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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Dosimetric comparison of helical tomotherapy, RapidArc, and a novel IMRT & Arc technique for esophageal carcinoma.
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Dosimetric comparison of helical tomotherapy, RapidArc, and a novel IMRT & Arc technique for esophageal carcinoma.

机译：螺旋断层扫描，RapidArc和新型IMRT＆Arc技术在食管癌中的剂量学比较。

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PURPOSE: To compare radiotherapy treatment plans for mid- and distal-esophageal cancer with primary involvement of the gastroesophageal (GE) junction using a novel IMRT & Arc technique (IMRT & Arc), helical tomotherapy (HT), and RapidArc (RA1 and RA2). METHODS AND MATERIALS: Eight patients treated on HT for locally advanced esophageal cancer with radical intent were re-planned for RA and IMRT&Arc. RA plans employed single and double arcs (RA1 and RA2, respectively), while IMRT&Arc plans had four fixed-gantry IMRT fields and a conformal arc. Dose-volume histogram statistics, dose uniformity, and dose homogeneity were analyzed to compare treatment plans. RESULTS: RA2 plans showed significant improvement over RA1 plans in terms of OAR dose and PTV dose uniformity and homogeneity. HT plan provided best dose uniformity (p=0.001) and dose homogeneity (p=0.002) to planning target volume (PTV), while IMRT&Arc and RA2 plans gave lowest dose to lungs among four radiotherapy techniques with acceptable PTV dose coverage. Mean V(10) of the lungs was significantly reduced by the RA2 plans compared to IMRT&Arc (40.3%, p=0.001) and HT (66.2%, p<0.001) techniques. Mean V(15) of the lungs for the RA2 plans also showed significant improvement over the IMRT&Arc (25.2%, p=0.042) and HT (34.8%, p=0.027) techniques. These improvements came at the cost of higher doses to the heart volume compared to HT and IMRT&Arc techniques. Mean lung dose (MLD) for the IMRT&Arc technique (21.2 +/- 5.0% of prescription dose) was significantly reduced compared to HT (26.3%, p=0.004), RA1 (23.3%, p=0.028), and RA2 (23.2%, p=0.017) techniques. CONCLUSION: The IMRT&Arc technique is a good option for treating esophageal cancer with thoracic involvement. It achieved optimal low dose to the lungs and heart with acceptable PTV coverage. HT is a good option for treating esophageal cancer with little thoracic involvement as it achieves superior dose conformality and uniformity. The RA2 technique provided for improved treatment plans using additional arcs with low doses to the lungs at the cost of increased heart dose. Plan quality could still be improved through the use of additional arcs.
机译：目的：比较使用新型IMRT＆Arc技术（IMRT＆Arc），螺旋体层放射疗法（HT）和RapidArc（RA1和RA2）对食管中段和远端癌主要涉及胃食管（GE）交界处的放射治疗方案）。方法和材料：8例接受过HT治疗的局部晚期食管癌且有根治性治疗的患者被重新规划了RA和IMRT＆Arc。 RA计划使用单弧和双弧（分别为RA1和RA2），而IMRT＆Arc计划具有四个固定门架IMRT场和一个共形弧。分析剂量-体积直方图统计数据，剂量均一性和剂量均一性，以比较治疗方案。结果：RA2计划在OAR剂量和PTV剂量均匀性和均一性方面均比RA1计划有显着改善。 HT计划为计划的目标体积（PTV）提供了最佳的剂量均匀性（p = 0.001）和剂量均一性（p = 0.002），而IMRT＆Arc和RA2计划在可接受的PTV剂量覆盖范围内的四种放射治疗技术中给肺部的剂量最低。与IMRT＆Arc（40.3％，p = 0.001）和HT（66.2％，p <0.001）技术相比，RA2计划显着降低了肺的平均V（10）。 RA2计划的肺部平均V（15）也显示出比IMRT＆Arc（25.2％，p = 0.042）和HT（34.8％，p = 0.027）技术显着改善。与HT和IMRT＆Arc技术相比，这些改进以牺牲心脏体积为代价。与HT（26.3％，p = 0.004），RA1（23.3％，p = 0.028）和RA2（23.2）相比，IMRT＆Arc技术的平均肺部剂量（MLD）（处方剂量的21.2 +/- 5.0％）显着降低％，p = 0.017）技术。结论：IMRT＆Arc技术是治疗胸椎侵犯食管癌的良好选择。通过可接受的PTV覆盖范围，它可以达到对肺和心脏的最佳低剂量。 HT是治疗食管癌的好选择，几乎没有胸腔受累，因为它可实现优异的剂量保形性和均匀性。 RA2技术提供了改进的治疗计划，使用了额外的低剂量肺弧，但增加了心脏剂量。计划质量仍可以通过使用其他弧线来提高。

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