RapidArc® vs intensity-modulated radiation therapy for hepatocellular carcinoma: a comparative planning study
RapidArc® vs intensity-modulated radiation therapy for hepatocellular carcinoma: a comparative planning study
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DOI：
10.1259/bjr/19088580
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发表时间：
2012-07-01
影响因子：
2.6
通讯作者：
Ha, S. W.
中科院分区：
文献类型：
--
作者：
Park, J. M.;Kim, K.;Ha, S. W.
目的：本研究的目的是比较RapidArc（R）（RA Varian Medical Systems，Palo Alto，CA）与调强放射治疗（IMRT）治疗肝细胞癌的剂量-体积结果。方法：20例既往接受过肝细胞癌治疗的患者是本计划研究的受试者。10例患者接受门静脉肿瘤血栓形成治疗（A组），10例患者接受原发性肝脏肿瘤治疗（B组）。处方剂量的计划靶体积为54戈伊，在30个部分，和计划的目标是提供超过95%的处方剂量至少95%的计划靶volume.Results：在A组，平均剂量增加肝脏与RA与IMRT（22.9戈伊与22.2戈伊，p=0.0275）。然而，RA的肝脏V-30（戈伊）低于IMRT（31.1% vs 32.1%，p=0.0283）。相反，在B组中，两个计划之间的平均剂量和肝脏的V-30（戈伊）均无显著差异。在A组和B组中，RA分别降低了十二指肠的V-35（戈伊）和肾脏的V-20（戈伊）（分别为p=0.0058和0.0124）。两个最大剂量的脊髓和监测单位显着降低RA计划，无论group.Conclusion：RA与调强放疗的剂量体积的结果是不同的，根据不同的目标位置在肝脏内。一般而言，RA倾向于更有效地保留非肝脏器官的风险，如十二指肠，肾脏和/或脊髓。此外，RA是更有效的治疗交付比调强放射治疗的总监测单位使用。
Objective: The purpose of this study is to compare the dose-volumetric results of RapidArc (R) (RA Varian Medical Systems, Palo Alto, CA) with those of intensity-modulated radiation therapy (IMRT) for hepatocellular carcinoma.Methods: 20 patients previously treated for hepatocellular carcinoma were the subjects of this planning study. 10 patients were treated for portal vein tumour thrombosis (Group A), and 10 patients for primary liver tumour (Group B). Prescription dose to the planning target volume was 54 Gy in 30 fractions, and the planning goal was to deliver more than 95% of prescribed dose to at least 95% of planning target volume.Results: In Group A, mean doses to liver were increased with RA vs IMRT (22.9 Gy vs 22.2 Gy, p=0.0275). However, V-30 (Gy) of liver was lower in RA vs IMRT (31.1% vs 32.1%, p=0.0283). In Group B, in contrast, neither mean doses nor V-30 (Gy) of liver significantly differed between the two plans. V-35 (Gy) of duodenum and V-20 (Gy) of kidney were decreased with RA in Groups A and B, respectively (p=0.0058 and 0.0124, respectively). Both maximal doses to spinal cord and monitor unit were significantly lower in the RA plan, regardless of the group.Conclusion: The dose-volumetric results of RA vs IMRT were different according to the different target location within the liver. In general, RA tended to be more effective in the sparing of non-liver organs at risk such as duodenum, kidney, and/or spinal cord. Moreover, RA was more efficient in the treatment delivery than IMRT in terms of total monitor unit used.