Chophy Atokali, Gupta Sweety, Joseph Deepa, Verma Swati, Gupta Manoj
Department of Radiation Oncology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND.
Cureus. 2024 Sep 12;16(9):e69251. doi: 10.7759/cureus.69251. eCollection 2024 Sep.
Intensity-modulated radiation therapy (IMRT) has brought about interest in adaptive radiotherapy (ART) due to its benefit of accurately prescribing doses to tumors and sparing normal critical organs. Critical dosimetric errors and geometrical misses can occur due to anatomical changes during radiotherapy. In the present study, five patients with head and neck malignancies undergoing radiation therapy were assessed for changes in primary gross tumor volume (GTVp), nodal gross tumor volume (GTVn), and clinical target volume-high risk (CTV-HR) using weekly megavoltage-cone beam computed tomography (MV-CBCT) scans. All patients had a reduction in GTV and lateral neck diameter (LND). There were reductions in tumor volumes leading to re-planning in the 20th fraction. Daily CBCT can guide the decision on the need for adaptation in patients with tumor volume reduction and with volumes going outside the body.
调强放射治疗（IMRT）因其能够精确地向肿瘤处方剂量并保护正常关键器官，引发了人们对自适应放射治疗（ART）的兴趣。在放射治疗期间，由于解剖结构的变化，可能会出现关键的剂量测定误差和几何误差。在本研究中，对5例接受放射治疗的头颈部恶性肿瘤患者，使用每周一次的兆伏级锥形束计算机断层扫描（MV-CBCT）评估原发大体肿瘤体积（GTVp）、淋巴结大体肿瘤体积（GTVn）和临床靶区高危（CTV-HR）的变化。所有患者的GTV和侧颈直径（LND）均减小。肿瘤体积减小导致在第20次分割时重新规划。每日CBCT可指导对肿瘤体积减小且体积超出体外的患者是否需要进行适应性调整的决策。
