Dosimetric comparison between volumetric modulated arc therapy planning techniques for prostate cancer in the presence of intrafractional organ deformation.
Dosimetric comparison between volumetric modulated arc therapy planning techniques for prostate cancer in the presence of intrafractional organ deformation.
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DOI：
10.1093/jrr/rraa123
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发表时间：
2021-03-10
影响因子：
2
通讯作者：
Ogawa K
中科院分区：
文献类型：
--
作者：
Varnava M;Sumida I;Oda M;Kurosu K;Isohashi F;Seo Y;Otani K;Ogawa K
本研究的目的是比较单弧（SA）和双弧（DA）治疗计划，这是前列腺癌体积调制式弧治疗（VMAT）中经常使用的计划技术，在存在分次内变形（ID）的情况下，以确定哪种技术在靶剂量覆盖和保留危及器官（OAR）方面上级。为27例局限性前列腺癌患者制定了SA和DA计划。使用内部软件将ID引入临床靶体积（CTV）、直肠和膀胱，以获得模糊的剂量分布。ID基于每个结构体素的运动概率函数和相应器官的分次内运动。从SA和DA计划的模糊剂量分布中，评估了各种参数，包括肿瘤控制概率、正常组织并发症概率、均匀性指数、一致性指数、VMAT调制复杂性评分、剂量体积指数和监测单位（MU），以比较两种技术。统计学分析表明，SA计划的CTV和直肠参数大多数显著大于DA计划（P < 0.05）。此外，SA计划的MU更少，复杂性更低（P < 0.05）。观察到的显著差异无临床意义，表明当考虑ID时，两种计划在靶点和OAR剂量测定方面具有可比性。建议前列腺癌VMAT使用SA计划，因为它们可以在比DA计划更短的治疗时间内提供，因此使患者受益。
The purpose of this study was to compare single-arc (SA) and double-arc (DA) treatment plans, which are planning techniques often used in prostate cancer volumetric modulated arc therapy (VMAT), in the presence of intrafractional deformation (ID) to determine which technique is superior in terms of target dose coverage and sparing of the organs at risk (OARs). SA and DA plans were created for 27 patients with localized prostate cancer. ID was introduced to the clinical target volume (CTV), rectum and bladder to obtain blurred dose distributions using an in-house software. ID was based on the motion probability function of each structure voxel and the intrafractional motion of the respective organs. From the resultant blurred dose distributions of SA and DA plans, various parameters, including the tumor control probability, normal tissue complication probability, homogeneity index, conformity index, modulation complexity score for VMAT, dose–volume indices and monitor units (MUs), were evaluated to compare the two techniques. Statistical analysis showed that most CTV and rectum parameters were significantly larger for SA plans than for DA plans (P < 0.05). Furthermore, SA plans had fewer MUs and were less complex (P < 0.05). The significant differences observed had no clinical significance, indicating that both plans are comparable in terms of target and OAR dosimetry when ID is considered. The use of SA plans is recommended for prostate cancer VMAT because they can be delivered in shorter treatment times than DA plans, and therefore benefit the patients.
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DOI：
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