Department of Oncology, University College London Hospitals NHS Foundation Trust, First Floor Central, 250 Euston Road, London NW1 2PG, UK.
Future Oncol. 2013 Mar;9(3):439-49. doi: 10.2217/fon.12.199.
The standard European radiotherapy technique for children with neuroblastoma is a conventional parallel opposed pair. This frequently results in compromise on planning target volume coverage to stay within normal tissue tolerances. This study investigates the use of an intensity-modulated arc therapy (IMAT) technique to improve dose distribution and allow better protocol compliance. Among 20 previously treated patients, ten had received the full prescribed dose with conventional planning (protocol compliant) and ten had a compromise on planning target volume coverage (protocol noncompliant). All patients were replanned with IMAT. Dosimetric parameters of the conventional radiotherapy and IMAT were compared. The dose received by 98% of the planning target volume, homogeneity and conformity indices were all improved with IMAT (p < 0.001). IMAT would have enabled delivery of the full protocol dose in eight out of ten protocol-noncompliant patients. IMAT may improve outcomes through improved protocol compliance and better dose distributions.
对于神经母细胞瘤患儿，标准的欧洲放射治疗技术是常规的平行对置技术。这通常会导致在规划靶区覆盖范围方面的妥协，以保持在正常组织耐受范围内。本研究探讨了使用强度调制弧形治疗（IMAT）技术来改善剂量分布并允许更好地遵守方案。在 20 名之前接受治疗的患者中，有 10 名患者接受了常规计划的全剂量治疗（符合方案），10 名患者在规划靶区覆盖方面存在妥协（不符合方案）。所有患者均重新进行了 IMAT 计划。比较了常规放疗和 IMAT 的剂量学参数。IMAT 可改善 98%的计划靶区的剂量、均匀性和适形指数（p<0.001）。对于 10 名不符合方案的患者中的 8 名，IMAT 可以使他们接受全剂量的方案治疗。IMAT 可以通过提高方案依从性和更好的剂量分布来改善治疗效果。
