- 期刊
Dosimetric Comparison of Treatment Plans between Intensity-modulated Radiotherapy, Intensity-modulated Arc Therapy and Helical Tomotherapy for Total Scalp Irradiation
強度調控放射治療、強度調控弧形治療及螺旋刀技術於全頭皮放射治療計畫的劑量比較
摘要
目的：比較螺旋刀、強度調控弧形治療及強度調控放射治療技術應用在全頭皮放射治療時的劑量差異。材料與方法：研究對象是一位因惡性血管肉瘤接受全頭皮強度調控放射治療的病人。針對此病人的治療範圍，進行強度調控放射治療、強度調控弧形治療和螺旋刀三種放射技術間放射劑量的評估與比較。本研究中治療計畫施予靶體積之放射劑量為50 Gy，研究項目包括比較三種治療技術間計畫的靶體積劑量的順行指數、腦與水晶體劑量、放射治療監測單位以及總治療時間。最後使用類似結構的實驗假體驗證其與臨床治療計畫結果的差異。結果：計畫的靶體積之覆蓋因子與均質指數於強度調控治療技術為0.99 / 1.04、強度調控弧形治療為0.95 / 1.14、螺旋刀為0.98 / 1.07，而三種技術的順行指數分別為0.74、0.74、與0.69。於強度調控技術中接受高於30 Gy / 40 Gy的正常腦組織比率為43.8% / 10.4%，強度調控弧形治療為40.7% / 18.5%，螺旋刀為20.6% / 7.4%。雖強度調控弧形技術相較於強度調控技術並無明顯的劑量優勢，但其優點為有較低的治療監測單位及較少的治療時間。假體的劑量研究比較結果與病人的治療計畫相近。結論：對於接受全頭皮放射治療的病人，三種放射治療技術可以達成類似的標靶體積覆蓋因子和均質指數，而螺旋刀對於正常腦部劑量的遮蔽效果優於強度調控弧形與強度調控治療技術。
並列摘要
Purpose: To compare the dosimetric advantage of helical tomotherapy (HT) over intensity-modulated arc therapy (IMAT) and sliding window intensity-modulated radiation therapy (SW-IMRT) for total scalp irradiation.Methods: Three treatment plans (SW-IMRT, IMAT and HT) were generated for a 73 year-old man with scalp angiosarcoma undergoing IMRT. The doses to the planning target volume (PTV) were 50 Gy. Conformity indexes, doses to the brain and lens, number of monitor units (MU), and treatment times were compared between techniques. Plan verification using a phantom study was also performed to compare the radiation planning results.Results: The coverage factors of the PTV and homogeneous index were 0.99/1.10 for SW-IMRT, 0.95/1.14 for IMAT, and 0.99/1.04 for HT. The conformation numbers for the three plans were 0.74, 0.74, and 0.69, respectively. The proportions of normal brain receiving above 30 Gy/40 Gy were 43.8%/10.4% for IMRT, 40.7%/18.5% for IMAT and 20.6%/7.4% for HT. Although IMAT showed no superior dosimetric advantage over SW-IMRT, a lower number of MUs and a shorter treatment time were needed for IMAT. The phantom study had similar dosimetric results.Conclusion: For patients receiving total scalp irradiation, these three techniques provide comparable target coverage. HT spares the brain better than IMAT and SW-IMRT.
延伸閱讀
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