Comparison of dosimetric parameters in the treatment planning of magnetic resonance imaging-based intracavitary image-guided adaptive brachytherapy with and without optimization using the central shielding technique.
Comparison of dosimetric parameters in the treatment planning of magnetic resonance imaging-based intracavitary image-guided adaptive brachytherapy with and without optimization using the central shielding technique.
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DOI：
10.1093/jrr/rry009
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发表时间：
2018-05-01
影响因子：
2
通讯作者：
Sasaki R
中科院分区：
文献类型：
--
作者：
Nishikawa R;Yoshida K;Ebina Y;Omoteda M;Miyawaki D;Ishihara T;Ejima Y;Akasaka H;Satoh H;Kyotani K;Takahashi S;Sasaki R
本研究旨在比较使用中心屏蔽（CS）技术的基于磁共振成像（MRI）的腔内（IC）图像引导自适应近距离放射治疗（IGABT）的非优化和优化治疗计划（分别为NOP和OP）之间的剂量学参数。评价了53例使用CS和基于MRI的IGABT单独使用IC入路接受外射束放疗的患者。总高危临床靶体积（HR-CTV）D90的目标是2次戈伊分割中的>70戈伊等效剂量（EQD 2）。在小HR-CTV组（≤30 cm 3）中，NOP/OP的平均D90 s为98.6/80.7戈伊。在大（30.1-40 cm 3）和广泛（>40 cm 3）HR-CTV组中，平均D90分别为81.9/77.5和71.1/73.6戈伊。尽管NOP中膀胱D2cc较高，但所有组中OP中危及器官（OAR）的平均D2cc值均可接受。首次近距离放射治疗（BT）时HR-CTV与NOP D90之间的相关性强于首次BT时HR-CTV与OP D90之间的相关性。16例NOP/47例OP患者的膀胱、39/50例直肠和47/50例乙状结肠均达到了OAR的目标HR-CTV D90和D2cc剂量限制（分别为P < 0.001、P = 0.007和P = 0.34）。对于小肿瘤，优化的作用是降低OAR的D2cc，同时保持靶向D90。然而，优化是有限的价值广泛的肿瘤。在考虑其有效性和局限性的同时，应规范IGABT与CS治疗宫颈癌的优化方法。
This study aimed to compare dosimetric parameters between non-optimized and optimized treatment planning (NOP and OP, respectively) of magnetic resonance imaging (MRI) –based intracavitary (IC) image-guided adaptive brachytherapy (IGABT) using the central shielding (CS) technique for cervical cancer. Fifty-three patients treated with external beam radiotherapy using CS and MRI-based IGABT with the IC approach alone were evaluated. The total high-risk clinical target volume (HR-CTV) D90 was aimed at >70 Gy equivalent dose in 2 Gy fractions (EQD2). In the small HR-CTV group (≤30 cm3), the mean D90s for NOP/OP were 98.6/80.7 Gy. In the large (30.1–40 cm3) and extensive (>40 cm3) HR-CTV groups, the mean D90s were 81.9/77.5 and 71.1/73.6 Gy, respectively. The mean D2cc values for organs at risks (OARs) in OP were acceptable in all groups, despite the high bladder D2cc in the NOP. The correlation between HR-CTV at first brachytherapy (BT) and NOP D90 was stronger than that between HR-CTV at first BT and OP D90. The targeted HR-CTV D90 and dose constraints of D2cc for OARs were both achieved in 16 NOP/47 OP patients for the bladder, 39/50 for the rectum, and 47/50 for the sigmoid colon (P < 0.001, P = 0.007, and P = 0.34, respectively). For small tumors, the role of optimization was to reduce the D2cc for OARs while maintaining the targeted D90. However, optimization was of limited value for extensive tumors. Methods of optimization in IGABT with CS for cervical cancer should be standardized while considering its effectiveness and limitations.
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DOI：
10.1016/j.ijrobp.2009.11.002
发表时间：
2011-02-01
影响因子：
7
作者：
Georg, Petra;Lang, Stefan;Poetter, Richard
通讯作者：
Poetter, Richard
影响因子：
2
作者：
Ohno T;Noda SE;Okonogi N;Murata K;Shibuya K;Kiyohara H;Tamaki T;Ando K;Oike T;Ohkubo Y;Wakatsuki M;Saitoh JI;Nakano T
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Nakano T
DOI：
10.1016/j.ijrobp.2005.02.040
发表时间：
2005-07-01
影响因子：
7
作者：
Kirisits, C;Pötter, R;Georg, D
通讯作者：
Georg, D
DOI：
10.1016/j.ijrobp.2008.10.033
发表时间：
2009-09-01
影响因子：
7
作者：
Dimopoulos, Johannes C. A.;Lang, Stefan;Poetter, Richard
通讯作者：
Poetter, Richard
DOI：
10.1016/j.ijrobp.2006.01.036
发表时间：
2006-06-01
影响因子：
7
作者：
Kirisits, C;Lang, S;Pötter, R
通讯作者：
Pötter, R