Yamashita Mako, Katayama Norihisa, Waki Takahiro, Katsui Kuniaki, Himei Kengo, Takemoto Mitsuhiro, Kanazawa Susumu
Department of Radiology, Nippon Kokan Fukuyama Hospital, Fukuyama, Hiroshima 721-0927, Japan.
Acta Med Okayama. 2015;69(4):189-95. doi: 10.18926/AMO/53554.
This study compared field-in-field (FIF) radiotherapy with conformal radiotherapy with physical wedges for the treatment of unilateral cervical malignant lymphoma. Two treatment plans, the FIF technique and conformal RT, were generated for each of 32 patients with unilateral cervical malignant lymphoma. To compare the 2 treatment plans, dose-volume histograms of the planning target volume (PTV), the thyroid, submandibular gland, carotid artery, mucosa, spinal cord, and surrounding normal tissue, and monitor unit (MU) were analyzed. The FIF technique showed significant reduction in the mean dose of thyroid, submandibular gland, carotid artery and mucosa, the maximum dose of the spinal cord and PTV, and the volume receiving＞107% of the prescribed dose of surrounding normal tissue (p＜0.001). In addition, there were gains in the homogeneity index of the PTV for FIF. Furthermore, the total MU was also lower for the FIF technique than for the wedge technique (p＜0.001). Compared with the wedge technique, the FIF technique improved the dose homogeneity of the PTV, reduced the dose to normal structures, and was associated with fewer MUs in the treatment of patients with cervical malignant lymphoma.
本研究比较了野中野（FIF）放射治疗与使用物理楔形板的适形放射治疗在单侧颈部恶性淋巴瘤治疗中的效果。为32例单侧颈部恶性淋巴瘤患者中的每一位制定了两个治疗计划，即FIF技术和适形放疗计划。为比较这两种治疗计划，分析了计划靶区（PTV）、甲状腺、下颌下腺、颈动脉、黏膜、脊髓及周围正常组织的剂量体积直方图，以及监测单位（MU）。FIF技术显示甲状腺、下颌下腺、颈动脉和黏膜的平均剂量、脊髓和PTV的最大剂量以及接受＞107%处方剂量的周围正常组织体积均显著降低（p＜0.001）。此外，FIF技术在PTV的均匀性指数方面有所提高。而且，FIF技术的总MU也低于楔形技术（p＜0.001）。与楔形技术相比，FIF技术改善了PTV的剂量均匀性，降低了对正常结构的剂量，并且在颈部恶性淋巴瘤患者的治疗中MU数量更少。
