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Non-coplanar VMAT plans for lung SABR to reduce dose to the heart: a planning study.

非共面VMAT计划肺SABR减少心脏剂量: 一项计划研究。

  • 影响因子:2.12
  • DOI:10.1259/bjr.20190596
  • 作者列表:"Kim ST","An HJ","Kim JI","Yoo JR","Kim HJ","Park JM
  • 发表时间:2020-01-01
Abstract

OBJECTIVE:This study aimed to compare the plan quality of non-coplanar partial arc (NPA) volumetric modulated arc therapy (VMAT) to that of coplanar partial arc (CPA) VMAT for stereotactic ablative radiotherapy (SABR) for lung cancer. METHODS:A total of 20 patients treated for lung cancer with the SABR VMAT technique and whose lung tumors were close to the heart were retrospectively selected for this study. For the CPA VMAT, three coplanar half arcs were used while two coplanar half arcs and one noncoplanar arc rotating 315°-45° with couch rotations of 315° ± 5° were used for the NPA VMAT. For each patient, identical CT image sets and identical structures were used for both the CPA and NPA VMAT plans. Dose-volumetric parameters of each plan were analyzed. RESULTS:For the planning target volume and both lungs, no statistically significant differences between the CPA and NPA VMAT plans were observed in general. For the heart, average values of D0.1cc of the CPA and NPA VMAT plans were 29.42 ± 13.37 and 21.71 ± 9.20 Gy, respectively (p < 0.001). For whole body, the mean dose and the gradient index of the CPA VMAT plans were 1.2 ± 0.5 Gy and 4.356 ± 0.608 while those of the NPA VMAT plans were 1.1 ± 0.5 Gy and 4.111 ± 0.480, respectively (both with p < 0.001). CONCLUSION:The NPA VMAT proposed in this study showed more favorable plan quality than the CPA VMAT plans for lung SABR with tumors located close to the heart. ADVANCES IN KNOWLEDGE:For lung SABR, NPA VMAT can reduce doses to the heart as well as whole-body irradiation.

摘要

目的: 本研究旨在比较非共面部分弧 (NPA) 容积调制弧治疗 (VMAT) 与共面部分弧 (CPA) 的计划质量VMAT用于肺癌的立体定向消融放疗 (SABR)。 方法: 回顾性选择 20 例采用SABR VMAT技术治疗的肺癌患者,其肺部肿瘤靠近心脏。对于注册会计师VMAT来说,使用三个共面半弧,而两个共面半弧和一个旋转 315 °-45 ° 的非共面弧,其中沙发旋转为 315 ° ± 5 °,用于NPA VMAT。对于每个患者,将相同的CT图像集和相同的结构用于CPA和NPA VMAT计划。分析每个计划的剂量-体积参数。 结果: 对于计划目标体积和双肺,总体上没有观察到CPA和NPA VMAT计划之间的统计学显著差异。对于心脏,CPA和NPA VMAT计划的D0.1cc平均值分别为 29.42 ± 13.37 和 21.71 ± 9.20 Gy (p <0.001)。对于整个身体,CPA VMAT计划的平均剂量和梯度指数分别为 1.2 ± 0.5 Gy和 4.356 ± 0.608,NPA VMAT计划的平均剂量和梯度指数分别为 1.1 ± 0.5 Gy和 4.111 ± 0.480,分别 (均与p <0.001)。 结论: 本研究中提出的NPA VMAT比CPA VMAT计划更有利于肿瘤靠近心脏的肺SABR的计划质量。 知识进展: 对于肺SABR,NPA VMAT可以减少对心脏的剂量以及全身照射。

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影响因子:6.93
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肺肿瘤,又叫支气管肺癌,是常见的恶性肿瘤之一。肺肿瘤的治疗为包括手术、中药、放疗、化疗及免疫等多学科的综合治疗。

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