Comparing step-and-shoot IMRT with dynamic helical tomotherapy IMRT plans for head-and-neck cancer

Comparing step-and-shoot IMRT with dynamic helical tomotherapy IMRT plans for head-and-neck cancer
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DOI:
10.1016/j.ijrobp.2005.04.011
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发表时间:
2005-08-01
影响因子:
7
通讯作者:
Fallone, BG
Fallone, BG
中科院分区:
医学1区
文献类型:
--
作者:
Van Vulpen, M;Field, C;Fallone, BG

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目的:本规划研究的目标是比较步进和拍摄调强放射治疗(IMRT)计划与螺旋动态IMRT计划口咽部patients on the basis of dose distribution.Methods和Materials:5例口咽部癌患者先前已在荷兰乌得勒支大学医学中心接受步进和拍摄调强放射治疗,应用5个领域和大约60-90段。使用Plato 2.6.2版进行逆向规划。对于每例患者,还使用Tomotherapy Hi-Art System 2.0版并使用相同的靶点和优化目标制定了反向调强放射治疗计划。统计分析进行了配对t test.Results:所有断层治疗计划相比,有利的步骤和拍摄计划的器官在风险和保持等效的目标剂量的均匀性。断层治疗计划,特别是实现了更尖锐的剂量梯度相比,步进和拍摄计划。所有腮腺(n = 10)的平均剂量平均降低6.5戈伊(范围:-4至14; p = 0.002)。在理论上减少正常组织并发症的概率,有利于断层治疗计划依赖于腮腺正常组织并发症的概率模型(范围,-3%至32%hold.Conclusion:螺旋断层治疗IMRT计划实现了更尖锐的剂量梯度相比,临床应用的步进和拍摄计划。预期它们能够进一步降低腮腺正常组织并发症的概率,保持类似的靶剂量均匀性。(c)2005年爱思唯尔公司
Purpose: The goal of this planning study was to compare step-and-shoot intensity-modulated radiotherapy (IMRT) plans with helical dynamic IMRT plans for oropharynx patients on the basis of dose distribution.Methods and Materials: Five patients with oropharynx cancer had been previously treated by step-and-shoot IMRT at the University Medical Centre Utrecht, The Netherlands, applying five fields and approximately 60-90 segments. Inverse planning was carried out using Plato, version 2.6.2. For each patient, an inverse IMRT plan was also made using Tomotherapy Hi-Art System, version 2.0, and using the same targets and optimization goals. Statistical analysis was performed by a paired t test.Results: All tomotherapy plans compared favorably with the step-and-shoot plans regarding sparing of the organs at risk and keeping an equivalent target dose homogeneity. Tomotherapy plans in particular realized sharper dose gradients compared with the step-and-shoot plans. The mean dose to all parotid glands (n = 10) decreased on average 6.5 Gy (range, -4 to 14; p = 0.002). The theoretical reduction in normal tissue complication probabilities in favor of the tomotherapy plans depended on the parotid normal tissue complication probability model used (range, -3% to 32%).Conclusion: Helical tomotherapy IMRT plans realized sharper dose gradients compared with the clinically applied step-and shoot plans. They are expected to be able to reduce the parotid normal tissue complication probability further, keeping a similar target dose homogeneity. (c) 2005 Elsevier Inc.