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Background and purpose <p>To evaluate the efficacy of surface-guided radiation therapy (SGRT) combined with real-time position management (RPM)-guided deep inspiratory breath-hold (DIBH) radiotherapy for left breast cancer.</p> Materials and methods <p>Twenty patients diagnosed with breast cancer, who underwent breast-conserving surgery and subsequent DIBH radiotherapy, were randomly assigned to two treatment groups: SGRT-guided (SGRT); and combined SGRT + RPM-guided (SGRT + RPM). Recorded setup and cone beam computed tomography (CBCT) validation execution Time (T1), Beam delivery time (T2). Residual vertical setup error (VRT Error), six-dimensional (6D) setup errors, and breath-hold error (BH Error) were obtained using breath hold CBCT. Correlations between BH Error and VRT Error were analyzed. Dose reconstruction was performed using velocity-generated adaptive CT to compute per-fraction and accumulated doses, with coefficient of variation (CV) analysis used to quantify interfractional dose variations in clinical target volume (CTV) and organs at risk (OARs).</p> Results <p>The mean (± SD) T1 and T2 times for the SGRT and SGRT + RPM groups were 452.53 ± 83.57&#xa0;s vs. 299.58 ± 53.52&#xa0;s (<i>p</i> &lt; 0.05), and 147.85 ± 46.35&#xa0;s vs. 135.3 ± 32.97&#xa0;s (<i>p</i> &gt; 0.05), respectively, with no statistical difference in 6D setup errors (<i>p</i> &gt; 0.05). The SGRT group exhibited a mean BH Error that was 0.4&#xa0;mm larger than that of the SGRT + RPM group, with a 0.7&#xa0;mm reduction in stability. There was a correlation between BH Error and VRT Error in the SGRT group (<i>r</i> = 0.635, <i>p</i> &lt; 0.05). Accumulated dose analysis revealed statistically significant decreases in CTV D98% and V95% in both groups (<i>p</i> &lt; 0.05). However, maintained CTV coverage meeting clinical acceptability criteria (V95% ≥ 95%). The accumulated OARs doses demonstrated no significant differences compared with the planned doses (<i>p</i> &gt; 0.05). There was no significant difference in CV values between the two groups (<i>p</i> &gt; 0.05).</p> Conclusion <p>The DIBH guided by SGRT + RPM simplify the radiotherapy workflow, improve the operation efficiency and breath-hold (BH) quality of patients. Simultaneously, it guaranteed alignment of the cumulative doses received by the CTV and OARs with the planned doses.</p>

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Surface-guided radiation therapy combined with real-time position management-guided deep inspiratory breath-hold radiotherapy for left breast cancer

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月14日

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  • Hai-liang Guo,
  • Hua-ying Xie,
  • Chun-ling Jiang,
  • Can-feng Weng,
  • Guo-Ping Liao,
  • Gang-feng Zhu,
  • Yi-peng Song,
  • Rui-lian Xie,
  • Jing-hua Zhong,
  • Huai-wen Zhang

摘要

Background and purpose

To evaluate the efficacy of surface-guided radiation therapy (SGRT) combined with real-time position management (RPM)-guided deep inspiratory breath-hold (DIBH) radiotherapy for left breast cancer.

Materials and methods

Twenty patients diagnosed with breast cancer, who underwent breast-conserving surgery and subsequent DIBH radiotherapy, were randomly assigned to two treatment groups: SGRT-guided (SGRT); and combined SGRT + RPM-guided (SGRT + RPM). Recorded setup and cone beam computed tomography (CBCT) validation execution Time (T1), Beam delivery time (T2). Residual vertical setup error (VRT Error), six-dimensional (6D) setup errors, and breath-hold error (BH Error) were obtained using breath hold CBCT. Correlations between BH Error and VRT Error were analyzed. Dose reconstruction was performed using velocity-generated adaptive CT to compute per-fraction and accumulated doses, with coefficient of variation (CV) analysis used to quantify interfractional dose variations in clinical target volume (CTV) and organs at risk (OARs).

Results

The mean (± SD) T1 and T2 times for the SGRT and SGRT + RPM groups were 452.53 ± 83.57 s vs. 299.58 ± 53.52 s (p < 0.05), and 147.85 ± 46.35 s vs. 135.3 ± 32.97 s (p > 0.05), respectively, with no statistical difference in 6D setup errors (p > 0.05). The SGRT group exhibited a mean BH Error that was 0.4 mm larger than that of the SGRT + RPM group, with a 0.7 mm reduction in stability. There was a correlation between BH Error and VRT Error in the SGRT group (r = 0.635, p < 0.05). Accumulated dose analysis revealed statistically significant decreases in CTV D98% and V95% in both groups (p < 0.05). However, maintained CTV coverage meeting clinical acceptability criteria (V95% ≥ 95%). The accumulated OARs doses demonstrated no significant differences compared with the planned doses (p > 0.05). There was no significant difference in CV values between the two groups (p > 0.05).

Conclusion

The DIBH guided by SGRT + RPM simplify the radiotherapy workflow, improve the operation efficiency and breath-hold (BH) quality of patients. Simultaneously, it guaranteed alignment of the cumulative doses received by the CTV and OARs with the planned doses.