在调强放疗中使用头倾基台缩短放疗时间并保护海马 spared 全脑放疗中的海马和晶状体
Use of a Head-Tilting Baseplate During Tomotherapy to Shorten the Irradiation Time and Protect the Hippocampus and Lens in Hippocampal Sparing-Whole Brain Radiotherapy.
机构信息
Department of Radiation Therapy, 37004JCHO Tokyo Shinjuku Medical Center, Tokyo, Japan.
Department of Radiation Oncology and Proton Medical Research Center, 13121University of Tsukuba, Ibaraki, Japan.
出版信息
Technol Cancer Res Treat. 2021 Jan-Dec;20:1533033820986824. doi: 10.1177/1533033820986824.
PURPOSE
The aim of this study is to comparatively examine the possibility of reducing the exposure dose to organs at risk, such as the hippocampus and lens, and improving the dose distribution of the planned target volume with and without the use of a head-tilting base plate in hippocampal-sparing whole-brain radiotherapy using tomotherapy.
METHODS
Five paired images of planned head computed tomography without and with tilt were analyzed. The hippocampus and planning target volume were contoured according to the RTOG 0933 contouring atlas protocol. The hippocampal zone to be avoided was delineated using a 5-mm margin. The prescribed radiation dose was 30 Gy in 10 fractions. The absorbed dose to planning target volume dose, absorbed dose to the organ at risk, and irradiation time were evaluated. The paired t-test was used to analyze the differences between hippocampal-sparing whole-brain radiotherapy with head tilts and without head tilts.
RESULTS
Hippocampal-sparing whole-brain radiotherapy with tilt was not superior in planning target volume doses using the homogeneity index than that without tilt; however, it showed better values, and for D and D, the values were closer to 30 Gy. Regarding the hippocampus, dose reduction with tilt was significantly greater at D, D, and D, whereas regarding the lens, it was significantly greater at D and D. The irradiation time was also predominantly shorter.
CONCLUSION
In our study, a tilted hippocampal-sparing whole-brain radiotherapy reduced the irradiation time by >10%. Therefore, our study indicated that hippocampal-sparing whole-brain radiotherapy with tomotherapy should be performed with a tilt. The head-tilting technique might be useful during hippocampal-sparing whole-brain radiotherapy. This method could decrease the radiation exposure time, while sparing healthy organs, including the hippocampus and lens.
目的
本研究旨在比较分析在使用调强放疗进行海马回避全脑放疗时，使用和不使用头倾斜垫板是否有可能降低危及器官（如海马和晶状体）的照射剂量，并改善计划靶区的剂量分布。
方法
分析了 5 对无倾斜和倾斜的计划头颅 CT 图像。根据 RTOG 0933 勾画图谱协议勾画海马和计划靶区。使用 5mm 的边界勾画需要避免的海马区。规定的放射剂量为 30Gy，分为 10 个分次。评估了计划靶区剂量、危及器官吸收剂量和照射时间。采用配对 t 检验分析了有头倾斜和无头倾斜的海马回避全脑放疗之间的差异。
结果
与无头倾斜相比，有头倾斜的海马回避全脑放疗在使用均匀性指数评估计划靶区剂量方面并不优越；然而，它显示出更好的数值，并且 D 和 D 值更接近 30Gy。关于海马，在 D、D 和 D 处，倾斜的剂量减少更为显著，而对于晶状体，在 D 和 D 处，剂量减少更为显著。照射时间也主要更短。
结论
在我们的研究中，倾斜的海马回避全脑放疗将照射时间缩短了 10%以上。因此，我们的研究表明，调强放疗的海马回避全脑放疗应采用倾斜技术。头倾斜技术在海马回避全脑放疗中可能是有用的。这种方法可以减少辐射暴露时间，同时保护包括海马和晶状体在内的健康器官。
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