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首页> 外文期刊>Journal of applied clinical medical physics / >Dosimetric benefits of intensity‐modulated radiotherapy and volumetric‐modulated arc therapy in the treatment of postoperative cervical cancer patients
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Dosimetric benefits of intensity‐modulated radiotherapy and volumetric‐modulated arc therapy in the treatment of postoperative cervical cancer patients

机译：调强放疗和容积调制弧光疗法在术后宫颈癌患者治疗中的剂量学优势

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As the advantage of using complex volumetric-modulated arc therapy (VMAT) in the treatment of gynecologic cancer has not yet been fully determined, the purpose of this study was to investigate the dosimetric advantages of VMAT by comparing directly with whole pelvic conformal radiotherapy (CRT) and intensity-modulated radiotherapy (IMRT) in the treatment of 15 postoperative cervical cancer patients. Four-field CRT, seven-field IMRT, and two-arc VMAT plans were generated for each patient with identical objective functions to achieve clinically acceptable dose distribution. Target coverage and OAR sparing differences were investigated through dose-volume histogram (DVH) analysis. Nondosimtric differences between IMRT and VMAT were also compared. Target coverage presented by V95% were 88.9%?±?3.8%, 99.9%?±?0.07%, and 99.9%?±?0.1% for CRT, IMRT, and VMAT, respectively. Significant differences on conformal index (CI) and conformal number (CN) were observed with CIs of 0.37?±?0.07, 0.55?±?0.04, 0.61?±?0.04, and CNs of 0.33?±?0.06, 0.55?±?0.04, 0.60?±?0.04 for CRT, IMRT, and VMAT, respectively. IMRT and VMAT decreased the dose to bladder and rectum significantly compared with CRT. No significant differences on the Dmean, V45, and V30 of small bowel were observed among CRT, IMRT, and VMAT. However, VMAT (10.4?±?4.8 vs. 19.8?±?11.0, P =?0.004) and IMRT (12.3?±?5.0 vs. 19.8?±?11.0, P =?0.02) decreased V40, increased the Dmax of small bowel and the irradiation dose to femoral heads compared with CRT. VMAT irradiated less dose to bladder, rectum, small bowel and larger volume of health tissue with a lower dose (V5 and V10) compared with IMRT, although the differences were not statistical significant. In conclusion, VMAT and IMRT showed significant dosimetric advantages both on target coverage and OAR sparing compared with CRT in the treatment of postoperative cervical cancer. However, no significant difference between IMRT and VMAT was observed except for slightly better dose conformity, slightly less MU, and significant shorter delivery time achieved for VMAT.
机译：由于尚未完全确定使用复杂的容积调制弧光疗法（VMAT）治疗妇科癌症的优势，因此本研究的目的是通过直接与全盆腔适形放疗（CRT）进行比较来研究VMAT的剂量学优势。 ）和调强放射疗法（IMRT）治疗15例术后宫颈癌患者。为具有相同目标功能的每位患者生成四场CRT，七场IMRT和两弧VMAT计划，以实现临床可接受的剂量分布。通过剂量-体积直方图（DVH）分析研究了靶标覆盖率和OAR保留差异。还比较了IMRT和VMAT之间的非剂量差异。对于CRT，IMRT和VMAT，V95％表示的目标覆盖率分别为88.9％±3.8％，99.9％±0.07％和99.9％±0.1％。观察到保形指数（CI）和保形数（CN）的显着差异，CI为0.37≤±0.07、0.55≤±0.04、0.61≤±0.04，CN为0.33≤±0.06、0.55≤±。 CRT，IMRT和VMAT分别为0.04、0.60±±0.04。与CRT相比，IMRT和VMAT显着降低了膀胱和直肠的剂量。 CRT，IMRT和VMAT在小肠的Dmean，V45和V30上没有观察到显着差异。但是，VMAT（10.4±±4.8 vs. 19.8±±11.0，P = 0.004）和IMRT（12.3±±5.0 vs. 19.8±±11.0，P =±0.02）降低了V40，增加了Dmax与CRT相比，小肠和股骨头的照射剂量更大。与IMRT相比，VMAT对膀胱，直肠，小肠和健康组织的照射量更少，而较低的剂量（V5和V10）与IMRT相比，尽管差异无统计学意义。总之，与CRT相比，VMAT和IMRT在靶标覆盖率和OAR节约方面均显示出显着的剂量学优势，与CRT在术后子宫颈癌的治疗中相比。但是，IMRT和VMAT之间没有观察到显着差异，除了剂量一致性稍好，MU稍少以及VMAT的递送时间明显缩短。

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