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前列腺癌放射治疗中三维适形放疗、强度调制放疗分步射野、螺旋断层放疗、容积调强弧形治疗的剂量学分析。

Dosimetric analysis of three-dimensional conformal radiotherapy, intensity-modulated radiotherapy-step and shoot, helical tomotherapy, and volumetric modulated arc therapy in prostate cancer radiotherapy.

机构信息

Radiation Oncology Department, Rumah Sakit Cipto Mangunkusumo, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.

出版信息

J Cancer Res Ther. 2021 Jul-Sep;17(4):893-900. doi: 10.4103/jcrt.JCRT_57_19.

DOI:10.4103/jcrt.JCRT_57_19
PMID:34528538
Abstract

INTRODUCTION

There is limited study comparing dosimetry parameters in detail. In regard to prostate cancer, there are four different techniques, namely three-dimensional conformal radiotherapy (3D-CRT), intensity-modulated radiotherapy-step and shoot (IMRT-SS), IMRT-helical tomotherapy (HT), and volumetric-modulated arc therapy (VMAT).

MATERIALS AND METHODS

Experimental study with intervention on ten prostate cancer patients' computed tomography planning data. 78 Gy dose in 39 fractions was given for planning target volume.Experimental study with intervention on ten prostate cancer patients' computed tomography planning data. 78 Gy dose in 39 fractions was given for planning target volume.

RESULTS

The mean V75 Gy rectum and bladder between 3D-CRT and the other three abovementioned techniques all showed significant results (P < 0.05). V5 Gy remaining volume at risk (RVR) between 3D-CRT versus VMAT and HT, IMRT-SS versus HT, and VMAT versus HT is statistically significant (P < 0.0001). The longest radiation time was done with HT (mean 4.70 ± 0.84 min).

CONCLUSION

V75 Gy rectum bladder between 3D-CRT techniques differ significantly compared to the three other techniques and may not be suitable to the implementation of escalation doses. The HT technique produced the highest V5 Gy RVR and needed the highest monitor unit amount and the longest radiation duration. The VMAT technique was considered capable of realizing dose escalation in prostate cancer radiotherapy by minimizing toxicity in the rectum and bladder with the shortest radiation duration.

摘要

介绍

目前仅有少数研究对剂量学参数进行了详细比较。在前列腺癌方面,有四种不同的技术,即三维适形放疗(3D-CRT)、强度调制放疗-步进和射击(IMRT-SS)、调强螺旋断层放疗(HT)和容积旋转调强放疗(VMAT)。

材料和方法

对十名前列腺癌患者的 CT 计划数据进行干预的实验研究。计划靶区给予 78Gy/39 次剂量。

结果

3D-CRT 与上述三种技术的直肠和膀胱 V75Gy 均值均有显著差异(P<0.05)。3D-CRT 与 VMAT 和 HT 、IMRT-SS 与 HT 、VMAT 与 HT 之间的 V5Gy 危险器官剩余体积(RVR)有统计学意义(P<0.0001)。HT 的最长放射时间(平均 4.70±0.84 分钟)。

结论

与其他三种技术相比,3D-CRT 技术的直肠和膀胱 V75Gy 有显著差异,可能不适合实施升量。HT 技术产生的 V5Gy RVR 最高,需要最高的监测单位数量和最长的放射时间。VMAT 技术通过将直肠和膀胱的毒性降到最低,在最短的放射时间内,被认为能够实现前列腺癌放疗的剂量升级。

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