Abstract：Objective To study dose of heart for patients with breast cancer in post-mastectomy radiotherapy by dual arc volumetric modulated arc therapy （VMAT）irradiation technique，to evaluate cardiac toxicity risk. Methods Thirty patientswith breast cancer treated withmastectomy surgery followed by radiotherapy in our hospital from June 2015 to January 2016 were given four kinds of irradiation technology，namely positive intensity-modulated radiotherapy（IMRT）（8-10 subfield），4 beam-IMRT（4B-IMRT），5 beam-field IMRT（5B-IMRT）（based 4B-IMRT in the fields increase of chestwall）and dual arc VMAT （Dual-Arc-VMAT）including the heart facing arc.Mean dose（Dmean）and V25of cardiac and themean dose of left anterior descending（LAD）coronary artery were recorded，normal tissue complication probability（NTCP）of cardiac were analyzed by statisticalmethod.Results The Dmean，V25，LAD，NTCP of heartwith tumor in right side was 2.38，3.21，4.53，2.74 Gy；0.23%，0.43%，0.61%，0.18%；2.5，3.8，3.6，3.2 Gy；0.004，0.001，0.000，0.000 respectively. Target area conformity index（CI）and homogeneity index（HI）value was 0.35，0.50，0.60，0.75；0.74，0.57，0.58，0.10 respectively.In theothersidewas8.2，7.3，10.2，6.5Gy；9.7%，8.3%，11.1%，5.2%；29.6，28.2，31.2，26.8Gy；0.030，0.010，0.010，0.009 respectively.Target area CI，HIvalue was 0.40，0.51，0.59，0.70；0.87，0.83，0.75，0.47 respectively.Compared with other static IMRT technique，CI and HI in the target area of breast cancer of VMAT technique after radicalmastectomy were better，and the difference was statistically significant（P＜0.01）.The difference was not statistically significant（P＞0.05）in the cardiac V25，Dmeanand NTCP in both the left and right tumors by VMAT technique.There was no significant difference between DmeanLAD of VMAT technique and that of other static IMRT techniques（P＞0.05）.Conclusion VMAT technology has slightly lower cardiac toxicity than other static IMRT technology，while has statistically significant benefit to improve CI and HI of target.It can be recommended as cardiac safe and efficient technique for patients with breast cancer in post-mastectomy surgery.
龚敏勇;叶威;熊超. 乳腺癌根治术后基于VMAT技术对比静态调强技术对心脏毒性的风险评估[J]. 中国当代医药, 2016, 23(29): 72-75转78.
GONGMin-yong;YE Wei;XIONG Chao. Risk assessment of static IMRT technology on cardiac toxicity in patients with breast cancer after radicalmastectomy based on VMAT technology. 中国当代医药, 2016, 23(29): 72-75转78.
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