Emphasizing conformal avoidance versus target definition for IMRT planning in head-and-neck cancer.
Emphasizing conformal avoidance versus target definition for IMRT planning in head-and-neck cancer.
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DOI：
10.1016/j.ijrobp.2009.09.062
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发表时间：
2010-07-01
影响因子：
7
通讯作者：
Tome, Wolfgang A.
中科院分区：
文献类型：
--
作者：
Harari, Paul M.;Song, Shiyu;Tome, Wolfgang A.
关键词：
描述一种简化H&N IMRT治疗计划中选择性淋巴结体积定义过程的方法。20例接受治疗意图放疗的H&N癌患者采用三种不同的方案设计技术进行综合治疗计划；常规三场设计（C3FD）、目标定义IMRT （TD-IMRT）和适形回避IMRT （CA-IMRT）。对于每位患者，首先创建C3FD，从而为后续IMRT设计提供“最外层边界”。简而言之，目标定义IMRT包括在连续1.25 mm CT图像上对GTV， CTV1， CTV2和正常组织回避结构进行医师轮廓。CA-IMRT仅涉及GTV和正常组织回避结构的医师轮廓。监测每种方法的总体医师时间，并严格比较最终的方案。设计各自H&N治疗轮廓的医生平均工作时间为：C3FD计划为0.3小时，TD-IMRT为2.7小时，CA-IMRT为0.9小时。剂量学分析证实，C3FD中剂量（50 Gy）和高剂量（70 Gy）处理的组织体积最大，其次是CA-IMRT，然后是TD-IMRT。然而，对于两种IMRT方法，在唾液腺和脊髓保护方面发现了相似的结果。CA-IMRT为H&N提供了TD-IMRT的替代方案。医生轮廓的总时间大大减少（约3倍），产生更标准化的选择性淋巴结体积。鉴于H&N IMRT靶点设计的复杂性，CA-IMRT可能最终被证明是一种更安全、更可靠的方法，可以推广给普通放射肿瘤学从业者，特别是那些H&N病例经验有限的从业者。
To describe a method for streamlining the process of elective nodal volume definition for H&N IMRT treatment planning. Twenty patients receiving curative-intent radiation for H&N cancer underwent comprehensive treatment planning using three distinct plan design techniques; conventional three-field design (C3FD), target defined IMRT (TD-IMRT) and conformal avoidance IMRT (CA-IMRT). For each patient, the C3FD was created first, thereby providing “outermost boundaries” for subsequent IMRT design. Briefly, target definition IMRT involved physician-contouring of a GTV, CTV1, CTV2 and normal tissue avoidance structures on consecutive 1.25 mm CT images. CA-IMRT involved physician contouring of a GTV and normal tissue avoidance structures only. The overall physician time for each approach was monitored and the resultant plans were rigorously compared. The average physician working time for design of respective H&N treatment contours was 0.3 hours for the C3FD plan, 2.7 hours for TD-IMRT and 0.9 hours for CA-IMRT. Dosimetric analysis confirmed that the largest volume of tissue treated to intermediate (50 Gy) and high dose (70 Gy) occurred with C3FD followed by CA-IMRT and then TD-IMRT. However, for the two IMRT approaches comparable results were found in terms of salivary gland and spinal cord protection. CA-IMRT for H&N offers an alternative to TD-IMRT. The overall time for physician contouring is substantially reduced (~3 fold) yielding a more standardized elective nodal volume. In light of the complexity of H&N IMRT target design, CA-IMRT may ultimately prove a safer and more reliable method to export to general radiation oncology practitioners, particularly those with limited H&N caseload experience.
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影响因子：
19.7
作者：
Martinez-Monge, R;Fernandes, PS;Gahbauer, R
通讯作者：
Gahbauer, R
DOI：
10.1016/j.ijrobp.2006.11.030
发表时间：
2007-04-01
影响因子：
7
作者：
Yao, Min;Chang, Kristi;Buatti, John M.
通讯作者：
Buatti, John M.
DOI：
10.1097/01.coc.0000248895.90193.7e
发表时间：
2006-12-01
影响因子：
2.6
作者：
Mendenhall, William M.;Morris, Christopher G.;Amdur, Robert J.
通讯作者：
Amdur, Robert J.
DOI：
10.1016/s0360-3016(02)02881-x
发表时间：
2002-08-01
影响因子：
7
作者：
Chao, KSC;Wippold, FJ;Dempsey, JF
通讯作者：
Dempsey, JF
DOI：
10.1016/j.ijrobp.2008.01.027
发表时间：
2008-11-01
影响因子：
7
作者：
Sanguineti, Giuseppe;Gunn, G. Brandon;Parker, Brent
通讯作者：
Parker, Brent