Department of Radiation Oncology, Patel Hospital, Civil Lines, Jalandhar, Punjab, India.
Department of Radiation Oncology, SGRD Institute of Medical Sciences and Research, Amritsar, Punjab, India.
J Cancer Res Ther. 2024 Jan 1;20(1):327-332. doi: 10.4103/jcrt.jcrt_1912_22. Epub 2023 Apr 6.
The purpose of this study was to evaluate the dosimetric benefits of carotid-sparing IMRT (intensity-modulated radiation therapy) over 3DCRT (three-dimensional conformal radiation therapy) in early glottic cancer patients.
Ten patients with histologically proven early-stage squamous cell cancer of glottis (T1N0), treated with definitive radiotherapy, were selected retrospectively for the dosimetric analysis. Patients were originally treated with 3DCRT technique. For comparison purpose, IMRT plans were generated for each patient. Dosimetric comparison was done between two techniques (IMRT and 3DCRT) in terms of PTV (planning target volume) coverage, HI (homogeneity index), CI (conformity index), and doses to right carotid artery, left carotid artery, and spinal cord.
V95% for the PTV was higher in IMRT plans (98.26%) as compared to 3DCRT plans (95.12%) (P-value <0.001), whereas V105% for PTV was significantly higher in 3DCRT plans (16.77%) as compared to IMRT plans (0.32%) (P-value 0.11). In terms of both HI and CI, IMRT plans showed better conformity as compared to 3DCRT plans, with statistically significant difference. Both right and left carotid arteries' average mean and maximum doses were significantly lower in IMRT plans as compared to 3DCRT plans (P-value <0.001). IMRT plans resulted in significant carotid-sparing as compared to 3DCRT plans in terms of V35 and V50 (P-value <0.001).
Carotid-sparing IMRT resulted in better PTV coverage and lower carotid artery dose as compared to 3DCRT in early glottic cancer patients.
本研究旨在评估早期声门癌患者颈动脉保护调强放疗（intensity-modulated radiation therapy，IMRT）与三维适形放疗（three-dimensional conformal radiation therapy，3DCRT）相比的剂量学优势。
回顾性选择 10 例经组织学证实的早期声门鳞状细胞癌（T1N0）患者，行根治性放疗。患者最初接受 3DCRT 技术治疗。为了进行比较，为每位患者生成了 IMRT 计划。从 PTV（计划靶区）覆盖、HI（均匀性指数）、CI（适形指数）以及右颈动脉、左颈动脉和脊髓的剂量等方面，对两种技术（IMRT 和 3DCRT）进行了剂量学比较。
IMRT 计划的 PTV 体积 95%（V95%）（98.26%）高于 3DCRT 计划（95.12%）（P 值＜0.001），而 PTV 体积 105%（V105%）3DCRT 计划（16.77%）显著高于 IMRT 计划（0.32%）（P 值=0.11）。在 HI 和 CI 方面，IMRT 计划均表现出比 3DCRT 计划更好的一致性，差异有统计学意义。与 3DCRT 计划相比，IMRT 计划右侧和左侧颈动脉的平均和最大剂量均显著降低（P 值＜0.001）。与 3DCRT 计划相比，IMRT 计划在 V35 和 V50 方面具有明显的颈动脉保护作用（P 值＜0.001）。
与 3DCRT 相比，早期声门癌患者的颈动脉保护调强放疗在 PTV 覆盖和降低颈动脉剂量方面具有优势。
