使用 6 或 10MV 光子能量的立体定向体部放射治疗中，容积调强弧形治疗与强度调强放射治疗的治疗计划比较。
Treatment plan comparison of volumetric-modulated arc therapy to intensity-modulated radiotherapy in lung stereotactic body radiotherapy using either 6- or 10-MV photon energies.
机构信息
Department of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Department of Radiation Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
出版信息
J Appl Clin Med Phys. 2022 Aug;23(8):e13714. doi: 10.1002/acm2.13714. Epub 2022 Jul 9.
PURPOSE
The aim of this study was to dosimetrically compare volumetric-modulated arc therapy (VMAT) with intensity-modulated radiotherapy (IMRT) techniques using either 6- or 10-MV photon beam energies in lung stereotactic body radiation therapy (SBRT) plans.
METHODS
Thirty patients with primary or metastatic lung tumors eligible for SBRT were randomly selected. VMAT and IMRT treatment plans using either 6- or 10-MV photon energies were generated through automatic SBRT planning software in the RayStation treatment planning system.
RESULTS
For planning target volume, there was no difference in D for all plans, whereas D and D were significantly increased by 5.22%-5.98% and 2.47%-2.59%, respectively, using VMAT plans compared to IMRT plans. When comparing the D of organs at risk (OARs), VMAT was 18.32%-47.95% lower than IMRT for almost all OARs. VMAT obviously decreased D , V , V , and V of whole lung by 9.68%-20.92% than IMRT . Similar results were found when comparing VMAT with IMRT or VMAT with IMRT . The differences in the D , heterogeneity index, and conformity index between 6- and 10-MV plans are not statistically significant. Plans using 6-MV performed 4.68%-8.91% lower levels of D of spinal cord, esophagus, great vessels, and trachea and proximal bronchial tree than those using 10-MV plans. Similarly, D , V , V , and V of whole lung were also reduced by 2.79%-5.25% using 6-MV. For dose fall-off analysis, the D and R of VMAT were lower than those of IMRT . Dose fall-off curve based on 10 rings was steeper for VMAT plans than IMRT plans regardless of the energy used.
CONCLUSIONS
For lung SBRT plans, VMAT-based plans significantly reduced OARs dose and steepened dose fall-off curves compared to IMRT-based plans. A 6-MV energy level was a better choice than 10-MV for lung SBRT. In addition, the dose differences between different techniques were more obvious than those between different energy levels.
目的
本研究旨在比较使用 6 或 10MV 光子束能量的容积调强弧形治疗（VMAT）与强度调制放射治疗（IMRT）技术在肺部立体定向体部放射治疗（SBRT）计划中的剂量学差异。
方法
随机选择 30 名适合 SBRT 的原发性或转移性肺部肿瘤患者。通过 RayStation 治疗计划系统中的自动 SBRT 计划软件生成使用 6 或 10MV 光子能量的 VMAT 和 IMRT 治疗计划。
结果
对于计划靶区，所有计划的 D 值均无差异，而与 IMRT 计划相比，VMAT 计划的 D 和 D 值分别显著增加 5.22%-5.98%和 2.47%-2.59%。在比较危及器官（OARs）的 D 值时，VMAT 对于几乎所有 OARs 的 D 值均比 IMRT 低 18.32%-47.95%。VMAT 明显降低了全肺的 D 、 V 、 V 、 V ，比 IMRT 分别降低了 9.68%-20.92%。比较 VMAT 与 IMRT 或 VMAT 与 IMRT 时，也发现了类似的结果。6-和 10-MV 计划之间的 D 、不均匀性指数和适形性指数的差异无统计学意义。脊髓、食管、大血管和气管及近端支气管树的 D 值，使用 6-MV 计划比使用 10-MV 计划分别低 4.68%-8.91%。同样，使用 6-MV 计划时，全肺的 D 、 V 、 V 、 V 也分别降低了 2.79%-5.25%。对于剂量衰减分析，VMAT 的 D 和 R 低于 IMRT。使用 RayStation 治疗计划系统，无论使用何种能量，VMAT 计划的剂量衰减曲线都比 IMRT 计划陡峭。对于肺部 SBRT，6-MV 能量水平优于 10-MV。此外，不同技术之间的剂量差异比不同能量水平之间的剂量差异更明显。
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