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유방전절제술 후 방사선치료를 위한 조직보상체 개발 및 3차원 치료계획을 통한 유용성 분석

Other Titles
 The Benefit of Individualized Custom Bolus in the Postmastectomy Radiation Therapy : Numerical Analysis with 3-D Treatment Planning 
Authors
 조재호  ;  조광환  ;  서창옥  ;  추성실  ;  김용배  ;  한영이  ;  금기창 
Citation
 Journal of the Korean Society for Therapeutic Radiology and Oncology (대한방사선종양학회지), Vol.21(1) : 82-93, 2003 
Journal Title
 Journal of the Korean Society for Therapeutic Radiology and Oncology (대한방사선종양학회지) 
ISSN
 1229-8719 
Issue Date
2003
MeSH
유방암 ; 수술 후 방사선 치료 ; 정상조직합병증발생률(NTCP) ; 조직보상체 ; 3차원 입체 조형치료계획
Keywords
유방암 ; 수술 후 방사선 치료 ; 정상조직합병증발생률(NTCP) ; 조직보상체 ; 3차원 입체 조형치료계획
Abstract
Purpose : To reduce the Irradiation dose to the lungs and heart in the case of chest wail irradiation using an oppositional electron beam, we used an Individualized custom bolus, which was precisely designed to compensate for the differences In chest wall thickness. The benefits were evaluated by comparing the normal tissue complication probablilties (NTCPS) and dose statistics both with and without boluses. Materials and Methods : Boluses were made, and their effects evaluated in ten patients treated using the reverse hockey-stick technique. The electron beam energy was determined so as to administer 80% of the irradiation prescription dose to the deepest lung-chest wall border, which was usually located at the internal mammary lymph node chain. An individualized custom bolus was prepared to compensate for a chest wall thinner than the prescription depth by meticulously measuring the chest wall thickness at 1 emf intervals on the planning CT Images. A second planning CT was obtained overlying the individuailzed custom bolus for each patient's chest wall. 3-D treatment planning was peformed using ADAC-Pinnacle3 for all patients with and without bolus. NTCPS based on 'the Lyman-Kutcher' model were analyzed and the mean, maximum, minimum doses, V50 and V95 for 4he heari and lungs were computed. Results .The average NTCPS in the ipsliateral lung showed a statistically significant reduction (p<0.01), from 80.2±3.43% to 47.7±4.61%, with the use of the individualized custom boluses. The mean lung irradiation dose to the ipsilateral iung was also significantly reduced by about 430 cGy, Trom 2757 cGy to 2,327 cGy (p<0.01). The V50 and V95 in the ipsilateral lung markedly decreased from the averages of 54.5 and 17.4% to 45.3 and 11.0%, respectively. The V50 and V95 In the heart also decreased from the averages of 16.8 and 6.1% to 9.8% and 2.2%, respectively. The NTCP In the contralateral lung and the heart were 0%, even for the cases with no bolus because of the small effective mean radiation volume values of 4.4 and 7.1%, respectively Conclusion : The use of an Individualized custom bolus in the radiotherapy of postrnastectorny chest wall reduced the NTCP of the ipsilateral lung by about 24.5 to 40.5%, which can improve the complication free
Files in This Item:
T200304738.pdf Download
DOI
OAK-2003-00761
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Keum, Ki Chang(금기창) ORCID logo https://orcid.org/0000-0003-4123-7998
Kim, Yong Bae(김용배) ORCID logo https://orcid.org/0000-0001-7573-6862
Suh, Chang Ok(서창옥)
Cho, Jae Ho(조재호) ORCID logo https://orcid.org/0000-0001-9966-5157
Choo, Sung Sil(추성실)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/113921
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