Potential benefits of using non coplanar field and intensity modulated radiation therapy to preserve the heart in irradiation of lung tumors in the middle and lower lobes
Potential benefits of using non coplanar field and intensity modulated radiation therapy to preserve the heart in irradiation of lung tumors in the middle and lower lobes
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DOI：
10.1016/j.radonc.2006.07.009
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发表时间：
2006-09-01
影响因子：
5.7
通讯作者：
Mornex, Francoise
中科院分区：
文献类型：
--
作者：
Chapet, Olivier;Khodri, Mustapha;Mornex, Francoise
目的：探讨非共面场和调强放射治疗（IMRT）在中、下肺肿瘤放射治疗中是否能降低对心脏的剂量。材料与方法：在10次CT扫描上比较4种方案：(1)参考方案，对应三维适形放疗（3DCRT）共面方案；(2)与参考方案不同的3DCRT（noncop1）方案，在非共面场中改变了一个场；(3)在与参考方案相同的共面平面上优化的IMRTcopl方案；(4)在与3DCRT（非copl）方案相同的非共面光束上优化的IMRTnoncopl方案。PTV的等效均匀剂量（EUD）为74 Gy，分为37份。结果：在所有方案中，95%等剂量面至少覆盖了99%的PTV，符合指标值非常相似。当使用非共面场或IMRT时，观察到心脏的EUD， V30， V40和V50显着降低。IMRT还降低了肺NTCP、V5、V13、V20和V30值以及食管NTCP。结论：使用非共面场和IMRT均可显著降低心脏接受的剂量。当这两种技术结合使用时，可以看到最大的好处。2006爱思唯尔爱尔兰有限公司版权所有。
Purpose: Investigate whether the use of non coplanar fields and intensity modulated radiation therapy (IMRT) reduces the dose to the heart, in irradiation of middle and lower lung tumors.Materials and methods: Four plans are compared on 10 CT scans: (1) a reference plan, corresponding to coplanar plan of 3D conformal radiotherapy (3DCRT); (2) a 3DCRT(noncop1) plan, differing from reference plan by the change of one field in non coplanar fields; (3) an IMRTcopl plan optimized on the same coplanar plan as reference plan; and (4) an IMRTnoncopl plan optimized on the same non coplanar beams as 3DCRT(noncopl) plan. The equivalent uniform dose (EUD) for PTV was 74 Gy in 37 fractions.Results: In all plans, the 95% isodose surface covers at least 99% of the PTV with very similar conformity index values. A significant reduction in EUD, V30, V40 and V50 is observed for heart when either non coplanar fields or IMRT is used. IMRT also reduces the lung NTCP, V5, V13, V20 and V30 values and esophagus NTCP.Conclusion: Both the use of non coplanar fields and IMRT dramatically reduces the dose received by the heart. The largest benefit is seen when the two techniques are combined. (c) 2006 Elsevier Ireland Ltd. All rights reserved.