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三维适形放疗、容积调强弧形放疗和螺旋断层放疗用于胃癌术后患者的剂量学比较

Dosimetric comparison of 3-dimensional conformal radiotherapy, volumetric modulated arc therapy, and helical tomotherapy for postoperative gastric cancer patients.

作者信息

Onal Cem, Dölek Yemliha, Akkuş Yıldırım Berna

机构信息

Department of Radiation Oncology, Adana Dr Turgut Noyan Research and Treatment Centre, Baskent University Faculty of Medicine, 01120, Adana, Turkey.

出版信息

Jpn J Radiol. 2018 Jan;36(1):30-39. doi: 10.1007/s11604-017-0696-x. Epub 2017 Nov 3.

Abstract

PURPOSE

To compare dosimetric data for the planning target volume (PTV) and organs at risk (OARs) between 3-dimensional conformal radiotherapy (3DCRT), volumetric modulated arc therapy (VMAT), and helical tomotherapy [1].

MATERIALS AND METHODS

The dosimetric data for 15 gastric cancer patients treated with 3DCRT, VMAT, or HT techniques were used. Cumulative dosimetric parameters, homogeneity index (HI), and conformal index (CI) were compared for the PTV and OARs.

RESULTS

The average maximum doses of PTV were significantly higher in VMAT plans than in 3DCRT (p = 0.04) and HT (p = 0.02) plans, whereas minimum dose values were significantly lower in 3DCRT plans compared with VMAT (p < 0.001) and HT (p = 0.02) plans. Liver mean dose (D ) and D values for both kidneys were significantly lower in HT plans than in 3DCRT and VMAT plans. The doses in high dose regions (V30-V45) using 3DCRT plans were significantly higher compared to both VMAT and HT plans. The bowel V5-V30 and V45 was significantly less in HT plans compared to VMAT plans. There were no significant differences in dose sparing of the spinal cord.

CONCLUSIONS

The HT plans reduced the maximum dose applied to the target and improved the conformality and homogeneity of radiation, while providing sufficient PTV coverage.

摘要

目的

比较三维适形放疗(3DCRT)、容积调强弧形放疗(VMAT)和螺旋断层放疗之间计划靶区(PTV)和危及器官(OARs)的剂量学数据[1]。

材料与方法

使用15例接受3DCRT、VMAT或HT技术治疗的胃癌患者的剂量学数据。比较PTV和OARs的累积剂量学参数、均匀性指数(HI)和适形指数(CI)。

结果

VMAT计划中PTV的平均最大剂量显著高于3DCRT(p = 0.04)和HT(p = 0.02)计划,而3DCRT计划中的最小剂量值与VMAT(p < 0.001)和HT(p = 0.02)计划相比显著更低。HT计划中肝脏平均剂量(D)和双肾的D值显著低于3DCRT和VMAT计划。与VMAT和HT计划相比,3DCRT计划在高剂量区域(V30 - V45)的剂量显著更高。与VMAT计划相比,HT计划中肠道的V5 - V30和V45显著更小。脊髓的剂量 sparing没有显著差异。

结论

HT计划降低了施加于靶区的最大剂量,改善了放射的适形性和均匀性,同时提供了足够的PTV覆盖。

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