Shao Wencheng, Chen Ziyin, Bai Yanchun, Xu Bingchen, Xu Lili, Zhao Qiushuang, Wang Yang, Tang Xiaobin
Department of Nuclear Science and Technology, Nanjing University of Aeronautics and Astronautics, Nanjing, P. R. China.
Department of Radiation Physics, Harbin Medical University Cancer Hospital, Harbin, P. R. China.
J Xray Sci Technol. 2021;29(4):635-643. doi: 10.3233/XST-210867.
This study aims to evaluate the planned dose of stereotactic body radiation therapy (SBRT) for treating early peripheral non-small cell lung cancer (NSCLC) using the non-coplanar radiation from Cyberknife and Varian linac. Moreover, this study investigates whether Cyberknife and Varian linac are qualified for non-coplanar radiation SBRT for treating early peripheral NSCLC, and which one is better for protecting organs at risk (OARs).
Retrospective analysis was performed based on the Cyberknife radiation treatment plans (RTPs) and Varian Eclipse RTPs of 10 patients diagnosed with early peripheral NSCLC. The dose distributions in the target and OARs were compared between the RTPs of Cyberknife and Varian Eclipse using Mim medical imaging software.
For PTV, no significant difference in D98 and D95 between the Cyberknife and Eclipse was observed (t = -0.35, -1.67, P > 0.05). The homogeneity indexes (HIs) of Cyberknife plans are higher (t = 71.86, P < 0.05) than those of Eclipse plans. The V10, V15, V20, V25, V30 and Dmean of the lung with NSCLC and the V20 of the whole lung for Cyberknife were less than those for Eclipse (t = -4.73, -5.62, -7.75, -6.38, -6.89, -3.14, -7.09, respectively, P < 0.05). Cyberknife plans have smaller spinal cord Dmax, trachea Dmax, heart Dmax, chest wall Dmax (t = -2.49, -2.57, -3.71, -3.56, respectively, P < 0.05) and esophagus Dmax (t = -1.95, P > 0.05) than Varian Eclipse plans.
To fulfill SBRT by non-coplanar radiation, Cyberknife is recommended for the institutions equipped with Cyberknife, while Varian linac can be applied for the institutions that have not adopted Cyberknife in clinical radiotherapy yet.
本研究旨在评估使用射波刀（Cyberknife）和瓦里安直线加速器（Varian linac）的非共面放射治疗早期外周型非小细胞肺癌（NSCLC）的立体定向体部放射治疗（SBRT）计划剂量。此外，本研究还调查射波刀和瓦里安直线加速器是否适用于非共面放射SBRT治疗早期外周型NSCLC，以及哪一种在保护危及器官（OARs）方面更好。
基于10例诊断为早期外周型NSCLC患者的射波刀放射治疗计划（RTPs）和瓦里安Eclipse RTPs进行回顾性分析。使用Mim医学成像软件比较射波刀和瓦里安Eclipse的RTPs中靶区和OARs的剂量分布。
对于计划靶体积（PTV），射波刀和Eclipse之间的D98和D95无显著差异（t = -0.35，-1.67，P > 0.05）。射波刀计划的均匀性指数（HIs）高于Eclipse计划（t = 71.86，P < 0.05）。射波刀治疗的NSCLC肺的V10、V15、V20、V25、V30和平均剂量（Dmean）以及全肺的V20均低于Eclipse（t分别为-4.73、-5.62、-7.75、-6.38、-6.89、-3.14、-7.09，P < 0.05）。射波刀计划的脊髓最大剂量（Dmax）、气管Dmax、心脏Dmax、胸壁Dmax（t分别为-2.49、-2.57、-3.71、-3.56，P < 0.05）和食管Dmax（t = -1.95，P > 0.05）均小于瓦里安Eclipse计划。
为通过非共面放射实现SBRT，对于配备射波刀的机构推荐使用射波刀，而瓦里安直线加速器可应用于临床放疗中尚未采用射波刀的机构。
