Abstract:Objective The patients with lung cancer undergoing stereotactic body radiation therapy (SBRT) were planned with deep
inspiration breath hold (DIBH) CT and conventional free breathing four-dimensional computed tomography (4D-CT) respectively,
and the dosimetric differences between the two groups were compared. Methods A total of ten patients with non-cell lung cancer
were enrolled. Two CT scans were acquired for each patient with and without breath hold (DIBH-CT and 4D-CT). Target and organ
at risk were contoured on DIBH-CT and 4D-CT. The plan design was carried out on the CT of DIBH and 4D-CT average phase
image (AVG) respectively, and the VMAT was selected to compare the volume of target area and organ at risk in the two groups,
and to analyze the difference of planned volume dose of target volume and organ at risk in the two groups. Results For all patients,
compared with the 4D-CT group, the planned target volume of the DIBH group decreased by 48%, the volume of the heart decreased
by 18.0%. While the volume of lung-tumor and the normal lung were increased 56% and 64%, respectively. Compared with the 4DCT
group, the V5, V10, V20 with the lung-tumor were reduced by 10.4%, 10.3%, 4.2% with DIBH plan, and the mean dose of heart
decreased by 34.6%, and the hot spot dose to the chest wall and artery was also significantly decreased (P<0.05). For the CI, GI and
MU, the DIBH plan had no significantly better plan quality (P>0.05). While for the D2 cm, the DIBH plan was significantly better than
the 4D-CT plan, and the difference was statistically significant (P<0.05). Conclusion Both plans can meet the clinical requirements.
DIBH can greatly reduce the target volume irradiation. The DIBH simultaneously increases the volume of the lung, reduces the
volume of the heart, and moves the heart away from the chest wall, thereby reducing the dose to normal tissues such as the heart and
lungs. DIBH will provide better treatment options for lung cancer patients with SBRT.
单书灿,周晖,王玉洁,贺晓东. 深吸气屏气技术在肺癌立体定向放射治疗中的应用[J]. 中国医疗设备, 2022, 37(10): 56-59.
SHAN Shucan, ZHOU Hui, WANG Yujie, HE Xiaodong. Application of DIBH at the Stereotactic Body Radiotherapy of Lung Cancer. China Medical Devices, 2022, 37(10): 56-59.