食管癌VMAT与IMRT剂量比较的<em>Meta</em>分析

doi:10.3760/cma.j.issn.1004-4221.2017.09.015

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Abstract

Objective To investigate the dosimetric comparison of target volumes and organs at risk (OAR) between volumetric-modulated arc therapy (VMAT) and intensity-modulated radiotherapy (IMRT) for esophageal cancer by a meta-analysis. Methods A literature search was performed to collect the clinical studies on dosimetric comparison between VMAT and IMRT. The primary endpoints of interest were dosimetric parameters of target volumes and OAR, number of monitor units (MUs), and treatment time (TT). Results A total of 17 studies involving 323 patients were included in this meta-analysis. When the total dose was>50.4 Gy, VMAT showed significantly lower mean dose (D_mean) of gross tumor volume (GTV) and maximum dose (D_max) of planning target volume (PTV) than IMRT (P=0.009;P=0.039). There were no significant differences in D_mean, V₃₀, and V₄₀ of the heart, D_max of the spinal cord, and V₅, V₁₀, and D_mean of the lung between VMAT and IMRT (P>0.05). VMAT showed significantly lower V₁₅, V₂₀, and V₃₀ of the lung than IMRT (P=0.001;P=0.000;P=0.023). When the single dose was 1.8 Gy and 2.0 Gy, VMAT showed significantly lower TT (reduced by 323.5 s and 193.7 s) and number of MUs (reduced by 275.4 MU and 134.2 MU) than IMRT (P=0.000 and 0.009;P=0.000 and 0.022). Conclusions VMAT can significantly reduce TT, MUs, irradiation dose to the lung, and the risk of radiation pneumonitis, and improve the utilization rate of equipment. Compared with IMRT, VMAT has no significant advantages in protection of the spinal cord and the heart and dosimetric parameters of target volumes except D_mean of PTV and D_mean and D_max of GTV when the total dose was ≤50.4 Gy.

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	Articles by authors
	Gao Han
	Jia Pengfei
	Chen Bingsen
	Tang Lemin

Key words： Esophageal neoplasms/volumetric-modulated arc therapy Esophageal neoplasms/intensity-modulated radiotherapy Meta-analysis

Received: 18 July 2016

Corresponding Authors: Tang Lemin,Email:lemint50@ntu.edu.cn

Cite this article:

Gao Han,Jia Pengfei,Chen Bingsen et al. Dosimetric comparison between volumetric-modulated arc therapy and intensity-modulated radiotherapy for esophageal cancer:a meta-analysis[J]. Chinese Journal of Radiation Oncology, 2017, 26(9): 1055-1061.

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http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.issn.1004-4221.2017.09.015 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2017/V26/I9/1055

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