Kyei Kofi Adesi, Daniels Joseph, Adom Ameyaw Kwame, Odonkor Philip, Nyantakyi Andrew Yaw, Adjabu Dorothy Ekua
Department of Radiography, University of Ghana, Legon, KB 143, Ghana.
National Centre for Radiotherapy, Oncology and Nuclear Medicine, Korle-Bu Teaching Hospital, Accra, KB 369, Ghana.
Ecancermedicalscience. 2024 May 31;18:1707. doi: 10.3332/ecancer.2024.1707. eCollection 2024.
External beam radiotherapy incorporates treatment techniques such as three-dimensional conformal radiotherapy (3DCRT), intensity-modulated radiotherapy (IMRT), image-guided radiotherapy and volumetric modulated arc therapy to deliver high-energy radiation to cancer. The use of IMRT for cancer treatment is also associated with significant costs for patients in low-middle-income countries. The purpose of this study was to compare the dosimetric properties of 3DCRT and IMRT treatment plans for the external beam irradiation of patients with prostate cancer (Pca) to ascertain the superiority of IMRT in terms of dose homogeneity, conformity and dose limitation to organs at risk (OAR) in a resource-limited setting. One hundred and sixty treatment plans for 80 patients were created using 3DCRT and IMRT on the Eclipse treatment planning system (version 13.6). Data were collected and assessed from the dose-volume histogram of each plan. The conformity and homogeneity index (HI) for each of the plans were calculated. The doses to the OAR were also recorded and evaluated. The mean HIs for the IMRT and 3DCRT treatment techniques were 0.04 ± 0.02 (range: 0.01-0.011) and 0.09 ± 0.02 (range: 0.04-0.016), respectively. The mean conformity index (CI) for IMRT and 3DCRT techniques were 1.257 ± 0.112 (range: 0.99-1.58) and 1.302 ± 0.196 (range: 1.10-2.26). IMRT had a better significant mean HI and CI compared to 3DCRT. Generally, for this study, IMRT had better organ sparing compared to 3DCRT. The mean doses for the OARs ranged from 4.3-74.6 Gy for IMRT and 3.1-75.9 Gy for the 3DCRT technique. Overall, this study demonstrates that IMRT may offer an enhanced therapeutic profile, potentially reducing toxicity to the patient and ensuring more precise dose delivery to the target volume compared to 3DCRT in PCa external beam irradiation.
外照射放疗采用三维适形放疗（3DCRT）、调强放疗（IMRT）、图像引导放疗和容积调强弧形放疗等治疗技术，向癌症患者输送高能辐射。在低收入和中等收入国家，患者使用IMRT进行癌症治疗的费用也很高。本研究的目的是比较3DCRT和IMRT治疗计划对前列腺癌（Pca）患者进行外照射时的剂量学特性，以确定在资源有限的情况下，IMRT在剂量均匀性、适形性和对危及器官（OAR）的剂量限制方面的优越性。使用Eclipse治疗计划系统（版本13.6）上的3DCRT和IMRT为80例患者创建了160个治疗计划。从每个计划的剂量体积直方图中收集和评估数据。计算每个计划的适形性和均匀性指数（HI）。还记录并评估了OAR的剂量。IMRT和3DCRT治疗技术的平均HI分别为0.04±0.02（范围：0.01 - 0.口11）和0.09±0.02（范围：0.04 - 0.016）。IMRT和3DCRT技术的平均适形指数（CI）分别为1.257±0.112（范围：0.99 - 1.58）和1.302±0.196（范围：1.10 - 2.26）。与3DCRT相比，IMRT的平均HI和CI明显更好。总体而言，在本研究中，与3DCRT相比，IMRT对器官的保护更好。IMRT的OAR平均剂量范围为4.3 - 74.6 Gy，3DCRT技术为3.1 - 75.9 Gy。总体而言，本研究表明，在前列腺癌外照射中，与3DCRT相比，IMRT可能具有更好的治疗效果，有可能降低对患者的毒性，并确保向靶体积输送更精确的剂量。
