Intensity modulation with photons for benign intracranial tumours: A planning comparison of volumetric single arc, helical arc and fixed gantry techniques
Intensity modulation with photons for benign intracranial tumours: A planning comparison of volumetric single arc, helical arc and fixed gantry techniques
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DOI：
10.1016/j.radonc.2008.07.021
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发表时间：
2008-12-01
影响因子：
5.7
通讯作者：
Cozzi, Luca
中科院分区：
文献类型：
--
作者：
Fogliata, Antonella;Clivio, Alessandro;Cozzi, Luca
背景和目的：与螺旋断层放射治疗和固定机架强度调制技术相比，新的 RapidArc 治疗概念的潜在益处和局限性已在 12 名患有“良性”脑肿瘤的患者的治疗计划水平上进行了评估。材料和方法：针对螺旋断层放射治疗 (HT) 装置计算了 5 个听神经瘤、5 个脑膜瘤和 2 个垂体腺瘤的计划，用于在直线加速器上进行 RapidArc 传输 (RA)配备两种类型的 MLC（RA_HD120 配备等中心叶宽为 2.5 mm 的新型高清 MLC，RA_M120 配备分辨率为 5 mm 的标准 Millennium）以及配备高清 MLC 的固定光束 IMRT。分析主要针对源自剂量体积直方图 (DVH) 的物理量进行。结果：目标覆盖结果在技术之间基本相当。所有技术的 V-95%（以 % 为单位）均高于 99%，IMRT 的最小显着剂量 (D-99%) 为 95.5 +/- 1.4，RA_HD120 和 RA_M120 方法为 96.2 +/- 1.4 和 97.0 +/- 1.2，HT 为 96.8 +/- 1.7，最大显着剂量（D-1%，以 % 为单位）分别为 102.2 +/- 0.8、102.7 +/- 0.5、102.4 +/- 0.5 和 103.0 +/- 1.1，标准差（以%计）分别为 1.4 +/- 0.4、1.3 +/- 0.3、1.1 +/- 0.2 和 0.8 +/- 0.3。合格指数 (Cl-95%) 分别为 0.47 +/- 0.112、0.46 +/- 0.12、0.43 +/- 0.11 和 0.38 +/- 0.11。对于处于危险中的器官，所有技术都尊重规划目标。关于健康组织：V-10Gy（％）分别为 9.4 +/- 5.5、9.9 +/- 6.1、9.2 +/- 6.1 和 12.1 +/- 8.8。在健康组织上测得的积分剂量分别为 7.5 +/- 3.3、9.7 +/- 3.4、8.7 +/- 3.4、10.4 +/- 4.2 10(3) Gy cm(3)。结论：对于本报告中研究的肿瘤类别，HT、RA 和 IMRT 被证明足以正确治疗患者。需要对更复杂的病例进行进一步的研究，以便从更广泛的临床角度评估这项新技术的有效性。 (C) 2008 Elsevier Ireland Ltd. 保留所有权利。放射治疗和肿瘤学 89 (2008) 254-262。
Background and purpose: The potential benefits and limitations of the new RapidArc treatment concept compared to Helical Tomotherapy and fixed gantry intensity modulation techniques have been assessed at treatment planning level on 12 patients presenting with 'benign' brain tumours.Materials and methods: Plans for five acoustic neurinomas, five meningiomas and two pituitary adenomas were computed for an Helical Tomotherapy (HT) unit, for RapidArc delivery (RA) on a linac equipped with two types of MLC (RA_HD120 with the new High Definition MLC with 2.5 mm leaf width at isocentre and RA_M120 with the standard Millennium with 5 mm resolution) and for fixed beam IMRT with the High Definition MLC. Analysis was mostly performed on physical quantities derived from Dose-Volume Histograms (DVHs).Results: Target coverage resulted basically equivalent among techniques. V-95% (in %) was higher than 99% for all techniques, minimum significant dose (D-99%) was 95.5 +/- 1.4 for IMRT, 96.2 +/- 1.4 and 97.0 +/- 1.2 for the RA_HD120 and RA_M120 approaches and 96.8 +/- 1.7 for HT, maximum significant dose (D-1%, in %) was 102.2 +/- 0.8, 102.7 +/- 0.5, 102.4 +/- 0.5 and 103.0 +/- 1.1, respectively, standard deviation (in %) was 1.4 +/- 0.4, 1.3 +/- 0.3, 1.1 +/- 0.2 and 0.8 +/- 0.3, respectively. Conformity Index (Cl-95%) was 0.47 +/- 0.112, 0.46 +/- 0.12, 0.43 +/- 0.11 and 0.38 +/- 0.11, respectively. For organs at risk all techniques respected planning objectives. Concerning the healthy tissue: V-10Gy (in %) was 9.4 +/- 5.5, 9.9 +/- 6.1, 9.2 +/- 6.1 and 12.1 +/- 8.8, respectively. Integral dose measured on the healthy tissue was 7.5 +/- 3.3, 9.7 +/- 3.4, 8.7 +/- 3.4, 10.4 +/- 4.2 10(3) Gy cm(3), respectively.Conclusions: For the class of tumours investigated in this report, HT and RA and IMRT proved to be adequate to properly treat patients. Further studies on more complex cases need to be investigated in order to assess the effectiveness of this new technique in a broader clinical perspective. (C) 2008 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 89 (2008) 254-262.