Evaluation of the dosimetric impact of heart function-based volumetric modulated arc therapy planning in patients with esophageal cancer
Evaluation of the dosimetric impact of heart function-based volumetric modulated arc therapy planning in patients with esophageal cancer
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DOI：
10.1007/s12194-021-00623-5
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发表时间：
2021-06-08
影响因子：
1.6
通讯作者：
Jingu，Keiichi
中科院分区：
文献类型：
--
作者：
Tanaka，Shohei;Kadoya，Noriyuki;Jingu，Keiichi
由于心肌在解剖学上与食管非常接近，食管癌的放射治疗需要对心肌进行高剂量照射。本研究旨在评估食管癌患者容量调节弧疗法（VMAT）功能性回避计划对心肌的剂量影响，并确定功能性计划的可行性。本研究纳入了 10 名早期食管癌患者。规定剂量为 60 Gy，分 30 次给药。一位经验丰富的医生绘制了心肌左心室 (LV) 的轮廓。使用 VMAT 为每位患者创建解剖计划（非左室保留计划）和功能计划（左室保留计划）。在功能计划中，接受≥ 30和≥ 40 Gy剂量的左心室体积的平均百分比分别为6.0%± 6.7%和2.4%± 2.7%，而在解剖计划中，它们分别为11.7%± 13.1%和4.9%± 6.5%。分别。解剖计划和功能计划之间计划靶区（PTV）最热1 cm3的剂量和大体肿瘤体积的最小剂量以及其他正常组织的剂量学参数没有显着差异。我们比较了接受 VMAT 的食管癌患者的解剖和功能计划。我们的结果表明，功能性计划减少了左心室的剂量，而危险器官和 PTV 没有显着差异，这表明在食管癌患者给予 VMAT 时可以安全地执行回避计划。
Radiotherapy for esophageal cancer entails high-dose irradiation of the myocardium owing to its close anatomical proximity to the esophagus. This study aimed to evaluate the dosimetric impact of functional avoidance planning for the myocardium with volumetric-modulated arc therapy (VMAT) in patients with esophageal cancer and determine the feasibility of functional planning. Ten patients with early stage esophageal cancer were included in this study. The prescribed dose was 60 Gy administered in 30 fractions. An experienced physician contoured the left ventricle (LV) of the myocardium. For each patient, an anatomical plan (non-LV-sparing plan) and a functional plan (LV-sparing plan) were created using the VMAT. In the functional plan, the mean percentage of LV volume receiving a dose of ≥ 30 and ≥ 40 Gy was 6.0% ± 6.7% and 2.4% ± 2.7%, respectively, whereas in the anatomical plan, they were 11.7% ± 13.1% and 4.9% ± 6.5%, respectively. There were no significant differences with respect to the dose to the hottest 1 cm3of the planning target volume (PTV) and the minimum dose of the gross tumor volume and the dosimetric parameters of other normal tissues between the anatomical and functional plans. We compared the anatomical and functional plans of patients with esophageal cancer undergoing VMAT. Our results demonstrated that the functional plan reduced the dose to the LV with no significant differences in the organs at risk and PTV, indicating that avoidance planning can be safely performed when administering VMAT in patients with esophageal cancer.