What Can Proton Beam Therapy Achieve for Patients with Pectus Excavatum Requiring Left Breast, Axilla and Internal Mammary Nodal Radiotherapy?
نویسندگان
چکیده
Aims Exposure of the heart to radiation increases risk ischaemic disease, proportionate mean dose (MHD). Radiotherapy techniques including proton beam therapy (PBT) can reduce MHD. The aims this study were quantify MHD reduction achievable by PBT compared with volumetric modulated arc in breath hold (VMAT-BH) patients pectus excavatum (PEx), identify an anatomical metric from a computed tomography scan that might indicate which will achieve greatest reductions PBT. Materials and methods Sixteen PEx (Haller Index ≥2.7) identified radiotherapy planning images. Left breast/chest wall, axilla (I–IV) internal mammary node (IMN) volumes delineated. VMAT plans prepared, all satisfying target coverage constraints. Signed-rank comparisons undertaken for heart, ipsilateral lung contralateral breast. Spearman's rho correlations calculated metrics against achieved Results VMAT-BH was 4.1 Gy 0.7 plans. reduced average 3.4 (range 2.8–4.4 Gy) (P < 0.001). significantly (4.7 Gy, P 0.001) breast (2.7 distance (mm) at most inferomedial extent IMN volume (IMN distance) negatively correlated (Spearman's –0.88 (95% confidence interval –0.96 –0.67, 0.001)). Conclusion For requiring left-sided radiotherapy, clinically significant is using PBT, optimal photon technique (VMAT-BH). This patient group whom could have benefit.
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ژورنال
عنوان ژورنال: Clinical Oncology
سال: 2021
ISSN: ['0936-6555', '1433-2981']
DOI: https://doi.org/10.1016/j.clon.2021.06.011