How Important Is a Reproducible Breath Hold for Deep Inspiration Breath Hold Breast Radiation Therapy?
How Important Is a Reproducible Breath Hold for Deep Inspiration Breath Hold Breast Radiation Therapy?
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DOI：
10.1016/j.ijrobp.2015.06.010
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发表时间：
2015-11-15
影响因子：
7
通讯作者：
Sintay, Benjamin
中科院分区：
文献类型：
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作者：
Wiant, David;Wentworth, Stacy;Sintay, Benjamin
目的：深吸气屏气(DIBH)治疗左侧乳腺癌可减少心脏剂量。表面成像有助于确保准确的乳房定位，但它不能保证DIBH治疗时的可重复性屏气(BH)。方法和材料：我们回顾了25例接受自由呼吸(FB)和DIBH扫描的患者。为每个患者创建四个计划：FB、DIBH、FB_DIBH(将DIBH计划复制到FB图像并重新计算，图像配准基于乳房组织)和P_DIBH(心脏在FB和DIBH位置之间中途移位的部分BH)。FB_DIBH计划给出了表面成像DIBH的“最坏情况”，即通过表面成像将乳房对齐，但患者不屏息。结果：在所有病例中，DIBH计划的心脏剂量和乳房覆盖率均低于FB。FB_DIBH计划与FB计划在乳房覆盖率、平均心脏剂量或最大心脏剂量方面没有显著差异(P>；=.10)。对于所有病例，FB_DIBH和FB之间的平均心脏剂量相差2GY；最大心脏剂量不同于
Purpose: Deep inspiration breath hold (DIBH) for left-sided breast cancer has been shown to reduce heart dose. Surface imaging helps to ensure accurate breast positioning, but it does not guarantee a reproducible breath hold (BH) at DIBH treatments. We examine the effects of variable BH positions for DIBH treatments.Methods and Materials: Twenty-five patients who underwent free breathing (FB) and DIBH scans were reviewed. Four plans were created for each patient: FB, DIBH, FB_DIBH (the DIBH plans were copied to the FB images and recalculated, and image registration was based on breast tissue), and P_DIBH (a partial BH with the heart shifted midway between the FB and DIBH positions). The FB_DIBH plans give a "worst-case" scenario for surface imaging DIBH, where the breast is aligned by surface imaging but the patient is not holding their breath. Kolmogorov-Smirnov tests were used to compare the dose metrics.Results: The DIBH plans gave lower heart dose and comparable breast coverage versus FB in all cases. The FB_DIBH plans showed no significant difference versus FB plans for breast coverage, mean heart dose, or maximum heart dose (P >=.10). The mean heart dose differed between FB_DIBH and FB by < 2 Gy for all cases, and the maximum heart dose differed by