Comparison of dose distributions among five radiotherapy apparatuses in stereotactic body radiation therapy for pancreatic cancer SBRT Group of Radiation Oncology Committee of Shanghai Medical Association
Cao Yangsen1, Zhang Jianying2, Li Tingting2, Qiu Jianjian3, Zhang Libo3, Zhuang Yayun4, Su Yang5, Guo Xiaojing6, Zhang Huojun1
1Department of Radiation Oncology, Changhai Hospital of Naval Medical University, Shanghai 200433, China; 2Department of Radiation Oncology, Zhongshan Hospital of Fudan University, Shanghai 200032, China; 3Department of Radiation Oncology, Huadong Hospital of Fudan University, Shanghai 200040, China; 4Department of Radiation Oncology, Dongfang Hospital of Tongji University, Shanghai 200120, China; 5OUR United Corporation, Xi'an 710016, China; 6Department of Health Statistics, Faculty of Medical Services, Naval Medical University, Shanghai 200433, China
Abstract：Objective To compare the dose distribution among CyberKnife, Tomotherapy, Edge, Triology and γ-knife in stereotactic body radiation therapy (SBRT) for pancreatic cancer. Methods Clinical data of 10 panreatic cancer patients receiving CyberKinife treatment were retrospectively analyzed. The treatment plans were designed by five apparatuses from five centers according to the uniform requirement. All plans were transferred to MIM system for the extraction of parameters, which mainly included Dmin, Dmean and Dmax of PTV, conformity index (CI), new conformity index (nCI), homogeneity index (HI), gradient index (GI), coverage, Dmax and dose-volume of the stomach and bowel. Results The best CI and nCI were obtained in Triology (P<0.001), and the worst HI was found in γ-knife (P<0.001). The best GI was found in CyberKnife, followed by γ-knife and Tomotherapy, and Edge showed the worst GI (P<0.001). The highest Dmin of PTV was found in both Edge and Triology, while lower Dmin of PTV was found in CyberKnife and Tomotherapy (P<0.001). Additionally, γ-knife provided the highest Dmean and Dmax of PTV (P<0.001). Regarding the organs at risk, the lowest Dmax and D5cm3 of the bowel (P<0.001), Dmax of the stomach (P=0.003), Dmax(P=0.001), D5cm3 (P<0.001) and D10cm3 (P=0.005) of the duodenum, Dmax(P<0.001) and D0.35cm3 (P<0.001) of the spinal cord were found in CyberKnife. The highest Dmax of the bowel was found in γ-knife. Furthermore, the highest D5cm3 of the duodenum was demonstrated in Edge (P<0.001) and Tomotherapy provided the highest Dmax(P<0.001) and D0.35cm3 of the spinal cord (P<0.001). Conclusions All five radiotherapy apparatuses can meet the requirement of SBRT for pancreatic cancer. More rapid dose fall-off could be obtained via CyberKnife and γ-knife. Triology and Edge provide better target conformity. CyberKnife can better protect the gastrointestinal tract.
Cao Yangsen,Zhang Jianying,Li Tingting et al. Comparison of dose distributions among five radiotherapy apparatuses in stereotactic body radiation therapy for pancreatic cancer SBRT Group of Radiation Oncology Committee of Shanghai Medical Association[J]. Chinese Journal of Radiation Oncology, 2021, 30(2): 156-163.
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