.phro.2020.04.003
复制
发表时间：
2020-04
影响因子：
--
通讯作者：
Jimenez RB
中科院分区：
文献类型：
--
作者：
Depauw N;Batin E;Johnson A;MacDonald SM;Jimenez RB
乳房切除术后质子放射治疗可实现手臂向下定位。臂向下位置在剂量学上与传统臂向上位置相当。手臂向下位置设置与传统手臂向上位置设置一样精确。为了再现性，提供了一个放下手臂的轮廓图谱。接受放射治疗的乳腺癌患者传统上是双臂向上的，但这可能对所有患者都不可行或不舒适。我们评估了使用质子笔形束扫描（PBS）接受乳房切除术后放射治疗（PMRT）的患者在手臂向上和手臂向下位置之间的治疗计划和定位再现性差异。计划接受PBS的10名PMRT患者在手臂向下和标准手臂向上位置进行了基于CT的治疗计划。为了治疗计划的一致性，开发了一个手臂向下轮廓图谱。在两次扫描中执行治疗计划。应用Wilcoxon检验来比较患者之间的手臂抬起和手臂放下指标。五名患者在我们的机构接受治疗时手臂向下，而其他人接受治疗时手臂向上。记录每例患者治疗部分的剩余设置误差，并在位置之间进行比较。目标结构覆盖范围在武器抬起和放下位置之间保持一致。关于OAR，手臂向上位置的心脏平均和最大剂量在统计学上显著低于手臂向下位置，但是，绝对差异不大。患者在所有方向上表现出相似的设置误差，差异小于0.5 mm。与传统的手臂向上定位相比，手臂向下位置的PMRT PBS似乎稳定且可重现。手臂放下组的OAR保留程度最低，但仍远上级传统光子治疗。
Arms down positioning is achievable for proton post-mastectomy radiation therapy. Arms down position is dosimetrically comparable to conventional arms up position. Arms down position setup is as accurate as the conventional arms up position setup. An arms-down contouring atlas has been provided for reproducibility. Breast cancer patients receiving radiation are traditionally positioned with both arms up, but this may not be feasible or comfortable for all patients. We evaluated the treatment planning and positioning reproducibility differences between the arms up and arms down positions for patients receiving post-mastectomy radiation therapy (PMRT) using proton pencil beam scanning (PBS). Ten PMRT patients who were scheduled to receive PBS underwent CT-based treatment planning in both an arms down and a standard arms up position. An arms down contouring atlas was developed for consistency in treatment planning. Treatment plans were performed on both scans. A Wilcoxon test was applied to compare arms up and arms down metrics across patients. Five patients received treatment in the arms-down position at our institution while others were treated with the arms up. Residual set-up errors were recorded for each patient’s treatment fractions and compared between positions. Target structure coverage remained consistent between the arms up and arms down positions. In regard to the OAR, the heart mean and maximum doses were statistically significantly lower in the arms up position versus the arms down position, however, the absolute differences were modest. Patients demonstrated similar setup errors, less than 0.5 mm differences, in all directions. PBS for PMRT in the arms down position appeared stable and reproducible compared to the traditional arms up positioning. The degree of OAR sparing in the arms down group was minimally less robust but still far superior to conventional photon therapy.
登录
查看更多内容
影响因子：
158.5
作者：
Darby, Sarah C.;Ewertz, Marianne;Hall, Per
通讯作者：
Hall, Per
影响因子：
5.7
作者：
Kirova, Youlia M.;Servois, Vincent;Fourquet, Alain
通讯作者：
Fourquet, Alain
影响因子：
3.1
作者：
Yang, Seoyon;Park, Dae Hwan;Kim, Won
通讯作者：
Kim, Won
DOI：
10.1016/j.ijrobp.2013.01.038
发表时间：
2013-07-01
影响因子：
7
作者：
MacDonald, Shannon M.;Patel, Sagar A.;Taghian, Alphonse G.
通讯作者：
Taghian, Alphonse G.
DOI：
10.1016/s0360-3016(98)00022-4
发表时间：
1998-05-01
影响因子：
7
作者：
Thilmann, C;Adamietz, IA;Böttcher, HD
通讯作者：
Böttcher, HD