Clinical experience with 3-dimensional surface matching-based deep inspiration breath hold for left-sided breast cancer radiation therapy
Clinical experience with 3-dimensional surface matching-based deep inspiration breath hold for left-sided breast cancer radiation therapy
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DOI：
10.1016/j.prro.2013.05.004
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发表时间：
2014-05-01
影响因子：
3.3
通讯作者：
Marks, Lawrence B.
中科院分区：
文献类型：
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作者：
Tang, Xiaoli;Zagar, Timothy M.;Marks, Lawrence B.
目的：三维（3D）表面匹配是一种新的方法，管理深吸气屏气（DIBH）放射治疗左侧乳腺癌，以减少心脏照射。我们分析了端口（X射线）的电影，以评估患者的设置精度和治疗时间，以评估本system.Methods和材料的实际工作流程：从50例左侧乳腺癌患者DIBH治疗的数据进行了研究。使用AlignRT（伦敦，英国）。将常规输液港片上观察到的射野边缘和前心包阴影之间的距离（d（PORT））与计划中数字重建X线片（DRR）上观察到的相应距离（d（DRR））进行比较，作为设置准确性的定量测量。评估d（PORT）-d（DRR）在治疗过程中的变化。在21例单独使用切向射束治疗的患者中，分析了每日治疗持续时间，以评估该系统的实际工作流程。考虑到所有50例患者，dPORT和dDRR之间的平均绝对系统不确定性为0.20 cm平均系统不确定度为-0.07 cm（范围，-1.22至0.67 cm），平均随机不确定度为0.19 cm（范围，0至0.84 cm）。d（PORT）-d（DRR）在治疗过程中无显著变化。研究的21例患者的平均患者治疗持续时间为11分48秒。在患者内评估中，15/21例患者在其治疗过程中具有缩短治疗持续时间的非显著趋势。在患者间的比较，平均治疗时间下降，因为我们获得了更多的经验与此technique.Conclusions：DIBH患者设置似乎提供了一个相当可重复的程度的心脏保留与随机不确定性约为0.2厘米。治疗持续时间在临床上是可接受的，并且在患者内的基础上似乎不会随时间发生显著变化，并且在患者间的基础上随时间改善。(C)2014年美国放射肿瘤学会。爱思唯尔公司出版All rights reserved.
Purpose: Three-dimensional (3D) surface matching is a novel method to administer deep inspiration breath-hold (DIBH) radiation therapy for left-sided breast cancer to reduce cardiac exposure. We analyzed port (x-ray) films to assess patient setup accuracy and treatment times to assess the practical workflow of this system.Methods and materials: The data from 50 left-sided breast cancer patients treated with DIBH were studied. AlignRT (London, UK) was used. The distance between the field edge and the anterior pericardial shadow as seen on the routine port films (d(PORT)), and the corresponding distance seen on the digitally reconstructed radiographs (DRR) from the planning (d(DRR)) were compared as a quantitative measure of setup accuracy. Variations of d(PORT)-d(DRR) over the treatment course were assessed. In a subset of 21 patients treated with tangential beams alone, the daily treatment durations were analyzed to assess the practical workflow of this system.Results: Considering all 50 patients, the mean absolute systematic uncertainty between dPORT and dDRR was 0.20 cm (range, 0 to 1.22 cm), the mean systematic uncertainty was -0.07 cm (range, -1.22 to 0.67 cm), and their mean random uncertainty was 0.19 cm (range, 0 to 0.84 cm). There was no significant change in d(PORT)-d(DRR) during the course of treatment. The mean patient treatment duration for the 21 patients studied was 11 minutes 48 seconds. On intrapatient assessments, 15/21 had nonsignificant trends toward reduced treatment durations during their course of therapy. On interpatient comparisons, the mean treatment times declined as we gained more experience with this technique.Conclusions: The DIBH patient setup appears to provide a fairly reproducible degree of cardiac sparing with random uncertainties of approximate to 0.2 cm. The treatment durations are clinically acceptable and appear not to change significantly over time on an intrapatient basis, and to improve over time on an interpatient basis. (C) 2014 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.