Efficacy of the Dynamic Jaw Mode in Helical Tomotherapy With Static Ports for Breast Cancer.
Efficacy of the Dynamic Jaw Mode in Helical Tomotherapy With Static Ports for Breast Cancer.
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DOI：
10.1177/1533034614558746
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发表时间：
2015-08
影响因子：
2.8
通讯作者：
Shibamoto Y
中科院分区：
文献类型：
--
作者：
Sugie C;Manabe Y;Hayashi A;Murai T;Takaoka T;Hattori Y;Iwata H;Takenaka R;Shibamoto Y
近年来发展起来的断层放射治疗的动态颌技术，可以在不延长治疗时间的情况下，减少头尾向的剂量扩散。本研究旨在探讨动态颌模式在乳腺癌断层治疗中的作用。在25例左侧乳腺癌患者中生成了全乳和锁骨上区域淋巴结的静态断层治疗计划以及仅全乳的计划。为每例患者制定了具有动态或固定钳口模式的2.5或5 cm射野宽度的计划。处方剂量为50戈伊，分25次。在全乳和锁骨上淋巴结放疗中，动态颌模式的计划靶区（PTV）的剂量分布和均匀性略低于固定颌模式（5 cm野宽）（P < .05）。然而，肺低剂量体积和喉、甲状腺、皮肤和所有健康组织的平均剂量在动态颌模式下小于在5 cm射野宽度的固定颌模式下（P < .001）。在全乳放疗中，动态颌模式的皮肤和健康组织的平均剂量低于固定颌模式（5 cm野宽）（P < .001），而PTV剂量分布、均匀性和一致性无显著差异。动态颌模式提供了更好的保留器官的风险与PTV的剂量-体积指数的干扰最小。考虑到治疗时间，5 cm场动态钳口模式比2.5 cm固定钳口模式更有效。
The recently developed dynamic jaw technology of tomotherapy can reduce craniocaudal dose spread without much prolonging the treatment time. This study aimed to investigate the efficacy of the dynamic jaw mode for tomotherapy of breast cancer. Static tomotherapy plans of the whole breast and supraclavicular regional lymph nodes, and plans for the whole breast only were generated in 25 patients with left-sided breast cancer. Plans with a field width of 2.5 or 5 cm with the dynamic or fixed jaw modes were made for each patient. The prescribed dose was 50 Gy in 25 fractions. In whole breast and supraclavicular nodal radiotherapy, dose distributions and homogeneity of the planning target volume (PTV) with the dynamic jaw mode were slightly inferior to those with the fixed jaw mode with a 5-cm field width (P < .05). However, lung low-dose volumes and mean doses of the larynx, thyroid, skin, and all the healthy tissues combined were smaller with the dynamic jaw mode than with the fixed jaw mode with a 5-cm field width (P < .001). In whole breast radiotherapy, mean doses of the skin and healthy tissues were lower with the dynamic jaw mode than with the fixed jaw mode with a 5-cm field width (P < .001) without significant differences in PTV dose distributions, homogeneity, and conformity. The dynamic jaw mode provided better sparing of organs at risks with minimal disturbance of dose–volume indices of PTV. Considering the treatment time, the 5-cm-field dynamic jaw mode is more efficient than the 2.5-cm fixed jaw mode.