探討呼吸調控對乳癌放射治療的影響

Explore the Influences of Respiratory Regulation on Breast Cancer Treatment

蘇啟文(CHI-WEN SU)

指導教授 ： 陳信雄

中臺科技大學/健康科學院/醫學影像暨放射科學系暨研究所/碩士(2019年)

摘要

本研究針對乳癌需要內乳淋巴結照射的患者，探討不同種呼吸調控技術，對心臟的保護效果。實驗收集三十位已完成電腦斷層定位的左側乳癌患者，不同呼吸調控技術各取十位。呼吸調控技術包含主動式、壓腹器以及沒有使用的部份。處方劑量為每日200 cGy，治療25個分次，總劑量共5000 cGy。研究方式為回顧性重做這30名患者的治療計畫，結果採用ANOVA統計分析。

研究結果顯示，在全乳加上內乳淋巴結照射下，使用主動式呼吸調控的心臟平均劑量為223±114 cGy，使用壓腹器呼吸調控的心臟平均劑量為770±261 cGy，沒有使用呼吸調控，採自由呼吸的心臟平均劑量為666±270 cGy。

使用主動式呼吸調控的LAD平均劑量為 1204±776 cGy，使用壓腹器呼吸調控的LAD平均劑量為3314±872 cGy，沒有使用呼吸調控的LAD平均劑量為2900±1043 cGy。使用主動式呼吸調控的心臟V30Gy為 1.03±1.13 %，使用壓腹器呼吸調控的心臟V30Gy為9.85±4.47 %，沒有使用呼吸調控的心臟V30Gy為8.39±5.02 %。綜合以上結果顯示，使用ABC技術對心臟保護的效果皆優於其他二者。

由統計看主動式呼吸調控的部份，所有患者的心臟平均劑量都小於4 Gy，也就是說，如果需要接受內乳淋巴結照射的患者，最好可以搭配主動式呼吸調控來做治療，以獲得最佳的保護效果。

關鍵字

內乳淋巴結 ； 主動式呼吸調控 ； 壓腹器呼吸調控

並列摘要

This study aimed at patients with breast cancer who need internal lymph node irradiation to explore the protective effects of the heart on different kinds of respiratory regulation techniques.
The experiment collected 30 patients with left breast cancer who had completed computed tomography.Ten different breathing control techniques were taken. Breathing control techniques include active, abdominal, and free breathing.
The prescribed dose is 200 cGy per fraction, 25 fractions, and a total dose of 5000 cGy.The study method was retrospectively redoing the treatment plan of 30 patients, and the results were statistically analyzed by ANOVA.
The results of the study showed that under total breast plus internal mammary lymph node irradiation,the average dose of the heart using active respiratory regulation was 223 ± 114 cGy, and the average dose of the heart regulated by abdominal compression was 770±261 cGy. Without respiratory regulation, the average dose of free-breathing heart was 666 ± 270 cGy.
The average dose of LAD using active respiratory regulation was 1204 ± 776 cGy, the average dose of LAD using respiratory control was 3314 ± 872 cGy, and the average dose of LAD without respiratory regulation was 2900 ± 1043 cGy. The V30Gy of the heart using active breathing was 1.03±1.13%, the V30Gy of the heart regulated by the abdominal device was 9.85±4.47%, and the heart V30Gy without respiratory regulation was 8.39±5.02%. Taken together, the results show that the use of ABC technology is better than the other two.
According to, the statistical part of active respiratory regulation, the average dose of the heart of all patients is less than 4 Gy. If patients who need to receive internal mammary lymph node irradiation, it is best to use active respiratory regulation for treatment to obtain the best protection. effect.

並列關鍵字

Internal mammary nodes ； Active breathing control ； Abdominal Compressor

參考文獻

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