A study of the dosimetric characteristics between different fixed-field IMRT and VMAT in early-stage primary mediastinal B-cell lymphoma
A study of the dosimetric characteristics between different fixed-field IMRT and VMAT in early-stage primary mediastinal B-cell lymphoma
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不同固定野IMRT与VMAT治疗早期原发性纵隔B细胞淋巴瘤的剂量学特征研究
DOI：
10.1016/j.meddos.2017.08.010
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发表时间：
2018-03-01
影响因子：
1.2
通讯作者：
Li, Ye-Xiong
中科院分区：
文献类型：
--
作者：
Xu, Li-Ming;Kang, Ming-Lei;Li, Ye-Xiong
这项分析旨在比较不同的固定场调强放射治疗(IMRT)方案和体积调制弧形疗法(VMAT)的剂量学参数，以确定哪种方案可以实现最低风险的器官危险(OARS)和有效的治疗提供。16例早期原发性纵隔大B细胞淋巴瘤(PMBCL)患者，男8例，女8例，计划大体肿瘤体积(PGTV)45GY，计划靶区体积(PTV)40GY。产生了四种不同的计划：5野、7野、9野调强放疗和VMAT。比较了PGTV和PTV桨(肺、左心室、心脏、甲状腺和乳房)的剂量分布。还评估了监测单元(MU)和治疗交付时间。5F-、7F-、9F-IMRT和VMAT的平均一致性指数(CI)和一致性指数(HI)分别为1.01和1.10、1.01和1.10、1.01和1.10、1.01和1.10、1.01和1.11(p=0.963和0.843)，而PTV的这两个指数分别为1.04和1.22、1.03和1.19、1.03和1.17、1.08和1.14(p=0.964和0.969)。VMAT组左、右乳房的D均值(GY)、V4(%)、D50(GY)和D80(GY)分别增加0.7Gy0.1Gy6.8%和7.7%，0.9Gy1.7Gy1.0Gy1.5Gy.9束调强放疗方案的MUS最高(25762.4 mU)，治疗传递时间最长(10.7分钟)，而VMAT的MUS最低(13345.0)，治疗传递时间最短(5.9分钟)。与5F-IMRT相比，七野和九野调强放疗和VMAT提供了更好的肿瘤覆盖范围，而VMAT显示出比调强放疗更高的治疗效率。与VMAT技术相比，七野和九野调强放疗略微减少了乳房的低剂量辐射暴露。7野和9野调强放疗和VMAT技术都可以安全有效地提供给PMBCL患者。(C)2018年，由爱思唯尔公司代表美国医学剂量师协会出版。
This analysis was designed to compare dosimetric parameters among different fixed-field intensity-modulated radiation therapy (IMRT) solutions and volumetric-modulated arc therapy (VMAT) to identify which can achieve the lowest risk of organs at risk (OARs) and treatment delivery efficiently. A total of 16 patients (8 male and 8 female) with early-stage primary mediastinal large B-cell lymphoma (PMBCL) were enrolled with planned gross tumor volume (PGTV) 45 Gy and planning target volume (PTV) 40 Gy. Four different plans were generated: 5-, 7, 9-field IMRT, and VMAT. The dose distributions for PGTV and PTV OARs (lungs, left ventricle, heart, thyroid gland, and breasts) were compared. The monitor units (MUs) and treatment delivery time were also evaluated. Mean conformity index (Cl) and homogeneity index (HI) for PGTV in 5F-, 7F-, 9F-IMRT, and VMAT were 1.01 and 1.10, 1.01 and 1.10, 1.01 and 1.10, and 1.01 and 1.11 (p = 0.963 and 0.843), whereas these 2 indices for PTV were 1.04 and 1.22, 1.03 and 1.19, 1.03 and 1.17, and 1.08 and 1.14 (p = 0.964 and 0.969), respectively. D-mean (Gy), V4 (%), D50 (Gy), and D80 (Gy) to the left and right breasts increased by 0.7 Gy and 0.1 Gy, 6.8% and 7.7%, 0.9 Gy and 1.7 Gy, and 1.0 Gy and 1.5 Gy in VMAT, respectively. The 9-beam IMRT plan had the highest MUs (25,762.4 MUs) and the longest treatment delivery time (10.7 minutes); whereas, the VMAT had the lowest MUs (13,345.0) and the shortest treatment delivery time (5.9 minutes). Seven- and 9-field IMRT and VMAT provide improved tumor coverage compared with 5F-IMRT, whereas VMAT shows higher treatment delivery efficiency than IMRT technique. Seven- and 9-field IMRT slightly reduce the low dose radiation exposure of breasts compared with VMAT technique. The 7- and 9-field IMRT and VMAT techniques both can be safely and efficiently delivered to patients with PMBCL. (C) 2018 Published by Elsevier Inc. on behalf of American Association of Medical Dosimetrists.