Feasibility of using intensity-modulated radiotherapy to improve lung sparing in treatment planning for distal esophageal cancer
Feasibility of using intensity-modulated radiotherapy to improve lung sparing in treatment planning for distal esophageal cancer
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DOI：
10.1016/j.radonc.2005.10.017
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发表时间：
2005-12-01
影响因子：
5.7
通讯作者：
Komaki, R
中科院分区：
文献类型：
--
作者：
Chandra, A;Guerrero, TM;Komaki, R
背景和目的：评价调强放疗（intensitymodulatedradiotherapy，IMRT）在食管下段恶性肿瘤治疗中是否能比三维适形放疗（three-dimensional conformal radiotherapy，3DCRT）减少正常肺剂量的可行性。为每位患者制定了使用4、7和9个射束（413、713和913）的IMRT计划，并与临床使用的3DCRT计划进行了比较。对IMRT和3DCRT计划的PTV覆盖范围和对照射正常结构的剂量体积进行了评价，并使用Wilcoxon配对符号秩检验对两种计划进行了统计学比较。IMRT计划（413，713，9 B）在高于10戈伊（V-10）、20戈伊（V-20）、平均肺剂量（MILD）、生物有效体积（V-eff）、肺积分剂量（P < 0.05）。调强放疗相对于三维适形放疗的绝对改善中位值，V-10约为10%，V-20约为5%，MILD约为2.5戈伊。IMRT改善了PTV异质性（P < 0.05），但7 B-9 B计划的符合性更好。脊髓，心脏，肝脏，或全身积分dose.Conclusions：剂量体积暴露的正常肺可以减少与调强放疗，虽然临床调查是必要的，以评估调强放疗治疗食管癌的结果没有临床意义的差异。(c)2005爱思唯尔爱尔兰有限公司保留所有权利。放射治疗和肿瘤学77（2005）247-253。
Background and purpose: To evaluate the feasibility whether intensity-modulated radiotherapy (IMRT) can be used to reduce doses to normal lung than three-dimensional conformal radiotherapy (3DCRT) in treating distal esophageal malignancies.Patients and methods: Ten patient cases with cancer of the distal esophagus were selected for a retrospective treatment-planning study. IMRT plans using four, seven, and nine beams (413, 713, and 913) were developed for each patient and compared with the 3DCRT plan used clinically. IMRT and 3DCRT plans were evaluated with respect to PTV coverage and dose-volumes to irradiated normal structures, with statistical comparison made between the two types of plans using the Wilcoxon matched-pair signed-rank test.Results: IMRT plans (413, 713, 9B) reduced total lung volume treated above 10 Gy (V-10), 20 Gy (V-20), mean lung dose (MILD), biological effective volume (V-eff), and lung integral dose (P < 0.05). The median absolute improvement with IMRT over 3DCRT was approximately 10% for V-10, 5% for V-20, and 2.5 Gy for MILD. IMRT improved the PTV heterogeneity (P < 0.05), yet conformity was better with 7B-9B IMRT plans. No clinically meaningful differences were observed with respect to the irradiated volumes of spinal cord, heart, liver, or total body integral doses.Conclusions: Dose-volume of exposed normal lung can be reduced with IMRT, though clinical investigations are warranted to assess IMRT treatment outcome of esophagus cancers. (c) 2005 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 77 (2005) 247-253.