Feasibility study of helical tomotherapy for total body or total marrow irradiationa).
Feasibility study of helical tomotherapy for total body or total marrow irradiationa).
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螺旋断层放射治疗全身或全骨髓照射的可行性研究a)。
DOI：
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发表时间：
2005
期刊：
影响因子：
--
通讯作者：
J. Welsh
中科院分区：
文献类型：
--
作者：
S. Hui;J. Kapatoes;J. Fowler;D. Henderson;G. Olivera;R. Manon;B. Gerbi;T. Mackie;J. Welsh
多年来，全身辐射一直被用作骨髓移植前的预处理剂。许多副作用仍然困扰着它的使用。我们研究了全身照射(TBI)和选择性全骨髓照射(TMI)的计划和实施，以及使用图像引导的螺旋断层放射治疗减少对敏感结构的辐射剂量。为了评估使用螺旋断层放射治疗的可行性，(A)我们研究了全身和全骨髓螺旋断层放射治疗中螺距、视野宽度和调制因子的变化。我们改变了这些参数，以提供统一的剂量和类似于常规TBI的治疗时间(15-30分钟)。(B)我们还研究了用于维度前处理设置验证的有限(头部、胸部和骨盆)MVCT(MVCT)扫描，而不是全身MVCT扫描，以缩短每个治疗部分的总体治疗时间。(C)我们在兰多体模内放置了热释光探测器(TLD)，以测量包括肺部在内的七个解剖部位的剂量。模拟的脑外伤治疗显示全身剂量覆盖均匀(±10%)。敏感器官的剂量减少了目标剂量的35%-70%。在Rando上的TLD测量显示，目标器官和关键器官的剂量分布准确(±7%)。在TMI研究中，剂量仅共形传递到骨髓。将下-上方向的视野宽度从2.5 cm增加到5.0 cm，可缩短TBI和TMI治疗的交付时间(50%)。与全身MVCT相比，有限的MVCT使靶点定位时间减少了60%。MVCT图像引导的螺旋断层放射治疗提供了一种新的方法，可以将精确、均匀的辐射剂量传递到全身靶点，同时显著减少对所有关键器官的剂量。为了产生均匀的剂量分布和可接受的治疗时间，需要合理地选择节距、调制因子和射野大小。此外，在使用图像引导的螺旋断层放射治疗的体外放射治疗中，对骨髓的适形放射治疗似乎是可行的。
Total body radiation (TBI) has been used for many years as a preconditioning agent before bone marrow transplantation. Many side effects still plague its use. We investigated the planning and delivery of total body irradiation (TBI) and selective total marrow irradiation (TMI) and a reduced radiation dose to sensitive structures using image-guided helical tomotherapy. To assess the feasibility of using helical tomotherapy, (A) we studied variations in pitch, field width, and modulation factor on total body and total marrow helical tomotherapy treatments. We varied these parameters to provide a uniform dose along with a treatment times similar to conventional TBI (15-30min). (B) We also investigated limited (head, chest, and pelvis) megavoltage CT (MVCT) scanning for the dimensional pretreatment setup verification rather than total body MVCT scanning to shorten the overall treatment time per treatment fraction. (C) We placed thermoluminescent detectors (TLDs) inside a Rando phantom to measure the dose at seven anatomical sites, including the lungs. A simulated TBI treatment showed homogeneous dose coverage (±10%) to the whole body. Doses to the sensitive organs were reduced by 35%-70% of the target dose. TLD measurements on Rando showed an accurate dose delivery (±7%) to the target and critical organs. In the TMI study, the dose was delivered conformally to the bone marrow only. The TBI and TMI treatment delivery time was reduced (by 50%) by increasing the field width from 2.5to5.0cm in the inferior-superior direction. A limited MVCT reduced the target localization time 60% compared to whole body MVCT. MVCT image-guided helical tomotherapy offers a novel method to deliver a precise, homogeneous radiation dose to the whole body target while reducing the dose significantly to all critical organs. A judicious selection of pitch, modulation factor, and field size is required to produce a homogeneous dose distribution along with an acceptable treatment time. In addition, conformal radiation to the bone marrow appears feasible in an external radiation treatment using image-guided helical tomotherapy.
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影响因子：
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