研究动态
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通过基于四维计算机断层扫描的体积调制弧形疗法治疗肺癌的自由呼吸与呼吸运动管理放疗的剂量学比较。

Dosimetric comparison of free-breathing versus respiratory motion-managed radiotherapy via four-dimensional computed tomography-based volumetric-modulated arctherapy for lung cancer.

发表日期:2023 Nov 02
作者: S Sarihan, S G Tunc, A Kahraman, Z K Irem
来源: HEART & LUNG

摘要:

本研究的目的是使用呼吸运动管理放射治疗 (RT) 来减少肺癌患者的副作用,并将剂量学因素与自由呼吸计划进行比较。使用四项技术在自由呼吸的 10 个呼吸阶段获得模拟图像。三维计算机断层扫描 (4D-CT) 扫描仪。创建规划目标体积 (PTV),在使用最大强度投影描绘的内部目标体积的每个方向上具有 5 毫米的边距。创建了体积弧治疗 (VMAT) 计划,以便规定剂量覆盖 98% 的 PTV。自由呼吸 VMAT 计划的目标体积是根据 ICRU 报告 62 创建的,并使用相同的处方剂量。患者于 2020 年 1 月接受评估。中位放疗剂量为 63Gy (59.4-64)。基于 4D-CT 和自由呼吸 VMAT 计划的中位 PTV 体积为 173.53 和 494.50cm3 (P=0.008),覆盖 95% PTV 体积的剂量分别为 62.97 和 60.51Gy (P=0.13)。平均心脏剂量和 V50 剂量分别为 6.03Gy(对比 10.36Gy,P=0.043)和 8.2%(对比 33.9%,P=0.007),并且在基于 4D-CT 的 VMAT 计划中明显较低,并且还发现了非-显着减少其他危险器官的剂量。10 名患者接受基于 4D-CT 的 VMAT 技术的呼吸运动管理 RT 治疗。据观察,PTV 没有增加,目标覆盖率达到 95%,心脏剂量具有统计显着性,所有危险器官剂量均较低。版权所有 © 2023 Société française de radiothérapie oncologique (SFRO)。由 Elsevier Masson SAS 出版。版权所有。
The aim of this study is to use respiratory motion-managed radiotherapy (RT) to reduce side effects and to compare dosimetric factors with free-breathing planning in patients with lung cancer.Simulation images were obtained in 10 respiratory phases with free breathing using four-dimensional computed tomography (4D-CT) scanner. Planning target volume (PTV) was created with 5mm margins in each direction of the internal target volume delineated using the maximum intensity projection. A volumetric arc treatment (VMAT) plan was created so that the prescribed dose would cover 98% of the PTV. Target volumes for the free-breathing VMAT plan were created according to ICRU Reports 62 and the same prescribed dose was used.Patients were evaluated during January 2020. Median 63Gy (59.4-64) RT was administered. Median PTV volumes were 173.53 and 494.50cm3 (P=0.008) and dose covering 95% of PTV volume was 62.97 and 60.51Gy (P=0.13) in 4D-CT based and free-breathing VMAT plans, respectively. The mean and V50 heart dose was 6.03Gy (vs. 10.36Gy, P=0.043) and 8.2% (vs. 33.9%, P=0.007), and significantly lower in 4D-CT based VMAT plans and there was also found a non-significant reduction for other risky organ doses.Ten patients treated with respiratory motion-managed RT with 4D-CT based VMAT technique. It was observed that PTV did not increase, the target was covered with 95% accuracy, and with statistical significance in heart doses, all risky organ doses were found to be less.Copyright © 2023 Société française de radiothérapie oncologique (SFRO). Published by Elsevier Masson SAS. All rights reserved.