Meme kanseri tanısı ile göğüs duvarına radyoterapi uygulanan hastalarda iki farklı tekniğin karşılaştırılması

Year 2014, Volume: 24 Issue: 3, 99 - 104, 01.01.2014

Çağdaş Yavaş Güler Yavaş Hilal Acar Özlem Ata

Abstract

Amaç: Meme kanseri tanısı ile mastektomi olan hastaların tedavi planlamasında kullanılan alan içi alan FIF ve 3-boyutlu konformal radyoterapi 3B-KRT tekniklerinin dozimetrik karşılaştırılması yapıldı. Gereç ve yöntemler: Meme kanseri tanısı ile modifiye radikal mastektomi operasyonu uygulanan yirmi hasta çalışmaya dahil edildi. Her hasta için göğüs duvarına yönelik iki farklı tedavi planı yapıldı. Planlanan hedef hacim PTV , risk altındaki organlar ipsilateral akciğer, kalp, sol asendan koroner arter ve karşı meme , doz homojenite indeksi DHI ve tedavi için gerekli olan monitör ünitler MU açısından FIF plan ile 3B-KRT planları karşılaştırıldı. İstatistiksek analizde student t test kullanıldı. Bulgular: FIF tekniği kullanıldığında PTV ve ipsilateral akciğerdeki maksimum dozlar anlamlı olarak azaldı. Aynı şekilde, ipsilateral akciğer hacminin % 30’unun aldığı doz FIF tekniği ile anlamlı olarak azaldı. FIF tekniği ile daha az MU kullanılarak daha homojen doz dağılımı elde edildiği görüldü. Sonuç: Meme kanseri nedeni ile göğüs duvarına yönelik radyoterapi uygulanan hastalarda FIF tekniği ile 3B-KRT karşılaştırıldığında FIF tekniğinin PTV’de daha iyi bir doz dağılımı sağladığı görülmüştür. Ayrıca, tedavi için gerekli olan MU’nun daha düşük olması da göz önüne alındığında FIF tekniği göğüs duvarı ışınlamalarında 3B-KRT’ye göre daha avantajlı olarak görünmektedir

Keywords

Konformal radyoterapi, doz volüm histogramları, alan içi alan tekniği, meme kanseri

Comparison of two different techniques in breast cancer patients who underwent chest wall irradiation

Abstract

Objectives: We aimed to compare field-in-field technique FIF with 3-dimesional conformal tangential field radiotherapy 3D-CRT with enhanced dynamic wedges in terms of dosimetric benefits in patients with breast cancer who underwent mastectomy operation. Material and methods: Twenty consecutive breast cancer patients who underwent modified radical mastectomy were included to the study. For each patient, two different treatment plans were created for the chest wall. FIF plans and 3D-CRT plans were compared for doses in the planning target volume PTV , the organ at risk OAR volume including ipsilateral lung, heart, left ascending coronary artery LAD and the contralateral breast, the homogeneity index HI , and the monitor unit counts MU required for the treatment. Student-t test was used for statistical analysis. Results: The FIF technique significantly reduced the maximum dose of the PTV and the ipsilateral lung. Similarly, the dose to 30% of the ipsilateral lung volume was significantly reduced FIF technique. FIF technique allowed us more homogenous dose distribution with lower MU. Conclusion: The FIF technique, compared to 3D-CRT, for chest wall irradiation in breast cancer patients provided better dose distribution in the PTV. Considering the lower monitor units required for treatment the FIF technique seems to be more advantageous than 3D-CRT during chest wall irradiation

Keywords

Conformal radiotherapy, dose volume histograms, field-in-field technique, breast cancer

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