Pourparvar Zahra, Shahbazi-Gahrouei Daryoush, Najafizade Nadia, Saeb Mohsen, Khaniabadi Bita Moradi, Khaniabadi Pegah Moradi
Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Radiation Oncology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
J Med Signals Sens. 2024 Sep 2;14:26. doi: 10.4103/jmss.jmss_42_23. eCollection 2024.
Using three-dimensional conformal radiation treatment (3D-CRT) and helical tomotherapy (HT), this study examines and contrasts the dosage received by the mandible, maxilla, and teeth.
Sixteen patients with head-and-neck cancer (H and NC) were the subject of treatment planning at the Seyyed Al-Shohada Hospital in Isfahan, Iran. This study examined target coverage quality, exposure of healthy tissue, and radiation delivery effectiveness.
In terms of a number of measures, including D, D, D, V, conformity index (CI), and homogeneity index (HI) for the planning target volume (PTV) and D, D, D, V, CI, and HI for the nodal PTV, HT showed considerable gains over 3D-CRT. The brainstem, D, and D received considerably lower maximum dosages in HT. Measurements of the right and left cochleas (D, V55, and D) revealed decreases in HT, with D revealing the most significant variations. The D and D values for HT significantly decreased in constrictors as well. In terms of several HT-related indicators, the larynx, optic chiasm, optic nerves, oral cavity, mandible, thyroid, and parotid glands all showed considerable decreases.
The findings of the comparison of the two treatment approaches revealed that the HT method was more than 50% more effective than the 3D-CRT method in sustaining organs at risk (OARs) and the target volume dose. In general, dosimetric coverage, homogeneity, conformity indices, and the absence of cold and hot patches showed that HT produced targets with greater accuracy than 3D-CRT. In addition, HT outperformed 3D-CRT in protecting important structures (OARs). HT as a result has the potential to be a more effective method of treatment for those with H and NC and involvement of regional lymph nodes.
本研究采用三维适形放射治疗（3D-CRT）和螺旋断层放射治疗（HT），对下颌骨、上颌骨和牙齿所接受的剂量进行检测和对比。
伊朗伊斯法罕的赛义德·阿尔-肖哈达医院对16例头颈癌（H和NC）患者进行了治疗计划。本研究检测了靶区覆盖质量、健康组织暴露情况和放射治疗的有效性。
在多项指标方面，包括计划靶区（PTV）的D、D、D、V、适形指数（CI）和均匀性指数（HI）以及淋巴结PTV的D、D、D、V、CI和HI，HT相较于3D-CRT有显著优势。脑干、D和D在HT中接受的最大剂量显著更低。左右耳蜗（D、V55和D）的测量结果显示HT中有所降低，其中D的变化最为显著。HT的D和D值在咽缩肌中也显著降低。在一些与HT相关的指标方面，喉、视交叉、视神经、口腔、下颌骨、甲状腺和腮腺均有显著降低。
两种治疗方法的比较结果显示，在保护危及器官（OARs）和靶区剂量方面，HT方法比3D-CRT方法有效率高出50%以上。总体而言，剂量学覆盖、均匀性、适形指数以及无冷热点显示HT生成的靶区比3D-CRT更精确。此外，在保护重要结构（OARs）方面HT优于3D-CRT。因此，HT有可能成为治疗H和NC且累及区域淋巴结患者的更有效方法。
