Buciuman Nikolett, Marcu Loredana G
Faculty of Physics, West University of Timisoara, 300223 Timisoara, Romania.
OncoHelp Foundation, 300239 Timisoara, Romania.
J Pers Med. 2022 Apr 21;12(5):668. doi: 10.3390/jpm12050668.
A dosimetric study was performed to show the importance of adaptive radiotherapy (ART) for head and neck cancer (HNC) patients using volumetric modulated arc therapy (VMAT). A total of 13 patients with HNC who required replanning during radiotherapy were included in this study. All plans succeeded to achieve the set objectives regarding target volume coverage and organ sparing. All target volumes presented a significant decrease with an average of 76.44 cm ( = 0.007) for PTV, 102.81 cm ( = 0.021) for PTV, and 47.10 cm ( = 0.003) for PTV. Additionally, a positive correlation was found between PTV shrinkage and the number of fractions completed before replanning. Significant volume decrease was also observed for the parotid glands. The ipsilateral parotid decreased in volume by a mean of 3.75 cm (14.43%) ( = 0.067), while the contralateral decreased by 4.23 cm (13.23%) ( = 0.033). For all analyzed organs, a reduction in the final dose received after replanning was found. Our study showed that ART via rescanning, recontouring, and replanning using VMAT is essential whenever anatomical and positional variations occur. Furthermore, comparison with the literature has confirmed that ART using VMAT offers similar results to ART with intensity modulated radiotherapy.
进行了一项剂量学研究，以显示使用容积调强弧形放疗（VMAT）对头颈部癌（HNC）患者进行自适应放疗（ART）的重要性。本研究共纳入13例在放疗期间需要重新计划的HNC患者。所有计划均成功实现了关于靶区覆盖和器官保护的既定目标。所有靶区体积均显著减小，计划靶体积（PTV）平均减小76.44 cm³（P = 0.007），PTV平均减小102.81 cm³（P = 0.021），PTV平均减小47.10 cm³（P = 0.003）。此外，发现PTV缩小与重新计划前完成的分次次数之间存在正相关。腮腺体积也有显著减小。同侧腮腺体积平均减小3.75 cm³（14.43%）（P = 0.067），对侧腮腺体积减小4.23 cm³（13.23%）（P = 0.033）。对于所有分析的器官，重新计划后接受的最终剂量均有所降低。我们的研究表明，每当出现解剖和位置变化时，通过重新扫描、重新勾画轮廓和使用VMAT重新计划进行ART是必不可少的。此外，与文献的比较证实，使用VMAT的ART与调强放疗的ART效果相似。
