Suzuki Toshihiro, Saito Masahide, Nomura Ryutaro, Nemoto Hikaru, Yanagisawa Naoto, Sawada Ryuma, Mochizuki Zennosuke, Sano Naoki, Onishi Hiroshi, Takahashi Hiroshi
CyberKnife Center, Kasugai General Rehabilitation Hospital, Yamanashi, Japan.
Department of Radiology, University of Yamanashi, Yamanashi, Japan.
J Appl Clin Med Phys. 2025 Jun;26(6):e70046. doi: 10.1002/acm2.70046. Epub 2025 Mar 5.
This study evaluates various radiotherapy techniques for treating metastatic brain tumor (BT), focusing on non-coplanar volumetric modulated arc radiotherapy (NC-VMAT), coplanar VMAT (C-VMAT), Helical TomoTherapy (HT), CyberKnife (CK), Gamma Knife (GK), and ZAP-X. CT images and structures of 12 patients who underwent CK for a single BT were utilized. Twelve treatment plans were created for each planning device. All plans adopted the approach of prescription doses to planning target volume D99.5%. They were divided into stereotactic radiosurgery (SRS) (prescription dose; 21-23 Gy) and stereotactic radiotherapy (SRT) (prescription dose; 30-36.5 Gy) groups and the same parameters evaluated included Gradient Index (GI), Paddick Conformity Index (CI), and treatment time (t-time). In the SRS group, mean values of GI and CI values were: NC-VMAT (4.28, 0.60), C-VMAT (5.61, 0.44), HT (4.68, 0.42), CK (4.31, 0.61), GK (2.81, 0.82), and ZAP-X (2.99, 0.80). In the SRT group: NC-VMAT (3.27, 0.84), C-VMAT (3.81, 0.82), HT (3.76, 0.65), CK (2.98, 0.77), GK (2.61, 0.90), and ZAP-X (2.80, 0.84). There were no significant differences in the mean values of CI and GI between ZAP-X and GK in both groups (p > 0.05). NC-VMAT and C-VMAT had shorter t-time than other techniques in both groups. ZAP-X is relatively superior in CI and GI for small tumors, similar to GK, while differences with NC-VMAT and CK diminish as tumor volume increases. ZAP-X, CK, and GK have longer t-time than other treatment techniques, regardless of volume.
本研究评估了用于治疗转移性脑肿瘤（BT）的各种放射治疗技术，重点关注非共面容积调强弧形放疗（NC-VMAT）、共面VMAT（C-VMAT）、螺旋断层放疗（HT）、射波刀（CK）、伽玛刀（GK）和ZAP-X。利用了12例因单一BT接受CK治疗的患者的CT图像和结构。为每个计划设备创建了12个治疗计划。所有计划均采用向计划靶体积D99.5%给予处方剂量的方法。它们被分为立体定向放射外科（SRS）（处方剂量；21-23 Gy）和立体定向放射治疗（SRT）（处方剂量；30-36.5 Gy）组，评估的相同参数包括梯度指数（GI）、帕迪克适形指数（CI）和治疗时间（t-time）。在SRS组中，GI和CI值的平均值分别为：NC-VMAT（4.28，0.60）、C-VMAT（5.61，0.44）、HT（4.68，0.42）、CK（4.31，0.61）、GK（2.81，0.82）和ZAP-X（2.99，0.80）。在SRT组中：NC-VMAT（3.27，0.84）、C-VMAT（3.81，0.82）、HT（3.76，0.65）、CK（2.98，0.77）、GK（2.61，0.90）和ZAP-X（2.80，0.84）。两组中ZAP-X和GK的CI和GI平均值均无显著差异（p>0.05）。在两组中，NC-VMAT和C-VMAT的t-time均比其他技术短。对于小肿瘤，ZAP-X在CI和GI方面相对优于GK，与GK相似，而随着肿瘤体积增加，其与NC-VMAT和CK的差异减小。无论肿瘤体积如何，ZAP-X、CK和GK的t-time均比其他治疗技术长。
