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复发性肺癌和头颈部癌症脉冲低剂量率调强放疗的优化策略。

Optimization strategies for pulsed low-dose-rate IMRT of recurrent lung and head and neck cancers.

机构信息

Sichuan Cancer Hospital.

出版信息

J Appl Clin Med Phys. 2014 May 8;15(3):4661. doi: 10.1120/jacmp.v15i3.4661.

Abstract

Pulsed low-dose-rate radiotherapy (PLDR) has been proven to be a valid method of reirradiation. Previous studies of recurrent cancer radiotherapy were mainly based on conventional 3D CRT and VMAT delivery techniques. There are difficulties in IMRT planning using existing commercial treatment planning systems (TPS) to meet the PLDR protocol. This work focuses on PLDR using ten-field IMRT and a commercial TPS for two specific sites: recurrent lung cancers and head and neck cancers. Our PLDR protocol requires that the maximum dose to the PTV be less than 0.4 Gy and the mean dose to be 0.2 Gy per field. We investigated various planning strategies to meet the PLDR requirements for 20 lung and head and neck patients. The PTV volume for lung cases ranged from 101.7 to 919.4 cm3 and the maximum dose to the PTV ranged from 0.22 to 0.39 Gy. The PTV volume for head and neck cases ranged from 66.2 to 282.1 cm3 and the maximum dose to the PTV ranged from 0.21 to 0.39 Gy. With special beam arrangements and dosimetry parameters, it is feasible to use a commercial TPS to generate quality PLDR IMRT plans for lung and head and neck reirradiation.

摘要

脉冲低剂量率放射治疗(PLDR)已被证明是一种有效的再照射方法。先前对复发性癌症放射治疗的研究主要基于常规的 3D CRT 和 VMAT 投递技术。使用现有的商业治疗计划系统(TPS)进行调强放疗(IMRT)计划存在困难,难以满足 PLDR 方案的要求。本工作重点研究了使用十野调强放疗和商业 TPS 进行的 PLDR,适用于两个特定部位:复发性肺癌和头颈部癌症。我们的 PLDR 方案要求 PTV 的最大剂量小于 0.4Gy,每个野的平均剂量为 0.2Gy。我们研究了各种规划策略,以满足 20 例肺癌和头颈部患者的 PLDR 要求。肺部病例的 PTV 体积范围为 101.7 至 919.4cm3,PTV 的最大剂量范围为 0.22 至 0.39Gy。头颈部病例的 PTV 体积范围为 66.2 至 282.1cm3,PTV 的最大剂量范围为 0.21 至 0.39Gy。通过特殊的光束排列和剂量学参数,可以使用商业 TPS 为肺部和头颈部再照射生成高质量的 PLDR IMRT 计划。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a8db/5711051/3e4d9fb66c93/ACM2-15-102-g001.jpg

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