Department of Radiation Oncology, The Second Affiliated Hospital of Soochow University, Suzhou, China.
Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, China.
Sci Rep. 2017 Nov 1;7(1):14863. doi: 10.1038/s41598-017-14629-w.
The study aimed to compare the dosimetric parameters to target dose coverage and the critical structures in the treatment planning of helical tomotherapy (TOMO), volumetric-modulated arc therapy (VMAT), and fixed-field intensity-modulated radiotherapy (IMRT) for NSCLC delivering conventionally fractionated radiotherapy. Thirty patients with pathologically confirmed NSCLC were included. Three radiation treatment plans were designed for each patient. All patients received the uniform prescription dose of 60 Gy to the planning target volume. The conformity index (CI), heterogeneity index (HI), and parameters of critical structures were calculated. A significantly superior mean CI was observed in VMAT than in TOMO or IMRT (P = 0.013, 0.001). Mean HI was also better using VAMT or IMRT than TOMO (P = 0.002, 0.003). Mean lung V and V were significantly reduced by TOMO compared to IMRT (P = 0.019, 0.029). The heart was spared by IMRT compared to TOMO in terms of mean heart dose, V, V, and V (P < 0.05). In larger tumor, VMAT provided the optimal dose distribution and sparing to heart. Compared to TOMO and IMRT, VMAT achieved better target dose distribution and similar sparing of critical structures. VMAT seemed to be the optimal technique for NSCLC.
本研究旨在比较体部螺旋断层放疗（TOMO）、容积旋转调强放疗（VMAT）和固定野调强放疗（IMRT）在治疗非小细胞肺癌（NSCLC）时的剂量学参数，以达到目标剂量覆盖和关键结构的保护。共纳入 30 例经病理证实的 NSCLC 患者，每位患者设计了 3 种不同的放射治疗计划。所有患者均接受 60Gy 常规分割放疗。计算适形指数（CI）、不均匀性指数（HI）和关键结构参数。VMAT 的平均 CI 明显优于 TOMO 或 IMRT（P=0.013，0.001）。VMAT 或 IMRT 的平均 HI 也优于 TOMO（P=0.002，0.003）。与 IMRT 相比，TOMO 可明显降低平均肺 V 和 V（P=0.019，0.029）。与 TOMO 相比，IMRT 可降低平均心脏剂量、V、V 和 V，从而保护心脏（P<0.05）。在较大肿瘤中，VMAT 可提供最佳的剂量分布和心脏保护。与 TOMO 和 IMRT 相比，VMAT 可实现更好的靶区剂量分布和类似的关键结构保护。VMAT 似乎是治疗 NSCLC 的最佳技术。
