Dosimetric comparisons of VMAT, IMRT and 3DCRT for locally advanced rectal cancer with simultaneous integrated boost.
Dosimetric comparisons of VMAT, IMRT and 3DCRT for locally advanced rectal cancer with simultaneous integrated boost.
复制标题
DOI：
10.18632/oncotarget.6401
复制
发表时间：
2016-02-02
期刊：
影响因子：
--
通讯作者：
Zhang Z
中科院分区：
文献类型：
--
作者：
Zhao J;Hu W;Cai G;Wang J;Xie J;Peng J;Zhang Z
术前局部进展期直肠癌（LARC）的同步强化放疗可提高局部控制率和总生存率。本研究的目的是比较LARC的体积调强弧治疗（VMAT）、固定野调强放疗（IMRT）和三维适形放疗（3DCRT）的剂量学差异。本研究回顾性分析了在我科使用同步升级策略治疗的10例LARC患者。所有患者均为T3伴N+/−，并接受调强放疗。为每例患者创建两个额外的VMAT和3DCRT计划。使用SmartArc计划模块设计VMAT计划。IMRT和SmartArc的优化目标相似。计划临床靶区（PTV-C）和计划大体靶区（PTV-G）的剂量分别为50戈伊和56戈伊。比较了所有技术的靶覆盖率和危及器官（OAR）。采用配对双尾Wilcoxon符号秩检验进行统计分析。本研究的结果表明，IMRT和SmartArc在靶区反应、OAR和正常组织保留的大多数相关评价值方面均显著上级3DCRT。它们提供了靶体积的可比剂量测定参数。但调强放射治疗对OAR和正常组织有更好的保护作用。
The simultaneous integrated boost radiotherapy for preoperative locally advanced rectal cancer (LARC) can improve the local control and overall survival rates. The purpose of this study is to compare the dosimetric differences among volumetric modulated arc therapy (VMAT), fixed-field intensity modulated radiotherapy (IMRT) and three-dimensional conformal radiotherapy (3DCRT) for the LARC. Ten LARC patients treated in our department using the simultaneous escalate strategy were retrospectively analyzed in this study. All patients had T3 with N+/− and were treated with IMRT. Two additional VMAT and 3DCRT plans were created for each patient. VMAT plans were designed using SmartArc planning module. Both IMRT and SmartArc had similar optimization objectives. The prescription was 50 Gy to the planning clinical target volume (PTV-C) and 56 Gy to the planning gross target volume (PTV-G). The target coverage and organs at risk (OARs) were compared for all the techniques. The paired, two-tailed Wilcoxon signed-rank test was applied for statistical analysis. Results of this study indicate that IMRT and SmartArc were all significantly superior to 3DCRT in most of the relevant values evaluated of target response, OARs and normal tissue sparing. They provided comparable dosimetric parameters for target volume. But IMRT shows better sparing for OARs and normal tissue.