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頁籤選單縮合
題名 | A Two-Year Experience of Using Moderate Deep Inspiration Breath-Hold for Patients with Early-Stage Breast Cancer and Dosimetric Comparison=使用適度深吸氣呼吸調控技術於早期乳癌患者的兩年經驗與放射劑量分析比較 |
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作者 | 林佳輝; 林立青; 郭珍妮; 林奎利; 林裕為; | 書刊名 | 放射治療與腫瘤學 |
卷期 | 21:1 2014.03[民103.03] |
頁次 | 頁13-20 |
分類號 | 416.226 |
關鍵詞 | 適度深吸氣呼吸調控; 主動呼吸調控; 早期乳癌; Moderate deep inspiration breath-hold; Active breathing control; Early stage breast cancer; |
語文 | 英文(English) |
中文摘要 | 目的:我們報告使用適度深吸氣呼吸調控技術於早期乳癌患者的兩年經驗並分析比較劑量,藉以評估此技術於心臟、肺臟與肝臟接受劑量減少的助益。材料與方法:我們回顧分析於2010年7月至2012年7月期間接受治療的所有新診斷早期乳癌病患,包括原位癌、第一期與第二期病患。此研究總計有81位病患,其中24位接受適度深吸氣呼吸調控技術,另外57位則採用自然呼吸。將兩組病患做劑量分析並比較心臟、肺臟與肝臟所接受放射劑量的差異。結果:有使用主動呼吸調控技術與自然呼吸的兩組病患,經過分析後發現以下因子並無差異:癌症分期分布、腫瘤部位分布、年齡分布、臨床靶區的劑量包覆率、臨床靶體積、心臟體積與肝臟體積。81位所有病患經分析後發現有使用主動呼吸調控技術的病患相較於自然呼吸的病患,有明顯較低的單側肺臟V10、單側肺臟V20、單側肺臟平均劑量、兩側肺臟V10、兩側肺臟V20、兩側肺臟平均劑量、肝臟V30與肝臟平均劑量。若針對37位左側乳癌病患進行分析,發現有使用主動呼吸調控技術的病患相較於自然呼吸的病患,有明顯較低的單側肺臟V10、單側肺臟V20、單側肺臟平均劑量、心臟V30、心臟V40、心臟平均劑量與肝臟平均劑量。若針對44位右側乳癌病患進行分析,發現有使用主動呼吸調控技術的病患相較於自然呼吸的病患,有明顯較低的單側肺臟V20、單側肺臟平均劑量、心臟平均劑量、肝臟V30與肝臟平均劑量。結論:使用適度深吸氣呼吸調控技術於早期乳癌患者不但可以降低心臟放射線劑量,亦可降低肺臟與肝臟劑量。因此常規地使用適度深吸氣呼吸調控技術可望幫忙減少放射線對於心臟、肺臟與肝臟的毒性。 |
英文摘要 | Purpose: We present our two-year experience of using moderate deep inspiration breath-hold (mDIBH) with an active breathing control (ABC) device for patients with early-stage breast cancer and dosimetric comparison to evaluate the benefit of mDIBH on the heart, lung, and liver.Materials and Methods: We retrospectively reviewed all patients with newly diagnosed breast cancer and having clinical stage Tis, I, or II disease treated between November 2010 and July 2012. Among the 81 patients included in this study, 24 patients were treated with mDIBH and 57 patients were treated with free breathing. Dosimetric analysis was performed to compare dose distribution in the heart, lung, and liver between the two treatment groups.Results: There was no significant difference in the distribution of stage, tumor site, age, clinical target volume (CTV) V50 and volume of CTV, heart, and liver between the non-ABC and ABC group. For all 81 patients, there was a significantly lower ipsilateral lung V10, ipsilateral lung V20, mean ipsilateral lung dose, whole lung V10, whole lung V20, mean whole lung dose, liver V30, and mean liver dose in the ABC group. For 37 patients with a left-sided breast tumor, significantly lower ipsilateral lung V10, ipsilateral lung V20, mean ipsilateral lung dose, heart V30, heart V40, mean heart dose, and mean liver dose were observed in the ABC group. For 44 patients with a right-sided breast tumor, significantly lower ipsilateral lung V20, mean ipsilateral lung dose, mean heart dose, liver V30, and mean liver dose were observed in the ABC group.Conclusions: For early-stage breast cancer patients, mDIBH reduces not only the heart dose but also the lung and liver doses. The routine integration of mDIBH using an ABC device may decrease radiation-induced toxicity in the heart, lung, and liver. |
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