Chow J, Jiang R
Princess Margaret Hospital.
Grand River Regional Cancer Center.
Med Phys. 2012 Jul;39(7Part3):4636. doi: 10.1118/1.4740169.
This study compared the dosimetry between prostate plans using the single-arc and double-arc technique in volumetric modulated arc therapy (VMAT). Single-arc and double-arc prostate VMAT plans were created in five patients with prostate volumes ranging from 39.0-68.1 cm . 6 MV photon beams generated by a Varian 21EX linac with 120-leaf multileaf collimator, and prescription dose of 78 Gy with 39 fractions were used. Dose-volume histograms of the target and critical organs, dose criteria such as the planning target volume (PTV) D99%, rectum D30% and rectum D50%, and dose profiles along the anterior-posterior and lateral directions crossing the isocenter were determined using the Eclipse treatment planning system with RapidArc optimization. It is found that the double-arc technique provided a better PTV coverage and rectal sparing compared to the single-arc for all patients. For dose profiles crossing the isocenter, it is seen that the dose in the anterior-posterior direction was shifted to the lateral, when the single-arc technique was replaced by the double-arc. This dosimetric change made the dose in the rectal position shift laterally to the femoral head, resulting in a lower rectal dose. The calculated monitor units (MUs) were 471-600 for the single-arc plans and 587-730 for the double-arc. Although the double-arc plans on average required more MUs of about 20%, and almost twice the treatment time compared to the single-arc, it is worthwhile to be considered particularly in some cases, where the dose criteria are difficult to achieve using the single-arc technique.
本研究比较了容积调强弧形放疗(VMAT)中使用单弧和双弧技术的前列腺计划之间的剂量学差异。为五名前列腺体积在39.0 - 68.1 cm³之间的患者制定了单弧和双弧前列腺VMAT计划。使用瓦里安21EX直线加速器产生的6 MV光子束和120叶多叶准直器,处方剂量为78 Gy,分39次照射。使用具有快速弧形优化功能的Eclipse治疗计划系统确定靶区和危及器官的剂量体积直方图、剂量标准,如计划靶区(PTV)的D99%、直肠的D30%和直肠的D50%,以及沿穿过等中心的前后和侧向方向的剂量分布。结果发现,对于所有患者,双弧技术与单弧技术相比,能提供更好的PTV覆盖和直肠保护。对于穿过等中心的剂量分布,当单弧技术被双弧技术取代时,可以看到前后方向的剂量向侧向偏移。这种剂量学变化使直肠位置的剂量侧向偏移到股骨头,从而降低了直肠剂量。单弧计划计算出的监测单位(MU)为471 - 600个,双弧计划为587 - 730个。虽然双弧计划平均需要多约20%的MU,且治疗时间几乎是单弧计划的两倍,但在某些使用单弧技术难以达到剂量标准的情况下,仍值得考虑采用双弧技术。