Analisis Kurva DVH Pasien Kanker Payudara Post Mastektomi Terhadap PTV dan OAR Paru-Paru dengan Teknik IMRT
Abstract
Breast cancer has become the most commonly suffered cancer in society, with approximately 66,271 cases of breast cancer in 2022. Breast cancer treatment can be carried out in various ways, one of which is radiotherapy, which has been proven effective in reducing recurrence rates and cancer symptoms. Treatment Planning System (TPS) is a device used for radiotherapy planning by optimizing the dose. One of the irradiation techniques that can be applied using TPS is the Intensity Modulated Radiation Therapy technique. (IMRT). The research method uses the analysis of TPS planning results, namely the Dose Volume Histogram (DVH) curve, which displays the dose distribution from the radiotherapy planning. The dose parameters analyzed are the Homogeneity Index (HI), Conformity Index (CI), and the dose comparison on the PTV and OAR according to QUANTEC, ICRU 62 of 1999, and ICRU 83 of 2010. The analysis was conducted statistically using SPSS and descriptively by examining the graphs formed from the calculations. The results obtained are HI values around 0,1–0,8. Next, the CI value is 0,75–0,95. Furthermore, the PTV95% value at 90% does not meet the ICRU requirement, which is PTV95% > 95%. The limits set by the ICRU are not met in all patients for PTV107%, which is PTV107% < 1%. The dose limits for the OAR lungs according to QUANTEC standards are met for all patients. However, in one patient, the dose received was very close to the QUANTEC limit, with the volume receiving a dose of 20 Gy being 29%, which is close to the QUANTEC limit of V20 < 30%.
Abstrak
Kanker payudara telah menjadi kanker paling banyak diderita oleh masyarakat yakni sekitar 66.271 kasus kanker payudara pada tahun 2022. Pengobatan kanker payudara dapat dilakukan berbagai cara, salah satunya radioterapi, yang telah terbukti efektif dalam mengurangi angka kekambuhan dan gejala kanker. Treatment Planning System (TPS) merupakan perangkat yang digunakan untuk perencanaan radioterapi dengan melakukan optimasi dosis. Salah satu teknik penyinaran yang dapat diaplikasikan menggunakan TPS adalah teknik Intensity Modulated Radiation Therapy (IMRT). Metode penelitian menggunakan analisis hasil perencanaan TPS yaitu kurva Dose Volume Histogram (DVH) yang menampilkan distribusi dosis dari perencanaan radioterapi. Parameter dosis yang dianalisis yaitu Homogeneity Index (HI), Conformity Index (CI), dan perbandingan dosis pada PTV dan OAR QUANTEC, ICRU 62 tahun 1999 dan ICRU 83 tahun 2010. Analisis dilakukan secara statistik menggunakan SPSS dan secara deskriptif dengan melihat hasil grafik yang terbentuk dari hasil perhitungan. Hasil yang diperoleh adalah Nilai HI berada dalam rentang 0,1-0,8. Selanjutnya nilai CI berada dalam rentang 0,75-0,95. Selanjutnya Nilai PTV95% pada 90% tidak memenuhi syarat ICRU yaitu PTV95% > 95%. Batasan yang ditentukan oleh ICRU tidak terpenuhi pada semua pasien pada PTV107% yaitu PTV107% < 1%. Batasan dosis pada OAR paru-paru sesuai standar QUANTEC terpenuhi untuk semua pasien. Meskipun begitu, pada salah satu pasien, dosis yang diterima sangat mendekati batasan QUANTEC yaitu volume yang menerima dosis 20 Gy adalah 29%, hal tersebut mendekati batasan QUANTEC yaitu V20 < 30%.
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