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首页> 外文学位 >Treatment of Multiple Brain Metastases Using Stereotactic Radiosurgery with Single-Isocenter Volumetric Modulated Arc Therapy: Comparison with Conventional Dynamic Conformal Arc and Static Beam Stereotactic Radiosurgery.
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Treatment of Multiple Brain Metastases Using Stereotactic Radiosurgery with Single-Isocenter Volumetric Modulated Arc Therapy: Comparison with Conventional Dynamic Conformal Arc and Static Beam Stereotactic Radiosurgery.

机译：立体定向放射外科与单等中心容积调制电弧疗法一起治疗多发性脑转移：与常规动态等角弧和静态束立体定向放射外科的比较。

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摘要

Both dynamic conformal arc therapy (DCAT) and three-dimensional conformal radiation therapy (3D-CRT) are well-established techniques and have commonly been used for stereotactic radiosurgery (SRS) treatment in brain metastases. However, for multiple metastases, a much longer treatment time results from multi-isocenter setup in DCAT and 3D-CRT. The aim of this study is to investigate the treatment of multiple brain metastases using single-isocenter volumetric modulated arc therapy (VMAT) compared with conventional multi-isocenter DCAT and 3D-CRT.;A series of 17 patients with 2 to 5 brain metastatic lesions were studied. For patients treated with DCAT/3D-CRT plans, VMAT plans were retrospectively generated, and vice versa. The number of isocenters was proportional to the number of PTVs in DCAT/3D-CRT plans while single-isocenter was employed in VMAT plans. The DCAT/3D-CRT and VMAT plans were generated using BrainLAB iPlan RTM RT Dose v4.1.1 and Varian Eclipse(TM) v8.6 treatment planning system, respectively. All plans were designed to be delivered on Novalis Tx(TM) system.;Conformity for VMAT plans was equivalent to or better than that for DCAT/3D-CRT plans. VMAT and DCAT/3D-CRT plans have similar target coverage, and VMAT plans have higher quality of coverage. However, the mean increase of 46% in the volume of low-dose region receiving 5 Gy was observed in VMAT plans. In addition, the distance between individual PTVs and VMAT isocenter has no impact on VMAT plans. The mean monitor units (MU) decreased by 42% and the mean treatment time decreased by 49% for VMAT plans.;This work suggests that single-isocenter VMAT is promising for SRS in the treatment of multiple brain metastases. Single-isocenter VMAT is able to achieve comparable dose conformity, target coverage, and quality of coverage to conventional DCAT and 3D-CRT plans with significantly superior delivery efficiency. However, single-isocenter VMAT might result in a larger low-dose region.
机译：动态保形弧治疗（DCAT）和三维保形放射治疗（3D-CRT）都是行之有效的技术，通常已用于脑转移的立体定向放射外科（SRS）治疗。但是，对于多个转移，DCAT和3D-CRT中的多等中心设置会导致更长的治疗时间。这项研究的目的是研究与传统的多等中心DCAT和3D-CRT相比，单等中心容积调制弧光治疗（VMAT）对多发性脑转移的治疗。；一系列17例2至5个脑转移病灶被研究了。对于接受DCAT / 3D-CRT计划治疗的患者，将追溯生成VMAT计划，反之亦然。在DCAT / 3D-CRT计划中，等中心点的数量与PTV的数量成正比，而在VMAT计划中采用等中心点的数量。 DCAT / 3D-CRT和VMAT计划分别使用BrainLAB iPlan RTM RT Dose v4.1.1和Varian Eclipse™v8.6治疗计划系统生成。所有计划均设计为在Novalis Tx（TM）系统上交付。VMAT计划的符合性等于或优于DCAT / 3D-CRT计划。 VMAT和DCAT / 3D-CRT计划的目标覆盖范围相似，VMAT计划的覆盖质量更高。但是，在VMAT计划中观察到接受5 Gy的低剂量区域的体积平均增加了46％。此外，单个PTV与VMAT等中心点之间的距离对VMAT计划没有影响。对于VMAT计划，平均监测单位（MU）减少了42％，平均治疗时间减少了49％。；这项工作表明，单等中心VMAT对于治疗多发性脑转移的SRS有希望。单等中心VMAT可以实现与传统DCAT和3D-CRT计划相当的剂量一致性，目标覆盖率和覆盖质量，并且传输效率显着提高。但是，单等中心VMAT可能会导致较大的低剂量区域。

著录项

  • 作者

    Huang, Chi.;

  • 作者单位

    Duke University.;

  • 授予单位 Duke University.;
  • 学科 Health Sciences Radiology.;Health Sciences Oncology.
  • 学位 M.S.
  • 年度 2012
  • 页码 50 p.
  • 总页数 50
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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