Treatment planning and evaluation of gated radiotherapy in left-sided breast cancer patients using the Catalyst(TM)/Sentinel(TM) system for deep inspiration breath-hold (DIBH).
Treatment planning and evaluation of gated radiotherapy in left-sided breast cancer patients using the Catalyst(TM)/Sentinel(TM) system for deep inspiration breath-hold (DIBH).
复制标题
使用催化剂（TM）/Sentinel（TM）系统对左侧乳腺癌患者进行封闭式放疗的治疗计划和评估，以进行深度灵感呼吸（DIBH）。
DOI：
10.1186/s13014-016-0716-5
复制
发表时间：
2016-10-26
期刊：
影响因子：
--
通讯作者：
Belka C
中科院分区：
文献类型：
--
作者：
Schönecker S;Walter F;Freislederer P;Marisch C;Scheithauer H;Harbeck N;Corradini S;Belka C
辅助放疗（RT）后的长期乳腺癌幸存者有潜在的不良心血管效应。为此，深度吸气屏气技术（DIBH）已被引入临床实践，以最大限度地减少对心脏的辐射剂量。然而，有各种各样的DIBH交付技术，患者定位和视觉患者反馈机制。本研究的目的是评估使用CatalystTM/SentinelTM系统的放射治疗在DIBH中的应用，特别强调自由呼吸（FB）和DIBH的治疗计划和剂量学计划的比较。本前瞻性临床试验共纳入13例保乳手术后左侧乳腺癌患者。治疗应用使用CatalystTM/SentinelTM系统（C-RAD AB, Uppsala, Sweden），并通过视听患者反馈系统进行门控控制。获得FB和DIBH的CT和表面数据，并使用铅笔束和塌陷锥卷积创建双重治疗方案。危险器官的剂量学输出参数采用Wilcoxon符号秩检验进行比较。在治疗期间，从iViewTM门静脉图像中提取肺中央距离（CLD）。该系统包含一个激光表面扫描仪（SentinelTM）和一个光学表面扫描仪（CatalystTM），通过门控接口连接到LINAC系统，并允许连续和非接触式表面扫描。总的来说，在视听指导下完成了225个治疗部分，没有任何实质性的困难。经过最初的患者培训和治疗设置，在DIBH中使用CatalystTM/SentinelTM系统进行放射治疗具有时间效率和可靠性。根据所有患者的双重治疗计划，13例患者中有9例在DIBH治疗。在这些患者中，与FB相比，DIBH的平均心脏剂量减少了52%（2.73至1.31 Gy; p = 0.011）。心脏和LAD的最大剂量分别降低了59% （47.90 ~ 19.74 Gy, p = 0.008）和75% （38.55 ~ 9.66 Gy, p = 0.008）。在9名患者中，有6名患者的心脏被DIBH完全移出了治疗范围。CLD的标准差在0.12 ~ 0.29 cm之间（平均值：0.16 cm）。CatalystTM/SentinelTM系统能够在日常临床常规中快速可靠地应用和监测DIBH。此外，目前的数据表明，在放疗期间使用DIBH技术可以显着减少心脏的高剂量区域和平均剂量。DRKS: 5号注册的DRKS00010929。2016年8月。
There is a potential for adverse cardiovascular effects in long-term breast cancer survivors following adjuvant radiotherapy (RT). For this purpose, the deep inspiration breath-hold technique (DIBH) has been introduced into clinical practice, to maximally reduce the radiation dose to the heart. However, there are a variety of DIBH delivery techniques, patient positioning and visual patient feedback mechanisms. The aim of the present study was to evaluate the application of radiotherapy in DIBH using the CatalystTM/SentinelTM system, with a special emphasis on treatment planning and dosimetric plan comparison in free breathing (FB) and DIBH. A total of 13 patients with left-sided breast cancer following breast conserving surgery were included in this prospective clinical trial. For treatment application the CatalystTM/SentinelTM system (C-RAD AB, Uppsala, Sweden) was used and gating control was performed by an audio-visual patient feedback system. CT and surface data were acquired in FB and DIBH and dual treatment plans were created using Pencil Beam and Collapsed Cone Convolution. Dosimetric output parameters of organs at risk were compared using Wilcoxon signed-rank test. Central lung distance (CLD) was retrieved from iViewTM portal images during treatment delivery. The system contains a laser surface scanner (SentinelTM) and an optical surface scanner (CatalystTM) interconnected to the LINAC systems via a gating interface and allows for a continuous and touchless surface scanning. Overall, 225 treatment fractions with audio-visual guidance were completed without any substantial difficulties. Following initial patient training and treatment setup, radiotherapy in DIBH with the CatalystTM/SentinelTM system was time-efficient and reliable. Following dual treatment planning for all patients, nine of 13 patients were treated in DIBH. In these patients, the reduction of the mean heart dose for DIBH compared to FB was 52 % (2.73 to 1.31 Gy; p = 0.011). The maximum doses to the heart and LAD were reduced by 59 % (47.90 to 19.74 Gy; p = 0.008) and 75 % (38.55 to 9.66 Gy; p = 0.008), respectively. In six of the nine patients the heart completely moved out of the treatment field by DIBH. The standard deviation of the CLD varied between 0.12 and 0.29 cm (mean: 0.16 cm). The CatalystTM/SentinelTM system enabled a fast and reliable application and surveillance of DIBH in daily clinical routine. Furthermore, the present data show that using the DIBH technique during RT could significantly reduce high dose areas and mean doses to the heart. DRKS: DRKS00010929 registered on 5. August 2016.
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
DOI：
10.1016/j.ijrobp.2010.12.021
发表时间：
2011-11-01
影响因子：
7
作者：
Pili, Giorgio;Grimaldi, Luca;Portaluri, Maurizio
通讯作者：
Portaluri, Maurizio
影响因子：
2.1
作者：
Smyth, Lloyd M;Knight, Kellie A;Aarons, Yolanda K;Wasiak, Jason
通讯作者：
Wasiak, Jason
DOI：
10.1186/s13014-015-0376-x
发表时间：
2015-03-19
期刊：
Radiation oncology (London, England)
影响因子：
--
作者：
Freislederer P;Reiner M;Hoischen W;Quanz A;Heinz C;Walter F;Belka C;Soehn M
通讯作者：
Soehn M
影响因子：
168.9
作者：
Albain, K.;Anderson, S.;Arriagada, R.;Barlow, W.;Bergh, J.;Bliss, J.;Buyse, M.;Cameron, D.;Carrasco, E.;Clarke, M.;Correa, C.;Coates, A.;Collins, R.;Costantino, J.;Cutter, D.;Cuzick, J.;Darby, S.;Davidson, N.;Davies, C.;Davies, K.;Delmestri, A.;Di Leo, A.;Dowsett, M.;Elphinstone, P.;Evans, V.;Ewertz, M.;Gelber, R.;Gettins, L.;Geyer, C.;Goldhirsch, A.;Godwin, J.;Gray, R.;Gregory, C.;Hayes, D.;Hill, C.;Ingle, J.;Jakesz, R.;James, S.;Kaufmann, M.;Kerr, A.;MacKinnon, E.;McGale, P.;McHugh, T.;Norton, L.;Ohashi, Y.;Paik, S.;Pan, H. C.;Perez, E.;Peto, R.;Piccart, M.;Pierce, L.;Pritchard, K.;Pruneri, G.;Raina, V.;Ravdin, P.;Robertson, J.;Rutgers, E.;Shao, Y. F.;Swain, S.;Taylor, C.;Valagussa, P.;Viale, G.;Whelan, T.;Winer, E.;Wang, Y.;Wood, W.
通讯作者：
Wood, W.