Hu Jiang, Xiao WeiWei, He ZhiChun, Kang DeHua, Chen Along, Qi ZhenYu
Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center of Cancer Medicine, Guangzhou 510060, China.
Radiat Oncol. 2014 Sep 16;9:204. doi: 10.1186/1748-717X-9-204.
To compare conventional lateral photon-electron, fixed-beam intensity modulated radiation therapy (IMRT), coplanar and non-coplanar RapidArc for the treatment of a diffuse sebaceous gland carcinoma of the scalp.
Comprehensive dosimetry comparisons were performed among 3D-CRT, IMRT and various RapidArc plans. Target coverage, conformity index (CI), homogeneity index (HI) and doses to organs at risk (OAR) were calculated. Monitor unites (MUs) and delivery time of each treatment were also recorded to evaluate the execution efficiency. The influence of target splitting technique and non-coplanar planning on plan quality was discussed.
IMRT was superior to 3D-CRT concerning targets' coverage at the sacrifice of larger irradiated brain volumes to low doses. CIs and HIs were better in coplanar RapidArc and non-coplanar RapidArc plans than 3D-CRT and IMRT. Best dose coverage and sparing of OARs were achieved in non-coplanar plans using target splitting technique. Treatment delivery time was longest in the IMRT plan and shortest in the coplanar RapidArc plan without target splitting. The 3%/3 mm gamma test pass rates were above 95% for all the plans.
Target splitting technique and non-coplanar arcs are recommended for total scalp irradiation.
比较传统侧向光子 - 电子放疗、固定束强度调制放射治疗（IMRT）、共面和非共面容积弧形调强放疗（RapidArc）治疗头皮弥漫性皮脂腺癌的效果。
对三维适形放疗（3D - CRT）、IMRT和各种RapidArc计划进行全面的剂量学比较。计算靶区覆盖率、适形指数（CI）、均匀性指数（HI）以及危及器官（OAR）的剂量。记录每种治疗的监测单位（MU）和照射时间，以评估执行效率。讨论了靶区分割技术和非共面计划对计划质量的影响。
IMRT在靶区覆盖方面优于3D - CRT，但以较大体积的脑区接受低剂量照射为代价。共面RapidArc和非共面RapidArc计划的CI和HI优于3D - CRT和IMRT。采用靶区分割技术的非共面计划实现了最佳的剂量覆盖和对OAR的保护。IMRT计划的照射时间最长，未采用靶区分割的共面RapidArc计划照射时间最短。所有计划的3%/3毫米伽马通过率均高于95%。
推荐采用靶区分割技术和非共面弧形照射进行全头皮放疗。
