文章：

深吸气屏气技术在质子治疗纵隔淋巴瘤中的应用：初步经验

Application of the Deep Inspiration Breath-Hold Technique in Proton Therapy for Mediastinal Lymphomas: Initial Experience

原文发布日期：14 June 2025

DOI: 10.3390/cancers17121985

类型: Article

开放获取: 是

英文摘要：

Background:This work presents the procedures and application of the deep inspiration breath-hold (DIBH) technique for mediastinal lymphoma patients at a proton therapy (PT) center. It also discusses the implementation and validation of the surface-guided radiotherapy (SGRT) protocol in terms of positioning accuracy.Methods:This study included six lymphoma patients. Dedicated computed tomography (CT) protocols and a treatment workflow based on international guidelines were developed. Clinical data from the treatment planning system (TPS) were used to assess the difference between DIBH and free-breathing irradiation. Additionally, data from an optical patient positioning system and kilovoltage (kV) imaging system were used to estimate positioning shifts. The new CT protocol reduced the volume CT dose index by over six times compared with the standard protocol.Results: The DIBH method decreased the mean dose to the heart and lungs by up to 7.02 Gy(RBE) and 0.83 Gy(RBE), respectively. The median magnitude of patient setup errors and repeatability in DIBH positioning was 0.4 cm and 0.18 cm (mean for males and females) for the SGRT protocol. The kV imaging showed a setup error of over 0.3 cm for both groups.Conclusions: Despite the small size of the patient cohort, the relatively large number of individual positioning sessions enabled the detection of statistically significant differences (p< 0.05) in certain areas between male and female patients; however, no significant difference in the displacement vector magnitude was observed. DIBH treatment with SGRT offers high reproducibility for patient positioning.

摘要翻译： 

背景：本研究介绍了质子治疗中心对纵隔淋巴瘤患者实施深吸气屏气技术的操作流程及其应用，并探讨了表面引导放射治疗协议在定位精度方面的实施与验证方法。 方法：本研究纳入六例淋巴瘤患者。根据国际指南制定了专用计算机断层扫描方案及治疗工作流程。利用治疗计划系统的临床数据评估深吸气屏气与自由呼吸照射的差异，同时结合光学患者定位系统与千伏级影像系统的数据测算定位位移。新型CT方案使容积CT剂量指数较标准方案降低六倍以上。 结果：深吸气屏气技术使心脏和肺部的平均受照剂量分别降低达7.02 Gy(RBE)和0.83 Gy(RBE)。表面引导放射治疗协议下，患者摆位误差中位值与深吸气屏气定位重复性分别为0.4 cm和0.18 cm（男女均值）。千伏级影像显示两组摆位误差均超过0.3 cm。 结论：尽管患者队列规模有限，但大量个体化定位数据使得男女患者在特定区域出现统计学显著差异(p<0.05)；然而位移矢量幅度未见显著差异。结合表面引导放射治疗的深吸气屏气技术可为患者定位提供高度可重复性。

原文链接：

Application of the Deep Inspiration Breath-Hold Technique in Proton Therapy for Mediastinal Lymphomas: Initial Experience