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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Quantification of incidental dose to potential clinical target volume (CTV) under different stereotactic body radiation therapy (SBRT) techniques for non-small cell lung cancer - Tumor motion and using internal target volume (ITV) could improve dose
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Quantification of incidental dose to potential clinical target volume (CTV) under different stereotactic body radiation therapy (SBRT) techniques for non-small cell lung cancer - Tumor motion and using internal target volume (ITV) could improve dose

机译：针对非小细胞肺癌，在不同的立体定向放射治疗（SBRT）技术下对潜在临床目标体积（CTV）的偶然剂量进行量化-肿瘤运动和使用内部目标体积（ITV）可以提高剂量

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PURPOSE: Clinical target volume (CTV), although present, is usually not considered during stereotactic body radiation therapy (SBRT) for non-small cell lung cancer. This study aimed to quantify the incidental dose to the potential CTV under different SBRT techniques. MATERIALS AND METHODS: Ten patients with various tumor motions were included in the study. Gated-4DCT was performed for all patients. Three treatment plans were generated. Plan A was based on free breathing gross tumor volume (GTV) from a regular CT. Plan B was based on internal target volume (ITV) from gated 4DCT. Plan C was a perfect gated treatment at the exhale phase. The hypothetical CTV was represented by three CTV shells (5, 10, and 15mm). Time-averaged dose for different respiratory phases was calculated for 18 representative points in each shell. RESULTS: The minimum doses for plans A, B, and C were 84+/-20%, 94+/-3%, and 80+/-17% of the isocenter dose to the 5mm shell, 72+/-27%, 64+/-7%, and 20+/-11% to the 10mm shell, and 38+/-27%, 27+/-17%, and 6+/-7% to the 15mm shell, respectively. The caudal and cranial ends of each shell usually had lower dose compared to the other points on the shell. Plan B had the most uniform and reasonable doses to the CTV shells, and patients with large respiratory motion had significantly higher minimum dose than patients with less motion. CONCLUSION: The potential CTV may incidentally receive adequate and relatively homogeneous doses when ITV is used and the patients have large respiratory motion. However, it could be underdosed for gated treatment or for patients with little motion.
机译：目的：尽管临床目标体积（CTV）存在，但在非小细胞肺癌的立体定向放射治疗（SBRT）期间通常不予考虑。这项研究旨在量化在不同SBRT技术下潜在CTV的偶然剂量。材料与方法：十名患有各种肿瘤运动的患者被纳入研究。对所有患者进行门控4DCT。生成了三个治疗计划。计划A基于常规CT的自由呼吸总肿瘤体积（GTV）。计划B基于门控4DCT的内部目标量（ITV）。计划C是呼气阶段的理想门控治疗。假设的CTV由三个CTV外壳（5、10和15mm）表示。计算每个外壳中18个代表点的不同呼吸阶段的平均时间剂量。结果：A，B和C计划的最低剂量分别是5mm炮弹等中心剂量的84 +/- 20％，94 +/- 3％和80 +/- 17％，72 +/- 27％对于10mm的外壳，分别为64 +/- 7％和20 +/- 11％，对于15mm的外壳，分别为38 +/- 27％，27 +/- 17％和6 +/- 7％。与壳上的其他部位相比，每个壳的尾端和颅端通常剂量较低。计划B对CTV炮弹的剂量最均匀，最合理，呼吸运动较大的患者的最低剂量明显高于运动较少的患者。结论：当使用ITV且患者有较大的呼吸运动时，潜在的CTV可能会偶然接受足够且相对均匀的剂量。但是，对于门诊治疗或运动很少的患者，可能剂量不足。

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