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首页> 外文期刊>Radiation oncology >A treatment planning study comparing IMRT techniques and cyber knife for stereotactic body radiotherapy of low-risk prostate carcinoma
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A treatment planning study comparing IMRT techniques and cyber knife for stereotactic body radiotherapy of low-risk prostate carcinoma

机译：比较IMRT技术和电子刀对低危前列腺癌的立体定向放射疗法的治疗计划研究

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Comparing radiation treatment plans by using the same safety margins and dose objectives for all techniques, to ascertain the optimal radiation technique for the stereotactic body radiotherapy (SBRT) of low-risk prostate cancer. Treatment plans for 27 randomly selected patients were compared using intensity-modulated (IMRT) techniques as Sliding Window (SW), volumetric modulated arc therapy (VMAT), and helical tomotherapy (HT), as well as Cyber Knife (CK) system. The target dose was calculated to 36.25?Gy delivered in five fractions over 1?week. Dosimetric indices for target volume and organs at risk (OAR) as well as normal tissue complication probability (NTCP) of late rectal and urinary bladder toxicities were analyzed. The CK provided lower homogeneity in the target volume, but higher values for most of the conformity indices compared to the IMRT approaches. The SW demonstrated superior rectum sparing at medium-to-high dose range (V18?Gy - V32.6?Gy) compared to other techniques (p??0.05). The whole urinary bladder experienced the best shielding by SW and VMAT at the medium dose (V18?Gy, p??0.05 versus CK), however we obtained no relevant differences between techniques at the high dose. Generally, the CK demonstrated significantly superior rectum and bladder exposure at V18?Gy as compared to HT, SW, and VMAT. For the rectum, mean NTCP values were significantly superior for HT (NTCP?=?2.3%, p??0.05), and for urinary bladder, the NTCP showed no significant advantages for any technique. No absolute dosimetric advantage was revealed to choose between CK or IMRT techniques for the SBRT of low-grade prostate cancer. Using the same safety margins and dose objectives, IMRT techniques demonstrated superior sparing of the rectum and bladder at a medium dose compared to CK. Comparing different IMRT approaches SW displayed superior rectum sparing at a medium-to-high dose range, whereas both SW and RA revealed superior bladder sparing compared to HT. HT demonstrated a significantly lower NTCP outcome compared to CK or IMRT techniques regarding the rectum. Radiation plans can be optimized further by an individual modification of dose objectives independent of the treatment plan strategy.
机译：通过对所有技术使用相同的安全裕度和剂量目标来比较放射治疗计划，以确定低风险前列腺癌的立体定向放射疗法（SBRT）的最佳放射技术。使用强度调制（IMRT）技术（如滑动窗口（SW），体积调制弧光治疗（VMAT）和螺旋断层扫描（HT）以及射波刀（CK）系统）比较了27位随机选择的患者的治疗计划。经计算，目标剂量为36.25？Gy，在1周内分五次递送。分析了目标体积和危险器官的剂量指数（OAR）以及晚期直肠和膀胱毒性的正常组织并发症发生率（NTCP）。与IMRT方法相比，CK在目标体积中提供了较低的同质性，但大多数合格指数的值较高。与其他技术相比，SW在中至高剂量范围（V18？Gy-V32.6？Gy）表现出优异的直肠保留能力（p？<？0.05）。在中剂量（V18≤Gy，p≤0.05，相对于CK）下，整个膀胱对SW和VMAT的屏蔽效果最佳，但是在高剂量时，我们在技术上没有相关的区别。通常，与HT，SW和VMAT相比，CK在V18？Gy处显示出明显优越的直肠和膀胱暴露。对于直肠，HT的平均NTCP值显着优于NTCP（NTCP≤2.3％，p≤0.05），对于膀胱，NTCP对任何技术均无明显优势。对于低度前列腺癌的SBRT，在CK或IMRT技术之间没有选择的绝对剂量优势。使用相同的安全裕度和剂量目标，IMRT技术证明与CK相比，中等剂量的直肠和膀胱具有更好的备用性。比较不同的IMRT方法，SW在中高剂量范围内显示出优越的直肠保留，而SW和RA均比HT显示出优越的膀胱保留。与直肠的CK或IMRT技术相比，HT的NTCP结局明显降低。可以通过独立于治疗计划策略的剂量目标的单独修改来进一步优化放射计划。

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