Plastic surgery for breast conservation therapy: How to define the volume of the tumor bed for the boost?
Plastic surgery for breast conservation therapy: How to define the volume of the tumor bed for the boost?
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DOI：
10.1016/j.ejso.2014.03.009
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发表时间：
2014-07-01
期刊：
影响因子：
3.8
通讯作者：
Kirova, Y. M.
中科院分区：
文献类型：
--
作者：
Furet, E.;Peurien, D.;Kirova, Y. M.
目的：描述肿瘤整形外科手术后，使用术前和术后计算机断层扫描 (CT) 和手术夹在肿瘤床中定义增压量的过程。 患者和方法：对 31 名连续接受简单肿瘤切除术或肿瘤整形手术的乳腺癌患者进行研究。所有患者均在术前和术后接受治疗位CT扫描，以评估计划靶体积（PTV）增量体积并定义原发肿瘤（大体肿瘤体积（GTV））和瘤床区（CTV），横向总体边缘为5毫米，头尾方向总体边缘为10毫米，对应于定位和设置的不确定性。结果：33例患者接受了简单的肿瘤切除术，18例接受了肿瘤整形手术。体积分析显示，拥有三个或更多夹子的患者中，GTV 和 CTV 夹子之间的交集显着更高（28.4% vs 3.14%；p < 0.001）。对于接受肿瘤整形手术的患者，需要三个以上的夹子才能准确确定肿瘤床体积。夹子的数量与增压量的精确定义直接相关。结论：使用三个以上的夹子可以更好地定义肿瘤整形外科手术后的 PTV 增压量。 (C) 2014 Elsevier Ltd. 保留所有权利。
Purpose: To describe the procedure of definition of the boost volume using pre- and post-operative computed tomography (CT) and surgical clips in the tumor bed after oncoplastic surgical procedure.Patients and methods: Thirty-one consecutive breast cancer patients who underwent simple lumpectomy or oncoplastic surgery were studied. All of them underwent pre- and post-operative CT scan in treatment position to evaluate the planning target volume (PTV) boost volume and define the primary tumor (gross tumor volume (GTV)) and tumor bed zones (CTV), with an overall margin of 5 mm in lateral and 10 mm in craniocaudal directions, corresponding to localization and setup uncertainties.Results: Thirteem patients underwent simple lumpectomy and 18 oncoplastic surgery. The volumetric analysis showed that the intersection between GTV and CTV clips was significantly higher in patients with three and more clips (28.4% vs 3.14%; p < 0.001). In the case of patients With oncoplastic surgery, more than three clips were needed to define the tumor bed volume with accuracy. The number of clips was directly related to the exact definition of the boost volume.Conclusions: The use of more than three clips allows better definition of the PTV boost volume after oncoplastic surgical procedure. (C) 2014 Elsevier Ltd. All rights reserved.