Análisis de los riesgos asociados al uso de la técnica VMAT frente a 3DCRT en tratamientos de mama con cadenas ganglionares axilo-claviculares
DOI:
https://doi.org/10.37004/sefm/2021.22.1.001Palabras clave:
VMAT, 3DCRT, cáncer de mama, tumores radioinducidos, cardiotoxicidadResumen
La utilización de arcoterapia volumétrica de intensidad modulada (VMAT) para el tratamiento de cáncer de mama siempre ha sido un asunto controvertido. La mayor conformación de las dosis absorbidas altas que se consigue con la VMAT frente a la radioterapia conformada (3DCRT) viene acompañada de un incremento del volumen irradiado con dosis absorbidas bajas, cuyas consecuencias hay que analizar. El presente estudio pretende, mediante el análisis de las dosimetrías clínicas de 80 pacientes con cáncer de mama tratadas en nuestro centro con ambas técnicas, evaluar la idoneidad de la elección de una técnica frente a la otra para el tratamiento de pacientes con cáncer de mama que precisan la irradiación de cadenas ganglionares axilo-claviculares, pero no de la cadena mamaria interna. Para ello se tienen en cuenta por un lado criterios puramente dosimétricos, como el cumplimiento de los límites de dosis absorbida establecidos en órganos de riesgo, y por otro se realiza una estimación del aumento en la probabilidad de desarrollar tumores secundarios sólidos por la irradiación a baja dosis de órganos sanos y se evalúan las posibles la toxicidades, cardiacas y pulmonares, en base a lo descrito en la literatura.
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