Meta分析保乳术后三维适形与调强技术剂量学比较

doi:10.11889/j.1000-3436.2016.rrj.34.030201

Journal of Radiation Research and Radiation Proces ›› 2016, Vol. 34 ›› Issue (3): 30201-030201.doi: 10.11889/j.1000-3436.2016.rrj.34.030201

• RADIOBIOLOGY AND RADIOMEDICINE • Previous Articles Next Articles

Meta-analysis of dosimetric comparision between three-dimensional conformal radiotherapy and intensity-modulated radiotherapy for breast cancer with conserving surgery

CUI Qinling, SUN Yan, ZHONG Wen, GUO Genyan, CHEN Yanzhi, ZHAO Yuxia

Department of Radiation Oncology of Cancer Center, Fourth Affiliated Hospital of China Medical University, Shenyang 110032, China

Received:2016-01-14 Revised:2016-03-06 Online:2016-06-20 Published:2016-04-29
Supported by:
Supported by the Key Program of Clinical Diagnosis and Treatment of Hospital Reform in Liaoning Province (NCCC-B08-2014)

Abstract

Abstract:

The aim was to evaluate the dosimetry superiority of IMRT (Intensity-modulated radiotherapy) in early-stage breast cancer with conserving surgery and provide more valuable evidences to the clinical researches. Clinical trials of dosimetric comparision between 3D-CRT and IMRT for early-stage breast cancer with conserving surgery were obtained from PubMed, EMbase, Sciencedirect, Wei pu, CNKI (China national knowledge Infrastructure), and Wanfang databases, which were evaluated and analyzed with the Cochrane Collaboration's RevMan 5.2.0 software. Fifteen samples were included. Compared with 3D-CRT plans, IMRT plans had a lower ipsilateral lung V₂₀ (p=0.004), V₃₀ (p=0.008), V₄₀ (p=0.000 8), D_max (p=0.001) and heart V₃₀ (p=0.002), V₄₀ (p<0.000 01), while had a higher ipsilateral lung V₅ (p=0.000 5), V₁₀ (p=0.05) and heart V₅ (p<0.000 1), V₁₀ (p=0.000 7). IMRT plans provided a significantly better coverage of the PTV V₉₅ (p=0.05), V₁₀₅ (p<0.000 1), V₁₁₀ (p<0.000 01) and maximal dose (p<0.000 01). IMRT plans had a better dose homogeneity index and conformity index than 3D-CRT plans, both with p=0.02, but had a higher contralateral lung V₅ (p=0.002), D_max (p=0.000 4) and contralateral breast V₃ (p=0.000 6). There was no significant difference between IMRT and 3D-CRT plans for V₁₀₀, mean and minimal doses of PTV, ipsilateral lung mean dose, heart V₂₀, maximum, mean dose, and contralateral mean dose, all p>0.05. Compared with 3D-CRT plans, IMRT plans had the dosimetry superiority for early-stage breast cancer with significantly better coverage and dose homogeneity of planning target volume while maintaining lower doses to high risk organs.

Key words: Breast cancer, Radiotherapy, Three-dimensional conformal radiotherapy (3D-CRT), Intensitymodulated radiotherapy (IMRT), Meta-analysis

CLC Number:

R730.55

CUI Qinling, SUN Yan, ZHONG Wen, GUO Genyan, CHEN Yanzhi, ZHAO Yuxia. Meta-analysis of dosimetric comparision between three-dimensional conformal radiotherapy and intensity-modulated radiotherapy for breast cancer with conserving surgery[J].Journal of Radiation Research and Radiation Proces, 2016, 34(3): 30201-030201.

References

1 Kelemen G L, Varga Z, Lázár G, et al. Cosmetic outcome 1~5 years after breast conservative surgery, irradiation and systemic therapy[J]. Pathology & Oncology Research, 2012, 18(2):421-427. DOI:10.1007/s12253-011-9462-z.

2 殷蔚伯, 余子豪, 徐国镇, 等. 肿瘤放射治疗学:第4 版[M]. 北京:中国协和医科大学出版, 2008:1171-1178. YIN Weibo, YU Zihao, XU Guozhen, et al. Radiation oncology[M]. 4^th ed. Beijing:Pecking Union Medical College Press, 2008:1171-1178.

3 Saibishkumar E P, MacKenzie M A, Severin D, et al. Skin-sparing radiation using intensity-modulated radiotherapy after conservative surgery in early-stage breast cancer:a planning study[J]. International Journal of Radiation Oncology Biology Physics, 2008, 70(2):485-491. DOI:10.1016/j.ijrobp.2007.06.049.

4 Vicent M, Trank A, Michael B, et al. Significant reductions in heart and lung dose using deep inspiration breath hold with active breathing control and intensity-modulated radiation therapy for patients treated with locoregional breast irradiation[J]. International Journal of Radiation Oncology Biology Physics, 2003, 55(2):392-406.

5 Martin K, Peter F, Sigrid K B, et al. Randomized study of postoperative radiotherapy and simultaneous temozolomide without adjuvant chemotherapy for glioblastoma[J]. Strah-lenther Onkol, 2008, 184(11):572-579. DOI:10.1007/s00066-008-1897-0.

6 Atkins D, Best D, Briss P A, et al. Grading quality of evidence and strength of recommendations[J]. BMJ Journals, 2004, 328(7454):1490. DOI:http://dx.doi.org/10.1136/bmj.328.7454.1490.

7 Gursel B, Meydan D, Ozbek N, et al. Dosimetric comparison of three different external beam whole breast irradiation techniques[J]. Advance in Therapy, 2011, 28(12):1114-1125. DOI 10.1007/s12325-011-0078-1.

8 Baycan D, Karacetin D, Balkanay A Y, et al. Field-in-field IMRT versus 3D-CRT of the breast. Cardiac vessels, ipsilateral lung, and contralateral breast absorbed doses in patients with left-sided lumpectomy:a dosimetric comparison[J]. Japanese Journal of Radiology, 2012, 30:819-823. DOI:10.1007/s11604-012-0126-z.

9 Haciislamoglu E, Colak F, Canyilmaz E, et al. Dosimetric comparison of left-sided whole-breast irradiation with 3DCRT, forward-planned IMRT, inverse-planned IMRT, helical tomotherapy, and volumetric arc therapy[J]. Physica Medica, 2015, 31:360-367. DOI:10.1016/j.ejmp. 2015.02.005.

10 Zhang F L, Zheng M M. Dosimetric evaluation of conventional radiotherapy, 3-Dconformal radiotherapy and direct machine parameter optimisation intensitymodulated radiotherapy for breast cancer after conservative surgery[J]. Journal of Medical Imaging and Radiation Oncology, 2011, 55:595-602. DOI:10.1111/j. 1754-9485.2011.02313.x.

11 Zhou G X, Xu S P, Dai X K, et al. Clinical dosimetric study of three radiotherapy techniques for postoperative breast cancer:helical tomotherapy, IMRT, and 3D-CRT[J]. Technology in Cancer Research and Treatment, 2011, 10(1):15-23. DOI:10.7785/tcrt. 2012.500174.

12 Badakhshi H, Kaul D, Nadobny J, et al. Image-guided volumetric modulated arc therapy for breast cancer:a feasibility study and plan comparison with three-dimensional conformal and intensity-modulated radiotherapy[J]. The British Journal of Radiology, 2013, 86(1032):1-9. DOI:10.1259/bjr.20130515.

13 Schubert L K, Gondi V, Sengbusch E, et al. Dosimetric comparison of left-sided whole breast irradiation with 3DCRT, forward-planned IMRT, inverse-planned IMRT, helical tomotherapy, and topotherapy[J]. Radiotherapy and Oncology, 2011, 100:241-246. DOI:10.1016/j. radonc.2011.01.004.

14 Selvaraj R, Beriwal S, Pourarian R, et al. Clinical implementation of tangential field intensity modulated radiation therapy (IMRT) using sliding window technique and dosimetric comparison with 3D conformal therapy (3DCRT) in breast cancer[J]. Medical Dosimetry, 2007, 32(4):299-304. DOI:10.1016/j.meddos.2007.03.001.

15 Xie X X, Ou-Yang S Y, Wang H, et al. Dosimetric comparison of left-sided whole breast irradiation with 3D-CRT, IP-IMRT and hybrid IMRT[J]. Oncology Reports, 2014, 31:2195-2205. DOI:10.3892/or.2014. 3058

16 乌晓礼, 王利华. 乳腺癌保乳术后3D-CRT 与IMRT 放射治疗的剂量学比较[J]. 内蒙古医学院学报, 2010, 32(1):46-48. DOI:1004-2113(2010) 01-0046-03. WU Xiaoli, WANG Lihua. Dosemetric comparision between Three-dimensional conformal radiotherapy and intensity-modulated radiotherapy for breast cancer with conserving surgery[J]. Acta Academiae Medicinae Neimongol, 2010, 32(1):46-48. DOI:1004-2113(2010) 01-0046-03.

17 包虹. 33 例I 期乳腺癌保乳术后不同放射治疗方式的剂量学研究[J]. 中国医学物理学杂志, 2011, 28(4):2725-2728. DOI:1005-202X(2011)04-2725-04. BAO Hong. Dosimetric study of different radiotherapy techniques in thirty three patients with stage I breast cancer after breast-conserving surgery[J]. Chinese Journal of Medical Physics, 2011, 28(4):2725-2728. DOI:1005-202X(2011)04-2725-04.

18 司马义力·买买提尼牙孜, 贺春钰, 艾秀清, 等. 早期乳腺癌保乳术后不同放疗技术的剂量学比较[J]. 中华放射肿瘤学杂志, 2012, 21(6):577-578. DOI:10.3760/cma. J.issn.1004-4221,2012.06.028. SIMAYILI·Maimaitiniyazi, HE Chunyu, AI Xiuqing, et al. Dosemetric comparision of different radiotherapy techniques in ealy-stage breast cancer with conserving surgery[J]. Chinese Journal of Radiation Oncology, 2012, 21(6):577-578. DOI:10.3760/cma.J.issn.1004-4221,2012. 06.028

19 李胜业, 戴安伟, 费明来, 等. 左侧乳腺癌保乳术后调强放疗与三维适形放疗的剂量学比较[J]. 实用癌症杂志, 2012, 27(5):524-526. DOI:1001-5930 (2012)05-0524-03. LI Shengye, DAI Anwei, FEI Minglai, et al. Dosemetric comparision between three-dimensional conformal radiotherapy and intensity-modulated radiotherapy for left-side breast cancer with conserving surgery[J]. The Practical Journal of Cancer, 2012, 27(5):524-526. DOI:1001-5930(2012)05-0524-03.

20 艾秀清, 木妮热·木沙江, 司马义力·买买提尼亚孜, 等. 左侧乳腺癌保乳术后调强放疗的剂量学研究[J]. 实用癌症杂志, 2014, 29(8):984-986. DOI:1001-5930(2014) 08-0984-03. AI Xiuqing, MUNIRE·Mushajiang, SIMAYILI·Maimaitiniyazi, et al. Dosimetry study on intensity modulated radiation therapy for left side breast cancer after conservative surgery[J]. The Practical Journal of Cancer, 2014, 29(8):984-986. DOI:1001-5930(2014)08-0984-03.

21 周桂霞, 戴相昆, 徐寿平, 等. 乳腺癌术后放疗3 种治疗计划的剂量学研究[J].中华放射医学与防护杂志, 2010, 30(3):314-316. DOI:10.3760/cma.j.issn.0254-5098. 2010.03.022. ZHOU Guixia, DAI Xiangkun, XU Shouping, et al. Dosimetric study of three different kinds of radiotherapy technique for post-operative breast cancer[J]. Chinese Journal of Radiological Medical and Protection, 2010, 30(3):314-316. DOI:10.3760/cma.j.issn.0254-5098.2010. 03.022.

22 Desantis C, Ma J, Bryan L, et al. Breast cancer statistics[J]. A Cancer Journal Clinicians, 2014, 64(1):52-62.

23 孙彦泽, 钱建军, 周钢, 等. 乳腺癌保乳术后瘤床同步加量两种放疗技术的比较[J]. 辐射研究与辐射工艺学报, 2014, 32:040202(5). DOI:10.11889/j.1000-3436. 2014.rrj.32.040202. SUN Yanze, QIAN Jianjun, ZHOU Gang, et al. Comparison between the two techniques for whole breast irradiation with tumor bed boost after breast-conserving surgery[J]. Journal Radiation Research and Radiation Processing, 2014, 32:040202(5). DOI:10.11889/j.1000-3436.2014.rrj.32.040202.

24 Kimura T, Togami T, Takashima H, et al. Radiation pneumonitis in patients with lung and mediastinal tumours:a retrospective study of risk factors focused on pulmonary emphysema[J]. The British Journal of Radiology, 2012, 85(1010):135-141. DOI:10.1259/bjr/32629867.

25 Shi A H, Zhu GY, Wu H, et al. Analysis of clinical and dosimetric factors associated with severe acute radiation pneumonitis in patients with locally advanced non-small cell lung cancer treated with concurrent chemotherapy and intensity-modulated radiotherapy[J]. Radiation Oncology, 2010, 12(5):35-40. DOI:10.1186/1748-717X-5-35.

26 Wang S L, Liao ZX, Wei X, et al. Analysis of clinical and dosimetric factors associated with treatment-related pneumonitis (TRP) in patients with non-small-cell lung cancer (NSCLC) treated with concurrent chemotherapy and three-dimensional conformal radiotherapy (3D-CRT)[J]. International Journal of Radiation Oncology Biology Physics, 2006, 66(5):1399-1407. DOI:10.1016/j. ijrobp. 2006.07.1337.

27 Hurkmans C W, Cho B C, Damen E, et al. Reduction of cardiac and lung complication probabilities after breast irradiation using conformal radiotherapy with or without intensity modulation[J]. Radiotherapy and Oncology, 2002, 62(2):163-171. DOI:10.1016/S0167-8140(01) 00473-X.

28 Dorr W, Herrmann T. Second primary tumors after radiotherapy for malignancies treatment-related parameters[J]. Strahlentherapie und Onkologie, 2002, 178:357-362. DOI:10.1007/s00066-002-0951-6.

29 Boice J D, Blettner M, Kleinerman R A, et al. Radiation dose and leukemia risk in patients treated forcancer of the cervix[J]. Journal of the National Cancer Institute, 1987, 79:1295-1311.

30 Hall E J, Wuu C S. Radiation-induced second cancers:the impact of 3D-CRT and IMRT[J]. International Journal of Radiation Oncology Biology Physics, 2003, 56:83-88. DOI:10.1016/S0360-3016(03)00073-7.

31 Murray E M, Werner D, Greeff E A, et al. Postradiation sarcomas:20 cases and a literature review[J]. International Journal of Radiation Oncology Biology Physics, 1999, 45:951-961. DOI:10.1016/S0360-3016 (99)00279-5.

32 Grantzau T, Overgaard J. Risk of second non-breast cancer after radiotherapy for breast cancer:a systematic review and meta-analysis of 762, 468 patients[J]. Radiotherapy and Oncology, 2015, 114(1):56-65. DOI:10.1016/j.radonc. 2014.10.004.

[1]	NIU Ruijun, ZHANG Hui, TAO Na, JIA Huailin, GUO Qing, LIU Tingting, TAO Fali, OUYANG Shuigen, GAO Liying, ZHAO Lin, WEI Shihong, LIU Zhiqiang, AN Yongwei, WEI Xiyi. Influence of CBCT online alignment technology on the target margin and analysis of dosimetric differences in intensity-modulated radiotherapy for postoperative patients suffered from cervical cancer [J]. Journal of Radiation Research and Radiation Proces, 2018, 36(6): 60202-060202.
[2]	YANG Xiyu, ZHAO Guoqi. Research progress in autophagy in nasopharyngeal carcinoma radiotherapy [J]. Journal of Radiation Research and Radiation Proces, 2017, 35(5): 50101-050101.
[3]	MENG Huipeng, FENG Yuanming, DONG Huajiang. Feasibility analysis of dose calculation for tumor radiotherapy planning based on cone-beam computed tomography images [J]. Journal of Radiation Research and Radiation Proces, 2017, 35(4): 40202-040202.
[4]	LI Junjun, TU Wenzhi, LIU Yong. Advances of exosome research in cancer radiotherapy and chemotherapy [J]. Journal of Radiation Research and Radiation Proces, 2017, 35(3): 30102-030102.
[5]	DONG Fang, GAO Liying, ZHANG Hong, WANG Tao, GUO Hongyun, RAN Juntao, GUO Haonan. Effects of carbon ion beams and X-rays on peripheral blood lymphocyte subsets in female patients with malignant tumors [J]. Journal of Radiation Research and Radiation Proces, 2017, 35(3): 30202-030202.
[6]	MENG Huipeng, FENG Yuanming, DONG Huajiang. Feasibility analysis of selecting optimal radiotherapy plan for chest tumor based on dose distribution index [J]. Journal of Radiation Research and Radiation Proces, 2017, 35(1): 10204-010204.
[7]	WEI Guisheng, XIANG Fawei, TIAN Tian, LIN Chenglie, LI Qian, LI Jiang, WANG Lihua. Application of gold nanoparticles in tumor detection and radiation therapy [J]. Journal of Radiation Research and Radiation Proces, 2016, 34(4): 40103-040103.
[8]	ZHANG Xin, SUN Zhijuan, ZHAO Yongcheng. Meta-analysis of the effect of low dose ionizing radiation on ECGs of radiation workers [J]. Journal of Radiation Research and Radiation Proces, 2016, 34(4): 40202-040202.
[9]	YAN Jiawei LIU Yang ZHAO Qiuyue ZHANG Hong. Influencing factors and calculation of RBE in heavy ion radiotherapy [J]. Journal of Radiation Research and Radiation Proces, 2015, 33(3): 30102-030102.
[10]	LIU Dan GUO Genyan ZHAO Yuxia BAI Lu. Relationship between genetic single-nucleotide polymorphisms of LIG4 and HSPB1 and the ratio of tumor-decreased-size by radiotherapy in non-small cell lung cancer [J]. Journal of Radiation Research and Radiation Proces, 2014, 32(6): 2-060201.
[11]	SUN Yanze QIAN Jianjun ZHOU Gang ZHU Yaqun LU Xueguan TIAN Ye. Comparison between the two techniques for whole breast irradiation with tumor bed boost after breast-conserving surgery [J]. Journal of Radiation Research and Radiation Proces, 2014, 32(4): 40202-040202.
[12]	WEI Jing1 YANG Wei1 SUN Ting2 LIU Fenju1. Anti-tumor effects of knockdown miR-210 combined with radiotherapy on human hepatoma xenograft in nude mice [J]. Journal of Radiation Research and Radiation Proces, 2013, 31(4): 4-040203.
[13]	MIAO Li SUN Yanze LI Xinmin. Analysis of the most commonly used dose distribution comparison methods in radiotherapy dosimetric verification [J]. Journal of Radiation Research and Radiation Proces, 2012, 30(4): 247-251.

Meta-analysis of dosimetric comparision between three-dimensional conformal radiotherapy and intensity-modulated radiotherapy for breast cancer with conserving surgery

PDF (PC)

Like

Knowledge

Abstract

Cite this article

share this article

References

Related Articles 13

Metrics

Comments

Recommended 10