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首页> 外文期刊>International Journal of Radiation Oncology, Biology, Physics >Potential for improved intelligence quotient using volumetric modulated arc therapy compared with conventional 3-dimensional conformal radiation for whole-ventricular radiation in children
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Potential for improved intelligence quotient using volumetric modulated arc therapy compared with conventional 3-dimensional conformal radiation for whole-ventricular radiation in children

机译：与传统的3维保形辐射相比，使用体积调制弧光疗法提高儿童智力的商机

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Purpose: To compare volumetric modulated arc therapy (VMAT) with 3-dimensional conformal radiation therapy (3D-CRT) in the treatment of localized intracranial germinoma. We modeled the effect of the dosimetric differences on intelligence quotient (IQ). Method and Materials: Ten children with intracranial germinomas were used for planning. The prescription doses were 23.4 Gy to the ventricles followed by 21.6 Gy to the tumor located in the pineal region. For each child, a 3D-CRT and full arc VMAT was generated. Coverage of the target was assessed by computing a conformity index and heterogeneity index. We also generated VMAT plans with explicit temporal lobe sparing and with smaller ventricular margin expansions. Mean dose to the temporal lobe was used to estimate IQ 5 years after completion of radiation, using a patient age of 10 years. Results: Compared with the 3D-CRT plan, VMAT improved conformality (conformity index 1.10 vs 1.85), with slightly higher heterogeneity (heterogeneity index 1.09 vs 1.06). The averaged mean doses for left and right temporal lobes were 31.3 and 31.7 Gy, respectively, for VMAT plans and 37.7 and 37.6 Gy for 3D-CRT plans. This difference in mean temporal lobe dose resulted in an estimated IQ difference of 3.1 points at 5 years after radiation therapy. When the temporal lobes were explicitly included in the VMAT optimization, the mean temporal lobe dose was reduced 5.6-5.7 Gy, resulting in an estimated IQ difference of an additional 3 points. Reducing the ventricular margin from 1.5 cm to 0.5 cm decreased mean temporal lobe dose 11.4-13.1 Gy, corresponding to an estimated increase in IQ of 7 points. Conclusion: For treatment of children with intracranial pure germinomas, VMAT compared with 3D-CRT provides increased conformality and reduces doses to normal tissue. This may result in improvements in IQ in these children.
机译：目的：比较容积调制弧光疗法（VMAT）与3D立体适形放射疗法（3D-CRT）在局部颅内发芽瘤的治疗中的作用。我们模拟了剂量差异对智商（IQ）的影响。方法和材料：十名颅内生殖器瘤患儿用于计划。对心室的处方剂量为23.4 Gy，随后对位于松果体区域的肿瘤的处方剂量为21.6 Gy。对于每个孩子，都会生成3D-CRT和全弧VMAT。通过计算合格指数和异质性指数来评估目标的覆盖范围。我们还生成了具有明确的颞叶保留和较小的心室边缘扩展的VMAT计划。辐射完成后5年，使用10岁的患者年龄，颞叶的平均剂量用于估计智商。结果：与3D-CRT计划相比，VMAT改善了整合性（整合指数1.10对1.85），异质性稍高（异质性指数1.09对1.06）。对于VMAT计划，左颞叶和右颞叶的平均平均剂量分别为31.3和31.7 Gy，对于3D-CRT计划，平均平均剂量分别为37.7和37.6 Gy。颞叶平均剂量的这种差异导致放疗后5年的智商差异估计为3.1点。当颞叶明确地包含在VMAT优化中时，平均颞叶剂量减少了5.6-5.7 Gy，导致估计的IQ差增加了3个点。将心室边缘从1.5 cm减少到0.5 cm可以减少平均颞叶剂量11.4-13.1 Gy，相当于智商提高了7点。结论：对于治疗颅内纯生殖细胞瘤的儿童，与3D-CRT相比，VMAT提供了更高的保形性并减少了对正常组织的剂量。这可能会导致这些孩子的智商提高。

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