Jaussaud S, Guihard S, Niederst C, Borel C, Meyer P, Hémar P, Schultz P, Noël G, Féki A
Faculté Dentaire, Hôpital Civil, 67000 Strasbourg, France.
Cancer Radiother. 2013 Jul-Aug;17(4):265-71. doi: 10.1016/j.canrad.2013.01.020. Epub 2013 May 29.
We compared intensity-modulated radiotherapy and 3D-conformal irradiation in oropharyngeal cancers according to the requirement of dentists.
From the files of seven patients with cancer of the oropharynx, two dosimetry plannings for 3D-conformal radiotherapy and intensity-modulated radiotherapy with tomotherapy were performed. The dose distributions in the target volumes and organs at risk in relation to the dental sphere were compared.
For the planning target volume of the primitive tumour sites, average values of V95%, D2%, D98% and of the conformal index were statistically in favour of tomotherapy. For the planning target volume of node areas, averages values of V95%, D2%, D98% were statistically in favour of tomotherapy. For ipsi- and controlateral parotide glands, average values of V15Gy, V26Gy, V30Gy, V40Gy were significantly lower for tomotherapy. For the submaxillary glands, average values of mean doses and V40Gy were statistically in favour of tomotherapy. For the buccal cavity, the average values of V45Gy were statistically in favour of tomotherapy. For ipsi- and controlateral masseter muscles, the average values of mean doses were statistically in favour of tomotherapy. For the ipsi- and controlateral temporomandibular joints, average values of mean doses and V60Gy were statistically in favour of tomotherapy. For mandibular bone, average values of mean doses and V40Gy, V50Gy, V60Gy and V70Gy were statistically in favour of tomotherapy. For maxillary bone, average values of V40Gy, V50Gy and V60Gy were statistically in favour of tomotherapy.
The radiation oncologist can constrain the intensity-modulated radiotherapy dosimetry to the needs of dentists to prevent or improve dental care and quality of life.
根据牙医的要求,我们比较了口咽癌的调强放疗和三维适形放疗。
从7例口咽癌患者的病历中,进行了三维适形放疗和断层放疗调强放疗的两种剂量学计划。比较了靶区和危及器官相对于牙体区域的剂量分布。
对于原发肿瘤部位的计划靶区,V95%、D2%、D98%的平均值和适形指数在统计学上有利于断层放疗。对于淋巴结区域的计划靶区,V95%、D2%、D98%的平均值在统计学上有利于断层放疗。对于同侧和对侧腮腺,断层放疗的V15Gy、V26Gy、V30Gy、V40Gy平均值显著更低。对于颌下腺,平均剂量和V40Gy的平均值在统计学上有利于断层放疗。对于颊腔,V45Gy的平均值在统计学上有利于断层放疗。对于同侧和对侧咬肌,平均剂量的平均值在统计学上有利于断层放疗。对于同侧和对侧颞下颌关节,平均剂量和V60Gy的平均值在统计学上有利于断层放疗。对于下颌骨,平均剂量和V40Gy、V50Gy、V60Gy和V70Gy的平均值在统计学上有利于断层放疗。对于上颌骨,V40Gy、V50Gy和V60Gy的平均值在统计学上有利于断层放疗。
放射肿瘤学家可以根据牙医的需求来调整调强放疗剂量学,以预防或改善口腔护理和生活质量。