Dosimetric and radiobiological comparison of volumetric modulated arc therapy, high-dose rate brachytherapy, and low-dose rate permanent seeds implant for localized prostate cancer
Dosimetric and radiobiological comparison of volumetric modulated arc therapy, high-dose rate brachytherapy, and low-dose rate permanent seeds implant for localized prostate cancer
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DOI：
10.1016/j.meddos.2016.06.002
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发表时间：
2016-09-01
影响因子：
1.2
通讯作者：
Qu, Ang
中科院分区：
文献类型：
--
作者：
Yang, Ruijie;Zhao, Nan;Qu, Ang
旨在研究体积调制弧疗法 (VMAT)、高剂量率 (HDR) 近距离放射治疗和低剂量率 (LDR) 永久粒子植入治疗局限性前列腺癌之间的剂量学和放射生物学差异。本研究总共选择了 10 名局限性前列腺癌患者。为每位患者制定了 VMAT、HDR 近距离放射治疗和 LDR 永久粒子植入计划。对于 VMAT，计划目标体积 (PTV) 定义为临床目标体积加上 5 毫米的边缘。直肠、膀胱、尿道和股骨头被认为是危险器官。 PTV 的处方为 78 Gy，分 39 次。对于 HDR 和 LDR 计划，剂量处方分别为 D-90 34 Gy（每次分次 8.5 Gy）和临床目标体积 145 Gy。评估靶标、危险器官和正常组织的剂量和剂量体积参数。将物理剂量转换为基于 2 Gy 分数的剂量（每分数 2 Gy 的等效剂量，EQD(2)），以比较 3 种技术。与VMAT相比，HDR和LDR显着减少了直肠和膀胱的剂量。直肠的 D 平均值 (EQD(2)) 分别从 VMAT 中的 30.24 Gy 降低到 HDR 中的 22.36 Gy 和 LDR 中的 17.01 Gy。膀胱的 D 均值 (EQD(2)) 从 VMAT 中的 13.46 Gy 降低到 HDR 中的 6.91 Gy 和 LDR 中的 2.53 Gy。对于股骨头和正常组织，与 VMAT 相比，HDR 和 LDR 的平均剂量也显着降低。对于尿道，VMAT、HDR 和 LDR 近距离放射治疗中的平均剂量 (EQD(2)) 分别为 80.26、70.23 和 104.91 Gy。对于局限性前列腺癌，与 VMAT 相比，HDR 和 LDR 近距离放射治疗在保留直肠、膀胱、股骨头和正常组织方面均明显优于 VMAT。与VMAT和LDR相比，HDR在保留尿道方面具有优势。 (C) 2016 年美国医学剂量师协会。
To investigate the dosimetric and radiobiological differences among volumetric modulated arc therapy (VMAT), high-dose rate (HDR) brachytherapy, and low -dose rate (LDR) permanent seeds implant for localized prostate cancer. A total of 10 patients with localized prostate cancer were selected for this study. VMAT, HDR brachytherapy, and LDR permanent seeds implant plans were created for each patient. For VMAT, planning target volume (PTV) was defined as the clinical target volume plus a margin of 5 mm. Rectum, bladder, urethra, and femoral heads were considered as organs at risk. A 78 Gy in 39 fractions were prescribed for PTV. For HDR and LDR plans, the dose prescription was D-90 of 34 Gy in 8.5 Gy per fraction, and 145 Gy to clinical target volume, respectively. The dose and dose volume parameters were evaluated for target, organs at risk, and normal tissue. Physical dose was converted to dose based on 2-Gy fractions (equivalent dose in 2 Gy per fraction, EQD(2)) for comparison of 3 techniques. HDR and LDR significantly reduced the dose to rectum and bladder compared with VMAT. The D-mean (EQD(2)) of rectum decreased 22.36 Gy in HDR and 17.01 Gy in LDR from 30.24 Gy in VMAT, respectively. The D-mean (EQD(2)) of bladder decreased 6.91 Gy in HDR and 2.53 Gy in LDR from 13.46 Gy in VMAT. For the femoral heads and normal tissue, the mean doses were also significantly reduced in both HDR and LDR compared with VMAT. For the urethra, the mean dose (EQD(2)) was 80.26, 70.23, and 104.91 Gy in VMAT, HDR, and LDR brachytherapy, respectively. For localized prostate cancer, both HDR and LDR brachytherapy were clearly superior in the sparing of rectum, bladder, femoral heads, and normal tissue compared with VMAT. HDR provided the advantage in sparing of urethra compared with VMAT and LDR. (C) 2016 American Association of Medical Dosimetrists.