The Feasibility and Efficiency of Volumetric Modulated Arc Therapy-Based Breath Control Stereotactic Body Radiotherapy for Liver Tumors
The Feasibility and Efficiency of Volumetric Modulated Arc Therapy-Based Breath Control Stereotactic Body Radiotherapy for Liver Tumors
复制标题
基于体积调制电弧治疗的呼吸控制立体定向全身放疗治疗肝脏肿瘤的可行性和有效性
DOI：
10.1177/1533034615596273
复制
发表时间：
2016-10-01
影响因子：
2.8
通讯作者：
Zheng, Xiangpeng
中科院分区：
文献类型：
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作者：
Qiu, Jian-Jian;Ge, Weiqiang;Zheng, Xiangpeng
有充分的证据表明，立体定向放射治疗肝脏肿瘤具有良好的肿瘤学效果。本研究旨在探讨基于图像引导体积调制弧线治疗的自主深呼气屏气技术在肝脏肿瘤立体定向放射治疗中的可行性、计划质量和输送效率。治疗计划采用体积调制弧线治疗2个改良部分弧线，并重新计划采用调强放射治疗技术进行比较。计算剂量学参数进行计划质量评价。质量保证研究包括点和多平面剂量验证。每日锥形束计算机断层成像用于测量和纠正靶体积和关键结构在治疗前和治疗过程中的位置误差。还评估了总监测单位和交付时间。在体积调制电弧治疗和常规调强放射治疗方案之间没有发现明显的剂量学差异。这两种技术都能将危及器官的剂量降至最低，包括正常的肝脏、肾脏、脊髓和胃。然而，体积调制弧线治疗的平均监护单位明显低于强度调制放疗（P = 0.012）（29.2%）。体积调制弧线治疗方案的平均照射时间比强度调制放射治疗方案短22.2%。综上所述，在呼吸控制模式下肝脏肿瘤立体定向放疗的治疗方案中应用体积调制电弧疗法是可行的。与传统的调强放射治疗方案相比，体积调弧治疗方案具有更少的监测单元、更短的照射时间、可容忍的影响内误差以及更好的剂量学等优点，值得进一步研究和临床评估。
There are strong evidences showing the promising oncologic results of stereotactic body radiotherapy for liver tumors. This study aims to investigate the feasibility, plan quality, and delivery efficiency of image-guided volumetric modulated arc therapy-based voluntary deep exhale breath-holding technique in the stereotactic body radiotherapy for liver tumors. Treatment was planned using volumetric modulated arc therapy with 2 modified partial arc and replanned using intensity modulated radiation therapy technique for comparison. Dosimetric parameters were calculated for plan quality assessment. Quality assurance studies included both point and multiple planar dose verifications. Daily cone beam computed tomography imaging was used to measure and correct positional errors for target volumes and critical structures immediately prior to and during treatment delivery. Total monitor units and delivery times were also evaluated. No significant dosimetric difference was found between volumetric-modulated arc therapy and conventional intensity modulated radiation therapy plans. Both techniques were able to minimize doses to organs at risk including normal liver, kidneys, spinal cord, and stomach. However, the average monitor units with volumetric-modulated arc therapy were significantly lower (29.2%) than those with intensity modulated radiation therapy (P = .012). The average beam-on time in volumetric-modulated arc therapy plans was 22.2% shorter than that in intensity modulated radiation therapy plans. In conclusion, it is feasible to utilize volumetric modulated arc therapy in the treatment planning of stereotactic body radiotherapy for liver tumors under breath control mode. In comparison to conventional intensity modulated radiation therapy plans, volumetric modulated arc therapy plans are of high efficiency with less monitor units, shorter beam-on time, tolerable intrafractional errors as well as better dosimetrics, meriting further investigations, and clinical evaluations.