title: Ð¡ÑÐ°Ð²Ð½ÐµÐ½Ð¸Ðµ Ð¼ÐµÑÐ¾Ð´Ð¾Ð² 3D-ÐºÐ¾Ð½ÑÐ¾ÑÐ¼Ð½Ð¾Ð¹ Ð¸ IMRT Ð´Ð¸ÑÑÐ°Ð½ÑÐ¸Ð¾Ð½Ð½Ð¾Ð¹ Ð»ÑÑÐµÐ²Ð¾Ð¹ ÑÐµÑÐ°Ð¿Ð¸Ð¸ ÑÐ°ÐºÐ° Ð¼Ð¾Ð»Ð¾ÑÐ½Ð¾Ð¹ Ð¶ÐµÐ»ÐµÐ·Ñ
title: Ð²ÑÐ¿ÑÑÐºÐ½Ð°Ñ ÐºÐ²Ð°Ð»Ð¸ÑÐ¸ÐºÐ°ÑÐ¸Ð¾Ð½Ð½Ð°Ñ ÑÐ°Ð±Ð¾ÑÐ° Ð¼Ð°Ð³Ð¸ÑÑÑÐ°
titleType: Subtitle
title: Comparison of 3D-conformal and IMRT external beam therapy for breast cancer
Creators: name: Ð¨Ð°ÑÑÐ¼ÐµÑÐ¾Ð²Ð°, ÐÐ¾Ð»Ð¸Ð½Ð°
Publisher: name: Ð¡Ð°Ð½ÐºÑ-ÐÐµÑÐµÑÐ±ÑÑÐ³ÑÐºÐ¸Ð¹ Ð¿Ð¾Ð»Ð¸ÑÐµÑÐ½Ð¸ÑÐµÑÐºÐ¸Ð¹ ÑÐ½Ð¸Ð²ÐµÑÑÐ¸ÑÐµÑ ÐÐµÑÑÐ° ÐÐµÐ»Ð¸ÐºÐ¾Ð³Ð¾
Year: 2023
Subjects: Ð£ÑÐºÐ¾ÑÐ¸ÑÐµÐ»Ð¸ Ð·Ð°ÑÑÐ¶ÐµÐ½Ð½ÑÑ ÑÐ°ÑÑÐ¸Ñ
ÐÑÑÐ¸ÑÐ»Ð¸ÑÐµÐ»ÑÐ½ÑÐµ Ð¼Ð°ÑÐ¸Ð½Ñ ÑÐ»ÐµÐºÑÑÐ¾Ð½Ð½ÑÐµ
Ð´Ð¸ÑÑÐ°Ð½ÑÐ¸Ð¾Ð½Ð½Ð°Ñ ÑÐ¾ÑÐ¾Ð½Ð½Ð°Ñ ÑÐµÑÐ°Ð¿Ð¸Ñ
Ð¼ÐµÐ´Ð¸ÑÐ¸Ð½ÑÐºÐ¸Ð¹ ÑÑÐºÐ¾ÑÐ¸ÑÐµÐ»Ñ ÑÐ»ÐµÐºÑÑÐ¾Ð½Ð¾Ð²
Ð¿Ð»Ð°Ð½Ð¸ÑÐ¾Ð²Ð°Ð½Ð¸Ðµ Ð¾Ð±Ð»ÑÑÐµÐ½Ð¸Ñ
3d-ÐºÐ¾Ð½ÑÐ¾ÑÐ¼Ð½Ð°Ñ Ð»ÑÑÐµÐ²Ð°Ñ ÑÐµÑÐ°Ð¿Ð¸Ñ
Ð»ÑÑÐµÐ²Ð°Ñ ÑÐµÑÐ°Ð¿Ð¸Ñ Ñ Ð¼Ð¾Ð´ÑÐ»ÑÑÐ¸ÐµÐ¹ Ð¸Ð½ÑÐµÐ½ÑÐ¸Ð²Ð½Ð¾ÑÑÐ¸
Ð¿Ð¾ÑÑÐ°Ð»ÑÐ½Ð°Ñ Ð´Ð¾Ð·Ð¸Ð¼ÐµÑÑÐ¸Ñ
remote photon therapy
medical electron accelerator
treatment planning
3d-conformal radiation therapy
intensity modulated radiation therapy
portral dosimetry

description: ÐÐ°Ð½Ð½Ð°Ñ Ð²ÑÐ¿ÑÑÐºÐ½Ð°Ñ ÐºÐ²Ð°Ð»Ð¸ÑÐ¸ÐºÐ°ÑÐ¸Ð¾Ð½Ð½Ð°Ñ ÑÐ°Ð±Ð¾ÑÐ° Ð²ÑÐ¿Ð¾Ð»Ð½ÐµÐ½Ð° Ð² Ð¡Ð°Ð½ÐºÑ-ÐÐµÑÐµÑÐ±ÑÑÐ³ÑÐºÐ¾Ð¼ ÐºÐ»Ð¸Ð½Ð¸ÑÐµÑÐºÐ¾Ð¼ Ð½Ð°ÑÑÐ½Ð¾-Ð¿ÑÐ°ÐºÑÐ¸ÑÐµÑÐºÐ¾Ð¼ ÑÐµÐ½ÑÑÐµ ÑÐ¿ÐµÑÐ¸Ð°Ð»Ð¸Ð·Ð¸ÑÐ¾Ð²Ð°Ð½Ð½ÑÑ Ð²Ð¸Ð´Ð¾Ð² Ð¼ÐµÐ´Ð¸ÑÐ¸Ð½ÑÐºÐ¾Ð¹ Ð¿Ð¾Ð¼Ð¾ÑÐ¸ (Ð¾Ð½ÐºÐ¾Ð»Ð¾Ð³Ð¸ÑÐµÑÐºÐ¾Ð¼) Ð¸ Ð¿Ð¾ÑÐ²ÑÑÐµÐ½Ð° ÑÑÐ°Ð²Ð½ÐµÐ½Ð¸Ñ Ð¼ÐµÐ¶Ð´Ñ ÑÐ¾Ð±Ð¾Ð¹ Ð´Ð²ÑÑ Ð¼ÐµÑÐ¾Ð´Ð¾Ð² Ð´Ð¸ÑÑÐ°Ð½ÑÐ¸Ð¾Ð½Ð½Ð¾Ð¹ Ð»ÑÑÐµÐ²Ð¾Ð¹ ÑÐµÑÐ°Ð¿Ð¸Ð¸ ÑÐ°ÐºÐ° Ð¼Ð¾Ð»Ð¾ÑÐ½Ð¾Ð¹ Ð¶ÐµÐ»ÐµÐ·Ñ 3D-CRT (3D-conform radiation therapy) Ð¸ IMRT (Intensity Modulated Radiation Therapy) Ð½Ð° Ð¼ÐµÐ´Ð¸ÑÐ¸Ð½ÑÐºÐ¾Ð¼ ÑÑÐºÐ¾ÑÐ¸ÑÐµÐ»Ðµ ÑÐ»ÐµÐºÑÑÐ¾Ð½Ð¾Ð² Varian TrueBeam Ñ Ð¼Ð°ÐºÑÐ¸Ð¼Ð°Ð»ÑÐ½Ð¾Ð¹ ÑÐ½ÐµÑÐ³Ð¸ÐµÐ¹ ÑÐ¾ÑÐ¼Ð¾Ð·Ð½Ð¾Ð³Ð¾ Ð¸Ð·Ð»ÑÑÐµÐ½Ð¸Ñ 6 ÐÑÐ. Ð¡ÑÐ°Ð²Ð½ÐµÐ½Ð¸Ðµ Ð¿ÑÐ¾Ð²Ð¾Ð´Ð¸Ð»Ð¾ÑÑ Ñ Ð¸ÑÐ¿Ð¾Ð»ÑÐ·Ð¾Ð²Ð°Ð½Ð¸ÐµÐ¼ Ð¸Ð½ÑÑÑÑÐ¼ÐµÐ½ÑÐ¾Ð² Ð¿ÑÐ¾Ð³ÑÐ°Ð¼Ð¼Ñ Ð´Ð¾Ð·Ð¸Ð¼ÐµÑÑÐ¸ÑÐµÑÐºÐ¾Ð³Ð¾ Ð¿Ð»Ð°Ð½Ð¸ÑÐ¾Ð²Ð°Ð½Ð¸Ñ Eclipse Ñ Ð¿ÑÐ¸Ð¼ÐµÐ½ÐµÐ½Ð¸ÐµÐ¼ Ð°Ð»Ð³Ð¾ÑÐ¸ÑÐ¼Ð° ÑÐ°ÑÑÑÑÐ° Ð´Ð¾Ð·Ð½Ð¾Ð³Ð¾ ÑÐ°ÑÐ¿ÑÐµÐ´ÐµÐ»ÐµÐ½Ð¸Ñ Acuros. ÐÐ»Ð³Ð¾ÑÐ¸ÑÐ¼ Acuros Ð¸ÑÐ¿Ð¾Ð»ÑÐ·ÑÐµÑÑÑ Ð´Ð»Ñ ÑÐ°ÑÑÑÑÐ° Ð´Ð¾Ð·Ð½Ð¾Ð³Ð¾ ÑÐ°ÑÐ¿ÑÐµÐ´ÐµÐ»ÐµÐ½Ð¸Ñ Ð² Ð±Ð¸Ð¾Ð»Ð¾Ð³Ð¸ÑÐµÑÐºÐ¸Ñ ÑÐºÐ°Ð½ÑÑ Ñ ÑÑÑÑÐ¾Ð¼ Ð³ÐµÑÐµÑÐ¾Ð³ÐµÐ½Ð½Ð¾ÑÑÐ¸ ÑÑÐµÐ´Ñ. Ð Ð´Ð°Ð½Ð½Ð¾Ð¹ ÑÐ°Ð±Ð¾ÑÐµ ÑÐ°ÑÐºÑÑÑÑ ÑÐ¸Ð·Ð¸ÑÐµÑÐºÐ¸Ðµ Ð°ÑÐ¿ÐµÐºÑÑ Ð´Ð¾Ð·Ð¸Ð¼ÐµÑÑÐ¸ÑÐµÑÐºÐ¾Ð³Ð¾ Ð¿Ð»Ð°Ð½Ð¸ÑÐ¾Ð²Ð°Ð½Ð¸Ñ Ð¾Ð±Ð»ÑÑÐµÐ½Ð¸Ñ Ð¼Ð¾Ð»Ð¾ÑÐ½Ð¾Ð¹ Ð¶ÐµÐ»ÐµÐ·Ñ: ÑÐ¾ÑÐ¼Ð¸ÑÐ¾Ð²Ð°Ð½Ð¸Ðµ ÑÐµÑÐ°Ð¿ÐµÐ²ÑÐ¸ÑÐµÑÐºÐ¾Ð³Ð¾ Ð¿ÑÑÐºÐ° Ð¸Ð·Ð»ÑÑÐµÐ½Ð¸Ñ Ð¼ÐµÐ´Ð¸ÑÐ¸Ð½ÑÐºÐ¸Ð¼ ÑÑÐºÐ¾ÑÐ¸ÑÐµÐ»ÐµÐ¼ ÑÐ»ÐµÐºÑÑÐ¾Ð½Ð¾Ð² Ð¸ Ð²Ð·Ð°Ð¸Ð¼Ð¾Ð´ÐµÐ¹ÑÑÐ²Ð¸Ðµ Ð¸Ð¾Ð½Ð¸Ð·Ð¸ÑÑÑÑÐµÐ³Ð¾ Ð¸Ð·Ð»ÑÑÐµÐ½Ð¸Ñ ÑÑÐ¾ÑÐ¼Ð¸ÑÐ¾Ð²Ð°Ð½Ð½Ð¾Ð³Ð¾ ÑÐµÑÐ°Ð¿ÐµÐ²ÑÐ¸ÑÐµÑÐºÐ¾Ð³Ð¾ Ð¿ÑÑÐºÐ° Ñ ÑÐµÐ»Ð¾Ð¼ Ð¿Ð°ÑÐ¸ÐµÐ½ÑÐ°. Ð ÑÐ°Ð¼ÐºÐ°Ñ Ð¸ÑÑÐ»ÐµÐ´Ð¾Ð²Ð°Ð½Ð¸Ñ Ð±ÑÐ»Ð¾ Ð¿ÑÐ¾Ð²ÐµÐ´ÐµÐ½Ð¾ Ð¿Ð»Ð°Ð½Ð¸ÑÐ¾Ð²Ð°Ð½Ð¸Ðµ Ð¾Ð±Ð»ÑÑÐµÐ½Ð¸Ñ Ð¼Ð¾Ð»Ð¾ÑÐ½Ð¾Ð¹ Ð¶ÐµÐ»ÐµÐ·Ñ Ð¼ÐµÑÐ¾Ð´Ð¾Ð¼ 3D-CRT Ð¸ IMRT Ð´Ð»Ñ 11 ÐºÐ»Ð¸Ð½Ð¸ÑÐµÑÐºÐ¸Ñ ÑÐ»ÑÑÐ°ÐµÐ² Ð¾Ð±Ð»ÑÑÐµÐ½Ð¸Ñ Ð¼Ð¾Ð»Ð¾ÑÐ½Ð¾Ð¹ Ð¶ÐµÐ»ÐµÐ·Ñ Ð² ÑÐµÐ¶Ð¸Ð¼Ðµ ÑÑÐ°ÐºÑÐ¸Ð¾Ð½Ð¸ÑÐ¾Ð²Ð°Ð½Ð¸Ñ 25 ÑÑÐ°ÐºÑÐ¸Ð¹ Ð¿Ð¾ 2 ÐÑ Ñ ÑÑÐ¼Ð¼Ð°ÑÐ½Ð¾Ð¹ Ð¿Ð¾Ð³Ð»Ð¾ÑÑÐ½Ð½Ð¾Ð¹ Ð´Ð¾Ð·Ð¾Ð¹ 50 ÐÑ. ÐÐ»Ñ ÐºÐ°Ð¶Ð´Ð¾Ð³Ð¾ Ð¿ÑÐ¾Ð°Ð½Ð°Ð»Ð¸Ð·Ð¸ÑÐ¾Ð²Ð°Ð½Ð½Ð¾Ð³Ð¾ ÐºÐ»Ð¸Ð½Ð¸ÑÐµÑÐºÐ¾Ð³Ð¾ ÑÐ»ÑÑÐ°Ñ Ð² ÑÐ¾Ð´Ðµ ÑÑÐ°Ð²Ð½ÐµÐ½Ð¸Ñ Ð²ÑÐ±ÑÐ°Ð½ Ð¿Ð¾Ð´ÑÐ¾Ð´ÑÑÐ¸Ð¹ Ð¿Ð»Ð°Ð½ Ð¾Ð±Ð»ÑÑÐµÐ½Ð¸Ñ. Ð¡ÑÐ°Ð²Ð½ÐµÐ½Ð¸Ðµ Ð´Ð²ÑÑ Ð¼ÐµÑÐ¾Ð´Ð¸Ðº Ð¿ÑÐ¾Ð²Ð¾Ð´Ð¸Ð»Ð¾ÑÑ Ñ ÑÑÑÑÐ¾Ð¼ Ð¾Ð±Ð»ÑÑÐ°ÐµÐ¼Ð¾Ð³Ð¾ Ð¾Ð±ÑÑÐ¼Ð°, Ð½Ð°ÑÐ¾Ð´ÑÑÐµÐ³Ð¾ÑÑ Ð²Ð½ÑÑÑÐ¸ Ð³ÑÐ°Ð½Ð¸ÑÑ 95%-Ð¾Ð¹ Ð¸Ð·Ð¾Ð´Ð¾Ð·Ñ Ð¾Ñ ÑÑÐ¼Ð¼Ð°ÑÐ½Ð¾Ð¹ Ð¿Ð¾Ð³Ð»Ð¾ÑÑÐ½Ð½Ð¾Ð¹ Ð´Ð¾Ð·Ñ 50 ÐÑ, ÐºÐ¾Ð»Ð¸ÑÐµÑÑÐ²Ð° 105%, 107% Ð¼Ð°ÐºÑÐ¸Ð¼ÑÐ¼Ð¾Ð² Ð¾Ñ 50 ÐÑ, Ð¾Ð±ÑÑÐ¼ Ð·Ð°ÑÑÐ¾Ð½ÑÑÑÑ Ð¾Ð±Ð»ÑÑÐµÐ½Ð¸ÐµÐ¼ Ð¾ÑÐ³Ð°Ð½Ð¾Ð² ÑÐ¸ÑÐºÐ° (ÑÐµÑÐ´ÑÐµ Ð¸ Ð»ÑÐ³ÐºÐ¸Ðµ) Ð¸ Ð³Ð»Ð¾Ð±Ð°Ð»ÑÐ½ÑÐ¹ Ð¼Ð°ÐºÑÐ¸Ð¼ÑÐ¼ Ð² ÑÐµÐ»Ðµ Ð¿Ð°ÑÐ¸ÐµÐ½ÑÐ°. Ð¢Ð°ÐºÐ¶Ðµ Ð´Ð»Ñ ÑÑÐ°Ð²Ð½Ð¸ÑÐµÐ»ÑÐ½Ð¾Ð³Ð¾ Ð°Ð½Ð°Ð»Ð¸Ð·Ð° Ð¿Ð»Ð°Ð½Ð¾Ð² Ð¾Ð±Ð»ÑÑÐµÐ½Ð¸Ñ Ð¿ÑÐ¾Ð²Ð¾Ð´Ð¸Ð»Ð°ÑÑ Ð¿Ð¾ÑÑÐ°Ð»ÑÐ½Ð°Ñ Ð´Ð¾Ð·Ð¸Ð¼ÐµÑÑÐ¸Ñ Ð² ÑÐ°Ð¼ÐºÐ°Ñ Ð¿ÑÐ¾Ð³ÑÐ°Ð¼Ð¼Ñ Ð³Ð°ÑÐ°Ð½ÑÐ¸Ð¸ ÐºÐ°ÑÐµÑÑÐ²Ð° Ð»ÐµÑÐµÐ±Ð½ÑÑ Ð¿Ð»Ð°Ð½Ð¾Ð² Ð¸ ÑÐ°ÑÑÑÐ¸ÑÐ°Ð½Ð° ÑÐºÐ¾ÑÐ¾ÑÑÑ Ð¿ÑÐ¾Ð²ÐµÐ´ÐµÐ½Ð¸Ñ ÑÐµÐ°Ð½ÑÐ° Ð¾Ð±Ð»ÑÑÐµÐ½Ð¸Ñ Ð½Ð° ÑÑÐºÐ¾ÑÐ¸ÑÐµÐ»Ðµ. ÐÐ° Ð¾ÑÐ½Ð¾Ð²Ðµ Ð²ÑÑÐµÐ¿ÐµÑÐµÑÐ¸ÑÐ»ÐµÐ½Ð½ÑÑ ÑÐ°ÐºÑÐ¾ÑÐ¾Ð² Ð² ÐºÐ°Ð¶Ð´Ð¾Ð¼ ÐºÐ¾Ð½ÐºÑÐµÑÐ½Ð¾Ð¼ ÑÐ»ÑÑÐ°Ðµ Ð±ÑÐ» ÑÐ´ÐµÐ»Ð°Ð½ Ð²ÑÐ±Ð¾Ñ Ð² ÑÑÐ¾ÑÐ¾Ð½Ñ Ð¾Ð´Ð½Ð¾Ð³Ð¾ Ð¸Ð· Ð¼ÐµÑÐ¾Ð´Ð¾Ð² Ð»ÐµÑÐµÐ½Ð¸Ñ. Ð ÑÐ¾Ð´Ðµ Ð°Ð½Ð°Ð»Ð¸Ð·Ð° ÐºÐ»Ð¸Ð½Ð¸ÑÐµÑÐºÐ¸Ñ ÑÐ»ÑÑÐ°ÐµÐ² Ð¾Ð±Ð»ÑÑÐµÐ½Ð¸Ñ Ð¼Ð¾Ð»Ð¾ÑÐ½Ð¾Ð¹ Ð¶ÐµÐ»ÐµÐ·Ñ Ð±ÑÐ»Ð¾ Ð²ÑÐ±ÑÐ°Ð½Ð¾ Ð¿ÑÐ¾Ð²ÐµÐ´ÐµÐ½Ð¸Ðµ Ð»ÑÑÐµÐ²Ð¾Ð¹ ÑÐµÑÐ°Ð¿Ð¸Ð¸ Ð¼ÐµÑÐ¾Ð´Ð¾Ð¼ IMRT, ÑÐ°Ðº ÐºÐ°Ðº Ð¸Ð¼ÐµÐ½Ð½Ð¾ ÑÑÐ¾Ñ Ð¼ÐµÑÐ¾Ð´ Ð´Ð¾ÐºÐ°Ð·Ð°Ð» ÑÐ²Ð¾Ñ Ð²ÑÑÐ¾ÐºÑÑ ÑÑÐµÐ¿ÐµÐ½Ñ ÐºÐ¾Ð½ÑÐ¾ÑÐ¼Ð½Ð¾ÑÑÐ¸ Ð¼Ð¸ÑÐµÐ½Ð¸ Ð¸ ÑÐºÐ¾ÑÐ¾ÑÑÑ ÑÐµÐ°Ð»Ð¸Ð·Ð°ÑÐ¸Ð¸ Ð² ÐºÐ»Ð¸Ð½Ð¸ÑÐµÑÐºÐ¾Ð¹ Ð¿ÑÐ°ÐºÑÐ¸ÐºÐµ. ÐÐ»Ñ Ð²ÑÐµÑ Ð¿ÑÐ¸Ð²ÐµÐ´ÑÐ½Ð½ÑÑ Ð² Ð´Ð°Ð½Ð½Ð¾Ð¹ ÑÐ°Ð±Ð¾ÑÐµ ÐºÐ»Ð¸Ð½Ð¸ÑÐµÑÐºÐ¸Ñ ÑÐ»ÑÑÐ°ÐµÐ² Ð±ÑÐ»Ð° ÑÑÐ¿ÐµÑÐ½Ð¾ Ð¿ÑÐ¾Ð²ÐµÐ´ÐµÐ½Ð° Ð¿Ð¾ÑÑÐ°Ð»ÑÐ½Ð°Ñ Ð´Ð¾Ð·Ð¸Ð¼ÐµÑÑÐ¸Ñ Ð² ÑÐ°Ð¼ÐºÐ°Ñ Ð¿ÑÐ¾Ð³ÑÐ°Ð¼Ð¼Ñ Ð³Ð°ÑÐ°Ð½ÑÐ¸Ð¸ ÐºÐ°ÑÐµÑÑÐ²Ð°.
description: This final qualification work was carried out at the St. Petersburg Clinical Scientific and Practical Center for Specialized Types of Medical Care (oncological) and is devoted to comparing two methods of remote radiation therapy for breast cancer 3D-CRT (3D-conformal radiation therapy) and IMRT (Intensity Modulated Radiation Therapy) on the Varian TrueBeam medical electron accelerator with a maximum bremsstrahlung energy of 6 MeV. The comparison was carried out using the tools of the Eclipse dosimetric planning program using the Acuros dose distribution calculation algorithm. The Acuros algorithm is used to calculate the dose distribution in biological tissues, taking into account the heterogeneity of the medium. This paper describes the physical aspects of dosimetric planning of breast irradiation: starting with the formation of a therapeutic beam of radiation and ending with the interaction of ionizing radiation with a substance. As part of the study, planning of breast irradiation using 3D-CRT and IMRT was carried out for 11 clinical cases of breast irradiation planning in the mode of fractionation of 25 fractions of 2 Gy with a total absorbed dose of 50 Gy. For each analyzed clinical case, a suitable treatment plan was selected during the comparison. Comparison of the two methods was carried out taking into account the qualitative and quantitative coverage of the irradiated volume by 95% isodose of the total absorbed dose of 50 Gy, the amount of 105%, 107% of the maxima from 50 Gy, the volume of risk organs affected by radiation (heart and lungs) and the global maximum in the body patient. Also, for a comparative analysis of irradiation plans, portal dosimetry was carried out as part of the quality assurance program for treatment plans, and the speed of the irradiation session at the accelerator was calculated. Based on the above factors, in each case, a choice was made in the direction of one of the methods of treatment. During the analysis of clinical cases of breast irradiation, IMRT radiation therapy was chosen, since it was this method that proved its high degree of target conformity and speed of implementation in clinical practice. For all the clinical cases presented in this paper, portal dosimetry was successfully performed as part of a quality assurance program.