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使用螺旋断层放射治疗实施点阵放射治疗时最佳射野大小和间距的可行性

Feasibility of optimal vertex size and spacing for lattice radiotherapy implementation using helical tomotherapy.

作者信息

Seol Yunji, Lee Young Kyu, Kim Byeong Jin, Choi Kyu Hye, Hong Ji Hyun, Park Chan-Beom, Kim Sun Hwa, Park Hyeong Wook, Kim Jung-Il, Cheon Wonjoong, Kang Young-Nam, Choi Byung Ock

机构信息

Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University, Seoul, Republic of Korea.

Department of Biomedicine & Health Sciences, The Catholic University of Korea, Seoul, Republic of Korea.

出版信息

Front Oncol. 2025 Mar 7;15:1512064. doi: 10.3389/fonc.2025.1512064. eCollection 2025.

DOI:10.3389/fonc.2025.1512064
PMID:40171269
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11959701/
Abstract

PURPOSE

Lattice radiotherapy (LRT), a type of spatially fractionated radiotherapy (SFRT), delivers high dose at specific volumes of lattice structure within the tumor to create a low valley-to-peak dose ratio (VPDR). This study aims to evaluate the feasibility of implementing SFRT using helical tomotherapy and to investigate the effects of vertex size and spacing for attaining the VPDR.

METHODS

A three-dimensional lattice structure with 3×3×3 vertices was designed in a cheese phantom. Vertex sizes of 0.5 cm, 1.0 cm, and 2.0 cm were assessed, with spacing from 1.0 cm to 5.0 cm. The prescribed dose was set to 20 Gy to the vertices in a single fraction. VPDR was calculated from dose profiles along lines connecting three vertices in the anterior-posterior (AP), lateral (LAT), and superior-inferior (SI) directions. The minimum, maximum, and mean dose for each vertex, as well as conformity, homogeneity and monitor unit (MU) analysis were also performed.

RESULTS

VPDR decreased significantly with increasing vertex size and spacing. While the AP and LAT directions showed similar VPDR values, the SI direction consistently exhibited lower VPDR values across all configurations. Vertex sizes of 0.5 cm, 1.0 cm, and 2.0 cm required spacing of at least 3.0 cm, 2.0 cm, and 1.0 cm, respectively, to achieve VPDR values below 0.4. The conformity indices ranged from 1.0 to 4.02, and the homogeneity indices ranged from 1.20 to 1.57 across all configurations. Additionally, the MUs increased with both vertex size and spacing.

CONCLUSIONS

This study quantitatively analyzed the impact of various vertex sizes and spacings on VPDR in lattice radiotherapy using helical tomotherapy. VPDR decreased with increasing vertex size and spacing, with consistently lower values in the SI direction. These findings provide crucial insights for optimizing LRT plans. The identified relationships between the parameters and VPDR offer a foundation for developing more effective LRT protocols in helical tomotherapy, potentially improving therapeutic outcomes.

摘要

目的

点阵放射治疗（LRT）是一种空间分割放射治疗（SFRT），它在肿瘤内特定的点阵结构体积处给予高剂量照射，以产生低的谷峰剂量比（VPDR）。本研究旨在评估使用螺旋断层放疗实施SFRT的可行性，并研究顶点大小和间距对实现VPDR的影响。

方法

在奶酪模型中设计了一个具有3×3×3个顶点的三维点阵结构。评估了顶点大小为0.5 cm、1.0 cm和2.0 cm，间距为1.0 cm至5.0 cm的情况。单次分割时对顶点的处方剂量设定为20 Gy。VPDR是根据沿前后（AP）、侧位（LAT）和上下（SI）方向连接三个顶点的直线上的剂量分布计算得出的。还对每个顶点的最小、最大和平均剂量以及适形度、均匀性和监测单位（MU）进行了分析。

结果

VPDR随着顶点大小和间距的增加而显著降低。虽然AP和LAT方向显示出相似的VPDR值，但在所有配置中，SI方向的VPDR值始终较低。顶点大小为0.5 cm、1.0 cm和2.0 cm时，分别需要至少3.0 cm、2.0 cm和1.0 cm的间距才能使VPDR值低于0.4。在所有配置中，适形指数范围为1.0至4.02，均匀性指数范围为1.20至1.57。此外，MU随着顶点大小和间距的增加而增加。

结论

本研究定量分析了在使用螺旋断层放疗的点阵放射治疗中，各种顶点大小和间距对VPDR的影响。VPDR随着顶点大小和间距的增加而降低，在SI方向的值始终较低。这些发现为优化LRT计划提供了关键见解。所确定的参数与VPDR之间的关系为在螺旋断层放疗中制定更有效的LRT方案奠定了基础，有可能改善治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d37/11959701/0c36f0530a27/fonc-15-1512064-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d37/11959701/8bedb8a7fa61/fonc-15-1512064-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d37/11959701/db5caac9b451/fonc-15-1512064-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d37/11959701/a8b6a7e3fff8/fonc-15-1512064-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d37/11959701/c2ccaa5a99a5/fonc-15-1512064-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d37/11959701/9496063e5883/fonc-15-1512064-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d37/11959701/0c36f0530a27/fonc-15-1512064-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d37/11959701/8bedb8a7fa61/fonc-15-1512064-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d37/11959701/db5caac9b451/fonc-15-1512064-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d37/11959701/a8b6a7e3fff8/fonc-15-1512064-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d37/11959701/c2ccaa5a99a5/fonc-15-1512064-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d37/11959701/9496063e5883/fonc-15-1512064-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d37/11959701/0c36f0530a27/fonc-15-1512064-g006.jpg

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Dosimetric Performance Evaluation of MLC-based and Cone-based 3D Spatially Fractionated LATTICE Radiotherapy.基于多叶准直器和基于锥形束的三维空间分割点阵放射治疗的剂量学性能评估
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