Inverse planning in three-dimensional conformal and intensity-modulated radiotherapy of mid-thoracic oesophageal cancer.
Inverse planning in three-dimensional conformal and intensity-modulated radiotherapy of mid-thoracic oesophageal cancer.
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中胸食管癌三维适形调强放射治疗的逆向规划。
DOI：
10.5353/th_b3124616
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发表时间：
2004
期刊：
影响因子：
--
通讯作者：
D. Kwong
中科院分区：
文献类型：
--
作者：
V. Wu;J. Sham;D. Kwong
本研究的目的是证明逆计划在食管癌患者三维适形放疗（3DCRT）中的应用，并通过与3DCRT正计划和调强放疗（IMRT）逆计划的比较来评价其剂量学结果。本研究15例食管癌患者均采用FOCUS治疗计划系统制作正向3DCRT、逆3DCRT和逆IMRT计划。记录剂量学结果和计划者与每个治疗方案相关的时间，以便进行比较。逆3DCRT计划在计划靶体积（PTV）和危险器官（OARs）方面显示与正向计划相似的剂量学结果。然而，在肿瘤控制概率和靶剂量符合性方面，它们不如IMRT计划。此外，与IMRT计划相比，逆3DCRT计划在减少剂量低于25 Gy的肺体积百分比方面效果较差。逆3DCRT计划提供的心脏剂量与正向计划相似，但高于IMRT计划。逆向3DCRT方案与正向方案相比，显著减少了操作人员的时间2.5倍。综上所述，对食管癌患者进行3DCRT逆计划治疗可替代正计划治疗，减少手术时间。然而，IMRT具有更好的潜力，可以进一步增加剂量并改善肿瘤控制。
The aim of this study is to demonstrate the use of inverse planning in three-dimensional conformal radiation therapy (3DCRT) of oesophageal cancer patients and to evaluate its dosimetric results by comparing them with forward planning of 3DCRT and inverse planning of intensity-modulated radiotherapy (IMRT). For each of the 15 oesophageal cancer patients in this study, the forward 3DCRT, inverse 3DCRT and inverse IMRT plans were produced using the FOCUS treatment planning system. The dosimetric results and the planner's time associated with each of the treatment plans were recorded for comparison. The inverse 3DCRT plans showed similar dosimetric results to the forward plans in the planning target volume (PTV) and organs at risk (OARs). However, they were inferior to that of the IMRT plans in terms of tumour control probability and target dose conformity. Furthermore, the inverse 3DCRT plans were less effective in reducing the percentage lung volume receiving a dose below 25 Gy when compared with the IMRT plans. The inverse 3DCRT plans delivered a similar heart dose as in the forward plans, but higher dose than the IMRT plans. The inverse 3DCRT plans significantly reduced the operator's time by 2.5 fold relative to the forward plans. In conclusion, inverse planning for 3DCRT is a reasonable alternative to the forward planning for oesophageal cancer patients with reduction of the operator's time. However, IMRT has the better potential to allow further dose escalation and improvement of tumour control.