Sterzing Florian, Sroka-Perez Gabriele, Schubert Kai, Münter Marc W, Thieke Christian, Huber Peter, Debus Jürgen, Herfarth Klaus K
Department of Radiation Oncology, University of Heidelberg, Germany.
Radiother Oncol. 2008 Feb;86(2):251-7. doi: 10.1016/j.radonc.2007.12.010. Epub 2008 Jan 18.
To evaluate the potential of helical tomotherapy in the adjuvant treatment of malignant pleural mesothelioma and compare target homogeneity, conformity and normal tissue dose with step-and-shoot intensity-modulated radiotherapy.
Ten patients with malignant pleural mesothelioma who had undergone neoadjuvant chemotherapy with cisplatin and permetrexed followed by extrapleural pneumonectomy (EPP) were treated in our department with 54 Gy to the hemithorax delivered by step-and-shoot IMRT. A planning comparison was performed by creating radiation plans for helical tomotherapy. The different plans were compared by analysing target homogeneity using the homogeneity indices HI(max) and HI(min) and target conformity by using the conformity index CI(95). To assess target coverage and normal tissue sparing TV(90), TV(95) and mean and maximum doses were compared.
Both modalities achieved excellent dose distributions while sparing organs at risk. Target coverage and homogeneity could be increased significantly with helical tomotherapy compared with step-and-shoot IMRT. Mean dose to the contralateral lung could be lowered beyond 5 Gy.
Our planning study showed that helical tomotherapy is an excellent option for the adjuvant intensity-modulated radiotherapy of MPM. It is capable of improving target coverage and homogeneity.
评估螺旋断层放射治疗在恶性胸膜间皮瘤辅助治疗中的潜力，并将靶区均匀性、适形性和正常组织剂量与静态调强放射治疗进行比较。
10例接受顺铂和培美曲塞新辅助化疗后行胸膜外全肺切除术（EPP）的恶性胸膜间皮瘤患者在我科接受了静态调强放射治疗，对半侧胸腔给予54 Gy剂量。通过创建螺旋断层放射治疗的放射治疗计划进行计划比较。通过使用均匀性指数HI(max)和HI(min)分析靶区均匀性以及使用适形指数CI(95)分析靶区适形性来比较不同计划。为评估靶区覆盖和正常组织受量，比较了TV(90)、TV(95)以及平均剂量和最大剂量。
两种方式在保护危及器官的同时均实现了出色的剂量分布。与静态调强放射治疗相比，螺旋断层放射治疗可显著提高靶区覆盖和均匀性。对侧肺的平均剂量可降低超过5 Gy。
我们的计划研究表明，螺旋断层放射治疗是恶性胸膜间皮瘤辅助调强放射治疗的极佳选择。它能够改善靶区覆盖和均匀性。
