Zhang Jun, Peng Yinglin, Ding Shouliang, Zhu Jinhan, Liu Yimei, Chen Meining, Sun Wenzhao, Zhou Linghong, Deng Xiaowu
Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, China.
School of Biomedical Engineering, Southern Medical University, Guangzhou, China.
Front Oncol. 2020 Apr 23;10:598. doi: 10.3389/fonc.2020.00598. eCollection 2020.
To aid in the selection of a suitable combination of irradiation mode and jaw width in helical tomotherapy (HT) for the treatment of nasopharyngeal carcinoma (NPC). Twenty patients with NPC who underwent radiotherapy were retrospectively selected. Four plans using a jaw width of 2.5 or 5-cm in dynamic jaw (DJ) or fix jaw (FJ) modes for irradiation were designed (2.5DJ, 2.5FJ, 5.0DJ, and 5.0FJ). The dose parameters of planning target volume (PTV) and organs at risk (OARs) of the plans were compared and analyzed, as well as the beam on time (BOT) and monitor unit (MU). The plans in each group were ranked by scoring the doses received by the OARs and the superity was assessed in combination with the planned BOT and MU. The prescribed dose coverage of PTV met the clinical requirements for all plans in the four groups. The groups using a 2.5-cm jaw width or a DJ mode provided better protection to most OARs, particularly for those at the longitudinal edges of the PTV ( < 0.05). The 2.5DJ group had the best ranking for OAR-dose, followed by the 2.5FJ and 5.0DJ groups with a same score. The BOT and MU of the groups using a 5.0-cm jaw width reduced nearly 45% comparing to those of the 2.5-cm jaw groups. 2.5DJ has the best dose distribution, while 5.0DJ has satisfactory dose distribution and less BOT and MU that related to the leakage dose. Both 2.5DJ or 5DJ were recommended for HT treatment plan for NPC based on the center workload.
为了辅助选择螺旋断层放射治疗(HT)中合适的照射模式与准直器宽度组合来治疗鼻咽癌(NPC)。回顾性选取了20例行放射治疗的鼻咽癌患者。设计了4种计划,分别采用动态准直器(DJ)或固定准直器(FJ)模式,准直器宽度为2.5 cm或5 cm进行照射(2.5DJ、2.5FJ、5.0DJ和5.0FJ)。比较并分析了各计划中计划靶区(PTV)和危及器官(OARs)的剂量参数,以及照射时间(BOT)和监测单位(MU)。通过对OARs所接受剂量进行评分对每组计划进行排序,并结合计划的BOT和MU评估优越性。四组所有计划的PTV处方剂量覆盖均满足临床要求。采用2.5 cm准直器宽度或DJ模式的组对大多数OARs提供了更好的保护,尤其是对PTV纵向边缘的器官(P<0.05)。2.5DJ组在OARs剂量方面排名最佳,其次是2.5FJ组和5.0DJ组,得分相同。与2.5 cm准直器宽度组相比,采用5.0 cm准直器宽度组的BOT和MU降低了近45%。2.5DJ具有最佳的剂量分布,而5.0DJ具有令人满意的剂量分布,且与漏剂量相关的BOT和MU较少。基于中心工作量,2.5DJ或5DJ均推荐用于NPC的HT治疗计划。