CPAP (Continuous Positive Airway Pressure) is an effective and stable solution for heart sparing radiotherapy of left sided breast cancer
CPAP (Continuous Positive Airway Pressure) is an effective and stable solution for heart sparing radiotherapy of left sided breast cancer
复制标题
DOI：
10.1186/s13014-020-01505-7
复制
发表时间：
2020-03-06
影响因子：
3.6
通讯作者：
Allon, Helena
中科院分区：
文献类型：
--
作者：
Allen, Aaron M.;Ceder, Yasmin Korzets;Allon, Helena
目的：限制左乳腺癌放射治疗中的心脏剂量是关键。我们试图研究使用CPAP（持续气道正压通气）作为减少乳腺癌放射治疗中心脏剂量的辅助手段的效果。方法对接受辅助放疗的左侧乳腺癌患者进行前瞻性临床试验，在放射治疗期间使用CPAP。每个病人都进行了模拟和计划，有和没有CPAP和最佳剂量测定结果确定病人的治疗。分析了有和无CPAP时肺和心脏体积和位置以及增压腔位置的差异数据。结果24例患者，年龄10/16 ~ 10/18。7例患者在研究中未接受治疗;其中只有2例是由于治疗问题。中位年龄为54岁。70%仅行乳腺照射，30%行乳腺、CW（胸壁）和区域淋巴结照射。使用CPAP的中位肺容量比不使用CPAP的中位肺容量大60%。(1637与996 cc相比）p < 0.001。CPAP治疗后平均心脏容积下降12%。(338与382 cc）关于DVH，CPAP将平均心脏剂量从3.02 Gy降至1.6 Gy（p = 0.0075），并将肺V20从17.1降至13.8，但这并不显著。结论CPAP辅助放射治疗左侧乳腺癌是一种耐受性较好的上级治疗方案。该方法作为一种保留正常组织的左侧乳腺癌治疗方法值得进一步研究。
Purpose Limiting the heart dose in left sided breast cancer radiotherapy is critical. We sought to study the effect of using CPAP (continuous positive airway pressure) as an aid in reducing heart dose in breast cancer radiotherapy. Methods Patients with left sided breast cancer receiving adjuvant radiotherapy were enrolled on a prospective IRB (institutional review board) approved clinical trial utilizing CPAP during radiotherapy. Each patient was simulated and planned with and without CPAP and the best dosimetric results determined the patient's treatment. Data on the differences in lung and heart volume and position as well as boost cavity position with and without CPAP were analyzed. Results Twenty-four women from 10/16 to 10/18 were enrolled. Seven patients were not treated on study; only two of these were due to treatment issues. Median age was 54 years. 70% had breast only radiation and 30% were treated to breast\CW (chest wall) and regional nodes. The median lung volume with CPAP was 60% larger than without CPAP. (1637 vs. 996 cc) p < 0.001. The median heart volume decreased 12% with CPAP. (338 vs. 382 cc) In regards to the DVH, CPAP decreased mean heart dose from 3.02 to 1.6Gy (p = .0075) and V20 of the lungs from 17.1 to 13.8 with CPAP but this was not significant. Conclusion CPAP assisted radiotherapy was tolerable and produced superior treatment plans in left sided breast cancer. This method is worthy of further investigation as a method to normal tissue sparing treatment of left sided breast cancer patients.