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Ocena parametrów rozkładu dawki dla pacjentek z lewostronnym nowotworem piersi napromienianych techniką VMAT na głębokim wdechu

Pietrzyk Izabela, Szczyrek Zofia, Daniluk Anna

Inżynier i Fizyk Medyczny

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2022

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Vol. 11, nr 3

247--252

PL

Celem pracy jest dokonanie analizy porównawczej parametrów rozkładu dawki na swobodnym oddechu (ang. Free breathing, FB) i wstrzymanym głębokim wdechu (ang. Deep inspiration breath-hold, DIBH) dla pacjentek z lewostronnym nowotworem piersi napromienianych techniką VMAT. Praca została wykonana w Narodowym Instytucie Onkologii im. Marii Skłodowskiej-Curie – Państwowym Instytucie Badawczym przy ul. Wawelskiej 15 w Warszawie. Analizę parametrów rozkładu dawki przeprowadzono na grupie 30 pacjentek napromienianych na obszar blizny po mastektomii oraz na obszar loży pooperacyjnej. Plany napromieniania wykonane zostały w systemie planowania leczenia Monaco firmy ELEKTA. Porównanie planów leczenia na swobodnym oddechu i wstrzymanym głębokim wdechu wykazało, że pod względem objęcia targetu żadna z technik nie jest wiodąca. Technika DIBH pozwoliła na zmniejszenie dawki w narządach krytycznych, przede wszystkim w sercu, płucu po stronie napromienianej i lewej tętnicy wieńcowej. Uzyskane redukcje średniej dawki średniej wynosiły: 40,5%, 11,2%, 56,6%, odpowiednio dla serca, płuca lewego i lewej tętnicy wieńcowej. Redukcja V20Gy i V5Gy dla serca wyniosła 91,4 i 56,6%. Dla płuca lewego V20Gy i V10Gy zredukowano o 12,9 i 8,1%, a dawkę maksymalną dla lewej tętnicy wieńcowej o 44,3%.

EN

The aim of the study is to perform a comparative analysis of the dose distribution parameters for free breathing (FB) and deep inspiration breath-hold (DIBH) for patients with left- -sided breast cancer irradiated with the VMAT technique. The work was carried out at the Maria Skłodowska-Curie – National Research Institute at Wawelska 15 Street in Warsaw. The analysis of the dose distribution parameters was carried out on a group of 30 patients irradiated on the scar after mastectomy and on the area after breast-conserving surgery. The irradiation plans were made in the Monaco treatment planning system by ELEKTA. A comparison of treatment plans with free breath and deep breath hold showed that none of the techniques was leading in terms of target acquisition. The DIBH technique allowed for dose reduction in organs at risk, mainly in the heart, lung on the irradiated side and left anterior descending. The obtained mean mean dose reductions were: 40,5%, 11,2%, 56,6% for the heart, left lung and left anterior descending, respectively. The reduction of V20Gy and V5Gy for the heart was 91,4 and 56,6%. For the left lung, V20Gy and V10Gy were reduced by 12,9 and 8,1%, and the maximum dose for the left coronary artery by 44,3%.

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Influence of force-time parameters of hip abductors on maintaining balance in frontal plane in young healthy females

Bugalska Aneta, Hadamus Anna, Wójtowicz Sebastian, Daniluk Anna, Wiaderna Karolina, Grabowicz Marta

Acta of Bioengineering and Biomechanics

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2022

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Vol. 24, no. 1

4--8

EN

The aim of this study was to determine the impact of isometric and isokinetic hip abductor muscle strength on the quality of maintaining static balance in healthy subjects. Methods: The study enrolled 51 healthy women aged 18–25. Balance assessment was carried out according to the M-CTSIB protocol and Single Leg Stance Test (with eyes open and closed) using the Biodex Balance System. An isokinetic evaluation conducted at 30 °/s and an isometric evaluation of the hip abductors were performed with the Humac Norm system. Results: Regression analysis for Sway Index (SW) and Stability Index (ST) in bipedal standing showed a significant importance of the presence of visual feedback (RSW EO = –0.922; p < 0.0001; RST EO = –0.613; p = 0.0493), and unstable surface (RSW US = 1.253; p < 0.0001; RSW US = 2.547; p < 0.0001). Regression analysis for single-leg stance showed correlations between the following indices: overall sway index (OR) in single-leg stance, the antero-posterior (AP) sway index and the medio-lateral (ML) sway index on the one hand and isometric abduction time to peak torque (R OR TPT = 0.769; p = 0.0005; R AP TPT = 0.565; p = 0.008; R ML TPT = –1.74; p < 0.05, respectively) as well as the test conditions on the other. Conclusions: Physiological activation of the hip abductors may be important for physiological maintenance of postural balance in young people, in both leg standing as well as in single-leg stance. The present results warrant prospective, randomized studies of larger groups that are diversified with regard to age and gender of the participants.

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Effect of smooth eye tracking in different patterns on results of the modified Clinical Balance Sensory Integration Test in healthy young adults

Wójtowicz Sebastian, Łakoma Aleksandra, Ferenc Aneta, Daniluk Anna, Wiaderna Karolina, Hadamus Anna

Acta of Bioengineering and Biomechanics

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2022

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Vol. 24, no. 4

57--64

EN

The aim of the study was to determine whether eye tracking of a point moving in different directions influences balance test performance in young healthy subjects. Methods: The study enrolled 45 healthy young adults aged 19–26. Balance assessment was carried out according to the modified Clinical Balance Sensory Integration Test protocol using the Biodex Balance System with an additional 63” screen to present the eye-tracking task. Each participant repeated measurements in standing on a stable and foam surface in six test conditions: two without eye tracking with eyes open and eyes closed, and four with eye tracking: with vertical, horizontal, star, and circle moving point. Each trial lasted 30 sec. Results: Regression analysis for the Sway Index showed that there was no impact of eye tracking on test results ( p = 0.4326), although detailed analysis showed a significant impact of tracking a point moving in a circle in standing on a foam surface ( p < 0.001). Conclusions: The presented results show that eye-tracking does not influence the results of the balance test with exception of eye-tracking of the circle movement in standing on a foam surface. It suggests that eye movements may affect the test results when performing more difficult balance tests.