Comparação de diferentes técnicas de irradiação de mama em radioterapia com recurso a acelerador linear em modo de fotões

Autores

  • C. Borges Medical Consult SA. Lisboa, Portugal.
  • Gilda Cunha Área Científica de Matemática, Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa. Lisboa, Portugal.
  • Nuno Teixeira Área Científica de Física, Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa. Lisboa, Portugal.

DOI:

https://doi.org/10.25758/set.614

Palavras-chave:

Radioterapia de mama, EBRT, IMRT, Arco dinâmico, Sistemas de planeamento, Histogramas de dose volume

Resumo

Introdução – A Radioterapia (RT) é uma abordagem terapêutica para tratamento de neoplasia de mama. Contudo, diferentes técnicas de irradiação (TI) podem ser usadas. Objetivos – Comparar 4 TI, considerando a irradiação dos volumes alvo (PTV) e dos órgãos de risco (OAR). Metodologia – Selecionaram-se 7 pacientes com indicação para RT de mama esquerda. Sobre tomografia computorizada foram feitos os contornos do PTV e dos OAR. Foram calculadas 4 planimetrias/paciente para as TI: conformacional externa (EBRT), intensidade modulada com 2 (IMRT2) e 5 campos (IMRT5) e arco dinâmico (DART). Resultados – Histogramas de dose volume foram comparados para todas as TI usando o software de análise estatística, IBM SPSS v20. Com IMRT5 e DART, os OAR recebem mais doses baixas. No entanto, IMRT5 apresenta melhores índices de conformidade e homogeneidade para o PTV. Conclusões – IMRT5 apresenta o melhor índice de conformidade; EBRT e IMRT2 apresentam melhores resultados que DART. Há d.e.s entre as TI, sobretudo em doses mais baixas nos OAR.

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Referências

Fisher B, Anderson S, Redmond CK, Wolmark N, Wickerham L, Cronin WM. Reanalysis and results after 12 years of follow-up in a randomized clinical trial comparing total mastectomy with lumpectomy with or without irradiation in the treatment of breast cancer. N Eng J Med. 1995;333(22):1456-61.

Veronesi U, Marubini E, Mariani L, Galimberti V, Luini A, Veronesi P, et al. Radiotherapy after breast-conserving surgery in small breast carcinoma: long-term results of a randomized trial. Ann Oncol. 2001;12(7):997-1003.

Poortmans P. Evidence based radiation oncology: breast cancer. Radiother Oncol. 2007;84(1):84-101.

Casebow MP. Matching of adjacent radiation beams for isocentric radiotherapy. Br J Radiol. 1984;57(680):735-40.

International Commission on Radiation Units & Measurements. Prescribing, recording and reporting photon beam therapy. Bethesda: ICRU; 1993. ISBN 0913394610

Donovan EM, Johnson U, Shentall G, Evans PM, Neal AJ, Yarnold JR. Evaluation of compensation in breast radiotherapy: a planning study using multiple static fields. Int J Radiat Oncol Biol Phys. 2000;46(3):671-9.

Richmond ND, Turner RN, Dawes PJ, Lambert GD, Lawrence GP. Evaluation of the dosimetric consequences of adding a single asymmetric or MLC shaped field to a tangential breast radiotherapy technique. Radiother Oncol. 2003;67(2):165-70.

Selveraj RN, Beriwal S, Pourarian RJ, Lalonde RJ, Chen A, Mehta K, 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. Med Dosim. 2007;32(4):299-304.

Huang XB, Jiang GL, Chen JY, Chen LF, Hu WG. Dosimetric evaluation of intensity-modulated tangential beam versus conventional tangential irradiation for breast cancer. Ai Zheng Chin J Cancer. 2006;25(7):855-60.

Smith W, Menon G, Wolfe N, Ploquin N, Trotter T, Pudney D. IMRT for the breast: a comparison of tangential planning techniques. Phys Med Biol. 2010;55(4):1231-41.

Pignol JP, Olivotto I, Rakovitch E, Gardner S, Sixel K, Beckham W, et al. A multicenter randomized trial of breast IMRT to reduce acute radiation dermatitis. J Clin Oncol. 2008;26(13):2085-92.

McDonald MW, Godette KD, Butker EK, Davis LW, Johnstone PA. Long-term outcomes of IMRT for breast cancer: a single-institution cohort analysis. Int J Radiat Oncol Biol Phys. 2008;72(4):1031-40.

Harsolia A, Kestin L, Grills I, Wallace M, Jolly S, Jones C, et al. Intensity-modulated radiotherapy results in significant decrease in clinical toxicities compared with conventional wedge-based breast radiotherapy. Int J Radiat Oncol Biol Phys. 2007;68(5):1375-80.

Woo TC, Pignol JP, Rakovitch E, Vu T, Hicks D, O'Brien P, et al. Body radiation exposure in breast cancer radiotherapy: impact of breast IMRT and virtual wedge compensation techniques. Int J Radiat Ocol Biol Phys. 2006;65(1):52-8.

Boice JD Jr, Harvey EB, Blettner M, Stovall M, Flannery JT. Cancer in the contralateral breast after radiotherapy for breast cancer. N Engl J Med. 1992;326(12):781-5.

Bhatnagar AK, Brandner E, Sonnik D, Wu A, Kalnicki S, Deutsch M, et al. Intensity modulated radiation therapy (IMRT) reduces the dose to the contralateral breast when compared to conventional tangential fields for primary breast irradiation. Cancer J. 2004;10(6):381-5.

Chang SX, Deschesne KM, Cullip TJ, Parker SA, Earnhart J. A comparison of different intensity modulation treatment techniques for tangential breast irradiation. Int J Radiat Oncol Biol Phys. 1999;45(5):1305-14.

Saur S, Fjellsboe LM, Lindmo T, Frengen J. Contralateral breast doses measured by film dosimetry: tangential techniques and an optimized IMRT technique. Phys Med Biol. 2009;54(15):4743-58.

Donovan EM, Ciurlionis L, Fairfoul J, James H, Mayles H, Manktelow S, et al. Planning with intensity-modulated radiotherapy and tomotherapy to modulate dose across breast to reflect recurrence risk (IMPORT High Trial). Int J Radiat Oncol Biol Phys. 2011;79(4):1064-72.

Zhou GX, Xu SP, Dai XK, Ju ZJ, Gong HS, Xie CB, et al. Clinical dosimetric study of three radiotherapy techniques for postoperative breast cancer: Helical Tomotherapy, IMRT, and 3D-CRT. Technol Cancer Res Treat. 2011;10(1):15-23.

Johansen S, Cozzi L, Olsen DR. A planning comparison of dose patterns in organs at risk and predicted risk for radiation induced malignancy in the contralateral breast following radiation therapy of primary breast using conventional, IMRT and volumetric arc treatment techniques. Acta Oncol. 2009;48(4):495-503.

Marks LB, Yorke ED, Jackson A, Ten Haken RK, Constine LS, Eisbruch A, et al. Use of normal tissue complication probability models in the clinic. Int J Radiat Oncol Biol Phys Med. 2010;76(3 Suppl):S10-9.

Shaw E, Kline R, Gillin M, Souhami L, Hirschfeld A, Dinapoli R, et al. Radiation Therapy Oncology Group: radiosurgery quality assurance guidelines. Int J Radiat Oncol Biol Phys. 1993;27(5):1231-9.

Feuvret L, Noël G, Mazeron JJ, Bey P. Conformity index: a review. Int J Radiat Oncol Biol Phys. 2006;64(2):333-42.

Marôco J. Análise estatística com o SPSS Statistics. 5ª ed. Lisboa: Report Number; 2011. ISBN 9789899676329

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Publicado

15-05-2013

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Como Citar

Comparação de diferentes técnicas de irradiação de mama em radioterapia com recurso a acelerador linear em modo de fotões. (2013). Saúde & Tecnologia, 09, 33-39. https://doi.org/10.25758/set.614