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首页> 外文期刊>Radiation oncology >RapidArc, SmartArc and TomoHD compared with classical step and shoot and sliding window intensity modulated radiotherapy in an oropharyngeal cancer treatment plan comparison
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RapidArc, SmartArc and TomoHD compared with classical step and shoot and sliding window intensity modulated radiotherapy in an oropharyngeal cancer treatment plan comparison

机译：RapidArc，SmartArc和Tomohd与古典步骤和拍摄和滑动窗强度调制的口咽癌症治疗计划比较

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Backround Radiotherapy techniques have evolved rapidly over the last decade with the introduction of Intensity Modulated RadioTherapy (IMRT) in different forms. It is not clear which of the IMRT techniques is superior in the treatment of head and neck cancer patients in terms of coverage of the planning target volumes (PTVs), sparing the organs at risk (OARs), dose to the normal tissue, number of monitor units needed and delivery time. The present paper aims to compare Step and Shoot (SS) IMRT, Sliding Window (SW) IMRT, RapidArc (RA) planned with Eclipse, Elekta VMAT planned with SmartArc (SA) and helical TomoHDTM (HT). Methods Target volumes and organs at risk (OARs) of five patients with oropharyngeal cancer were delineated on contrast enhanced CT-scans, then treatment plans were generated on five different IMRT systems. In 32 fractions, 69.12?Gy and 56?Gy were planned to the therapeutic and prophylactic PTVs, respectively. For the PTVs and 26 OARs ICRU 83 reporting guidelines were followed. Differences in the studied parameters between treatment planning systems were analysed using repeated measures ANOVA. Results Mean Homogeneity Index of PTVtherapeutic is better with HT(.06) followed by SA(.08), RA(.10), SW(.10) and SS(.11). PTVprophylactic is most homogeneous with RA. Parotid glands prescribed mean doses are only obtained by SA and HT, 20.6?Gy and 21.7?Gy for the contralateral and 25.6?Gy and 24.1?Gy for the ipsilateral, against 25.6?Gy and 32.0?Gy for RA, 26.4?Gy and 34.6?Gy for SW, and 28.2?Gy and 34.0?Gy for SS. RA uses the least monitor units, HT the most. Treatment times are 3.05?min for RA, and 5.9?min for SA and HT. Conclusions In the treatment of oropharyngeal cancer, we consider rotational IMRT techniques preferable to fixed gantry techniques due to faster fraction delivery and better sparing of OARs without a higher integral dose. TomoHD gives most homogeneous target coverage with more sparing of spinal cord, brainstem, parotids and the lower swallowing apparatus than most of the other systems. Between RA and SA, SA gives a more homogeneous PTVtherapeutic while sparing the parotids more, but the delivery of RA is twice as fast with less overdose to the PTVelective.
机译：在过去的十年中，在过去的十年中，在过去的十年中，在不同形式的强度调制放疗（IMRT）的速度，Backround放射疗法技术已经迅速发展。目前尚不清楚哪种IMRT技术在治疗头颈癌症患者方面的覆盖范围（PTVS），使风险（OARS），剂量为正常组织，数量监控单位需要和交货时间。本文旨在比较步骤和拍摄（SS）IMRT，滑动窗口（SW）IMRT，RAPIDARC（RA），采用Eclipse，Elekta VMAT计划，采用Smartarc（SA）和螺旋Tomohd TM （HT ）。方法对对比增强CT扫描的5例口咽癌的风险（OAR）的靶量和器官（OAR）的靶量和器官划算，然后在五种不同的IMRT系统上产生治疗计划。在32分级分中，69.12〜GY和56？GY分别用于治疗和预防性PTV。对于PTV和26个桨ICRU 83遵循报告指南。使用重复措施Anova分析了治疗计划系统之间研究参数的差异。结果PTV 治疗性的平均均匀性指数与HT（.06）更好，然后是SA（.08），RA（.10），SW（.10）和SS（.11）。 PTV 预防性是最均匀的Ra。规定的腮腺平均剂量仅通过SA和HT，20.6〜20.6〜21.7？GY为对侧和25.6？GY和24.1？GY为同侧，对抗25.6？GY和32.0？GY为RA，26.4？GY和34.6？对于SW，28.2？gy和34.0？gy for ss。 RA使用最少的监视器单位，最多。 RA的治疗时间为3.05？min，SA和HT为5.9？min。结论在治疗口咽癌症时，我们考虑旋转IMRT技术，其由于速度递送的速度速度较快，并且没有更高的整体剂量而更好地施用桨。 TOMOHD提供了大多数均匀的目标覆盖，脊髓，脑干，腮腺和下吞咽装置比大多数其他系统都有更多的脊髓，脑干，腮腺和下吞咽装置。在Ra和Sa之间，SA给予更均匀的PTV 治疗性，同时备注腮腺炎，但Ra的递送是PTV 选修效果较少过量的两倍。

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