Intensity-modulated radiation therapy for multiple targets with tomotherapy using multiple sets of static ports from different angles
Intensity-modulated radiation therapy for multiple targets with tomotherapy using multiple sets of static ports from different angles
复制标题
使用多组不同角度的静态端口通过断层放疗对多个目标进行调强放射治疗
DOI：
10.1002/acm2.12874
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发表时间：
2020
影响因子：
2.1
通讯作者：
Sugie Chikao
中科院分区：
文献类型：
--
作者：
Manabe Yoshihiko;Shibamoto Yuta;Murai Taro;Torii Akira;Niwa Masanari;Kondo Takuhito;Okazaki Dai;Sugie Chikao
背景为了在短时间内治疗在头尾方向上分离的多个靶点，我们发明了一种新技术，使用多静态端口断层治疗与动态颌模式，并将其命名为伪DJDC（pDJDC）技术。我们比较了pDJDC计划和使用动态颌模式（HDJ）针对多个靶点的螺旋断层治疗计划。在pDJDC计划中，我们使用2-7个端口的波束设置在同一水平的头尾方向的目标，并采用另一个波束设置为其他目标使用不同的端口角度（9-12个角度）。方法在7例患者中，两个计划使用pDJDC和HDJ技术进行了比较。对于多个靶点（n = 2-6），在D50%时，计划靶体积的剂量为20-60戈伊，分2 - 7.5戈伊。一致性指数，均匀性指数（D5%/D95%），剂量分布在肺，和治疗时间进行了evaluated.ResultsThe中位数一致性指数的所有7例患者为3.0的pDJDC计划和2.4的HDJ计划（P= 0.031）。两种计划的计划靶体积（n = 25）的平均均匀性指数分别为1.048和1.057（P= 0.10）。对于5例胸部靶点患者，中位平均肺剂量分别为2.6戈伊和2.4戈伊（P= 0.63）。5例患者肺部中位V5 Gy和V20 Gy分别为11.8%和8.5%（P= 0.63），1.6%和2.1%（P= 0.31）。pDJDC计划减少了48%的治疗时间相比，HDJ计划（中位数：462和884秒，分别为，P= 0.031）。pDJDC计划在剂量分布方面与HDJ计划相当，尽管符合性指数恶化。
BackgroundTo treat multiple targets separated in the craniocaudal direction within a short time, we invented a new technique using multiple static‐port tomotherapy with the dynamic‐jaw mode and named it the pseudo‐DJDC (pDJDC) technique. We compared the pDJDC plans and helical tomotherapy plans using the dynamic‐jaw mode (HDJ) for multiple targets. In the pDJDC plans, we used a beam set with 2–7 ports to the targets at the same level in the craniocaudal direction, and employed another beam set for other targets using different port angles (9–12 angles in total).MethodsIn seven patients, two plans using the pDJDC and HDJ techniques were compared. For multiple targets (n = 2–6), 20–60 Gy in 2‐ to 7.5‐Gy fractions were prescribed for the planning target volumes at D50%. The conformity index, uniformity index (D5%/D95%), dose distribution in the lung, and treatment time were evaluated.ResultsThe median conformity index of all seven patients was 3.0 for the pDJDC plans and 2.4 for the HDJ plans (P= 0.031). The median uniformity indices of the planning target volume (n = 25) for the two plans were 1.048 and 1.057, respectively (P= 0.10). For five patients with thoracic targets, the median mean lung doses were 2.6 Gy and 2.4 Gy, respectively (P= 0.63). The median V5Gy and V20Gy of the lungs in the five patients were 11.8% and 8.5% (P= 0.63), and 1.6% and 2.1% (P= 0.31), respectively. The pDJDC plans reduced the treatment time by 48% compared to the HDJ plans (median: 462 and 884 sec, respectively,P= 0.031).ConclusionThe pDJDC technique allows treatment of multiple targets in almost half the time of the HDJ technique. The pDJDC plans were comparable to the HDJ plans in dose distribution, although the conformity index deteriorated.