Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.
Department of Radiation Oncology, Fudan University Shanghai Cancer Center Xiamen Hospital, Xiamen, China.
Technol Cancer Res Treat. 2024 Jan-Dec;23:15330338241293321. doi: 10.1177/15330338241293321.
This study primarily aims to investigate the suitability of Halcyon in the context of cervical-thoracic esophageal cancer by exploring the dosimetric quality and delivery efficiency of Halcyon plans with different arc configurations. Additionally, it compares these findings with the dosimetric indices and delivery efficiency of TrueBeam and TomoTherapy accelerators, focusing on their capability to optimize protection for organs at risk (OARs) while maintaining efficient treatment delivery strategies.
This retrospective study involved 26 patients diagnosed with cervical-thoracic esophageal cancer, and new radiotherapy plans were created using Halcyon, TrueBeam, and TomoTherapy. Dose volume histogram (DVH) metrics and delivery efficiency for plans involving different arc numbers on Halcyon (2, 3, and 4 arcs) were compared with those from TrueBeam and TomoTherapy. T-tests were employed to evaluate differences in organ protection among the accelerators.
The Halcyon plans, especially those with 4 arcs, provided superior protection for organs at risk, including the heart, lungs, and spinal cord, while maintaining excellent delivery efficiency. Compared to TrueBeam 2arc plans and TomoTherapy helical plans, Halcyon plans with 3 arcs also showed slight advantages. Although TomoTherapy offered better uniformity in dose distribution, it did not demonstrate a clear advantage over the other accelerators in terms of OAR protection or treatment efficiency. Furthermore, despite the lack of clear advantages in TrueBeam 2arc plans with flattening filter (FF), TrueBeam with flattening filter free (FFF) plans may hold potential in the treatment.
Halcyon, particularly with 4 arcs, offers an optimal balance between reducing toxicity to organs at risk and maintaining treatment efficiency, making it a preferred choice in cervical thoracic esophageal cancer radiotherapy. The findings highlight the need for careful selection of radiotherapy accelerators based on specific clinical goals, with Halcyon showing potential advantages in scenarios where both treatment efficiency and OAR protection are paramount.
本研究主要旨在探讨 Halcyon 在颈胸段食管癌中的适用性，通过探索不同弧形配置下 Halcyon 计划的剂量学质量和治疗效率，来研究 Halcyon 计划。此外，还将这些发现与 TrueBeam 和 TomoTherapy 加速器的剂量学指标和治疗效率进行比较，重点关注它们在保护危及器官（OARs）的同时保持高效治疗策略的能力。
本回顾性研究纳入了 26 例颈胸段食管癌患者，使用 Halcyon、TrueBeam 和 TomoTherapy 为每位患者创建新的放疗计划。比较了 Halcyon 不同弧形数（2、3 和 4 个弧形）的计划的剂量体积直方图（DVH）指标和治疗效率，并与 TrueBeam 和 TomoTherapy 的结果进行比较。采用 t 检验评估了不同加速器之间的器官保护差异。
Halcyon 计划，特别是 4 个弧形的计划，为心脏、肺和脊髓等危及器官提供了更好的保护，同时保持了卓越的治疗效率。与 TrueBeam 2 个弧形计划和 TomoTherapy 螺旋计划相比，Halcyon 3 个弧形计划也具有轻微优势。尽管 TomoTherapy 在剂量分布均匀性方面表现更好，但在 OAR 保护或治疗效率方面，它并没有明显优于其他加速器。此外，尽管没有明显优势，TrueBeam 2 个弧形计划的无均整器（FF），但 TrueBeam 无均整器（FFF）计划可能在治疗中具有潜力。
Halcyon 特别是 4 个弧形的计划，在降低危及器官毒性和保持治疗效率之间提供了最佳平衡，是颈胸段食管癌放疗的首选方案。这些发现强调了根据特定临床目标仔细选择放疗加速器的必要性，在治疗效率和 OAR 保护都至关重要的情况下，Halcyon 显示出潜在的优势。
