AbstractObjective To explore the feasibility and safety of integrated intensity-modulated radiation therapy (IMRT) technology applied in craniospinal irradiation in a supine position. Methods The patients were fixed in a supine position using thermoplastic mask and vacuum mat. Three isocenters with a fixed interval of 20-25 cm were adopted according to the height of patients. A total of 13 beams with a length of 2-3 cm in the overlapping region were included in the treatment plan. Fixed jaw technique was employed and overall calculation was performed by the inverse optimization method. The γ-passing rate and absolute point dose verification were performed for three isocenters and two overlapping regions. Cone-beam CT (CBCT) images were scanned for three isocenters before treatment. The setup error of each isocenter in the x,y and z directions of the same coordinate system was recorded and overall analysis was conducted. Results Among 28 patients,the γ-passing rate (%) of three isocenters and two overlapping regions was 99.36%,99.60%,99.75%,94.77% and 95.09%,whereas the absolute point dose verification error was 1.56%,-1.56%,0.52%,-0.76% and -1.68%,respectively. Twenty-eight patients received 162 groups of IGRT with 486 setup errors from the CBCT images. The average deviation in the x,y and z direction for three isocenters (neck,chest and abdomen) was 0.17 mm,0.10 mm,0.02 mm,0.06 mm,0.04 mm,0.46 mm,0.19 mm,0.26 mm and 0.41 mm,respectively. Conclusions The integrated IMRT techniques for craniospinal irradiation in a supine position is feasible and safe,which is worthy of clinical application.
Cai Xiaojun,Guo Jian,Zhou Juying et al. Feasibility of integrated IMRT technique for craniospinal irradiation in a supine position[J]. Chinese Journal of Radiation Oncology, 2018, 27(12): 1078-1082.
Cai Xiaojun,Guo Jian,Zhou Juying et al. Feasibility of integrated IMRT technique for craniospinal irradiation in a supine position[J]. Chinese Journal of Radiation Oncology, 2018, 27(12): 1078-1082.
[1] 殷蔚伯,谷铣之.肿瘤放射治疗学[M].北京:中国协和医科大学出版社,2012:1025-1029. Yin WB,Gu XZ.Radiation oncology[M].Beijing:China union medical university press,2012:1025-1029. [2] Myers PA,Mavroidis P,Papanikolaou N,et al. Comparing conformal,arc radiotherapy and helical tomotherapy in craniospinal irradiation planning[J].J Appl Clin Med Phys,2014,15(5):4724.DOI:10.1120/jacmp.v15i5.4724. [3] 付雷,袁双虎,于金明.螺旋断层放射治疗系统在中枢神经系统肿瘤中的应用[J].肿瘤防治研究,2015,42(9):942-946.DOI:10.3971/j.issn.1000-8578.2015.09.018. Fu L,Yuan SH,Yu JM.Application of helical radiotherapy system in the treatment of central nervous system tumors[J].Cancer Res Prevt Treat,2015,42(9):942-946.DOI:10.3971/j.issn.1000-8578.2015.09.018. [4] Li B,Lu H,Luo L,et al. Novel technique for craniospinal radiotherapy with patient supine[J].J South Univ,2009,25(3):326-329.DOI:10.3969/j.issn.1003-7985.2009.03.009. [5] Panandiker AP,Ning H,Likhacheva A,et al. A Craniospinal irradiation with spinal IMRT to improve target homogeneity. Int J Radiat Oncol Biol Phys,2007,68(5):1402-1409.DOI:10.1016/j.ijrobp.2007.02.037. [6] 杨金磊,吴丹,卜明伟,等.全中枢照射技术新探索[J].中国医学物理学杂志,2012,29(3):3354-3357.DOI:10.3969/j.issn.1005-202X.2012.03.004. Yang JL,Wu D,Bu MW,et al. Novel exploration of craniospinal radiotherapy technique[J].Chin J Med Phys,2012,29(3):3354-3357.DOI:10.3969/j.issn.1005-202X.2012.03.004. [7] 傅玉川,李光俊,林大全,等.通过多种技术方法的综合使用优化全脑全脊髓照射技术[J].生物医学工程学杂志,2010,27(1):193-197. Fu YC,Li GJ,Lin DQ,et al. Optimization of the craniospinal radiation technique by synthesizing multiple advanced radiation techniques[J].J Biomed Engin,2010,27(1):193-197. [8] 谢秋英,石锦平,祁振宇,等.全中枢神经系统射野衔接方法研究[J].中华肿瘤防治杂志,2013,20(15):1190-1193. Xie QY,Shi JP,Qi ZY,et al. Field-matching technique for craniospinal irradiation[J].Chin J Cancer Prevent Treat,2013,20(15):1190-1193. [9] Seppala J,Kulmala J,Lindholm P,et al. A method to improve target dose homogeneity of craniospinal irradiation using dynamic split field IMRT (J).Radiother Oncol,2010,96(2):209-215.DOI:10.1016/j.radonc.2010.05.018. [10] Fogliata A,Bergstrom S,Cafaro I,et al. Cranio-spinal irradiation with volumetric modulated arc therapy:a multi-institutional treatment experience[J].Radiother Oncol,2011,99(1):79-85.DOI:10.1016/j.radonc.2011.01.023. [11] 戴越,胡春红,李小东,等.MatriXX两种调强放疗剂量验证方法的比较分析[J].中华放射肿瘤学杂志,2013,22(4):312.414.DOI:10.3760/cma.j.issn.1004-4221.2013.04.014. Dai Y,Hu CH,Li XD,et al. Analyse two kinds of intensity-modulated radiotherapy verification methods comparatively by using the MatriXX[J].Chin J Radiat Oncol,2013,22(4):312.414.DOI:10.3760/cma.j.issn.1004-4221.2013.04.014. [12] 杨瑞杰,张喜乐,刘路,等.2010例调强放疗患者计划剂量验证结果分析.中华放射医学与防护杂志,2016,36(12):917-921.DOI:10.3760/cma.j.issn.0254-5098.2016.12.008. Yang RJ,Zhang XL,Liu L,et al. Analysis of 2010 patient-specific intensity-modulated radiation therapy dosimetric verification results[J].Chin J Radiol Med Protect,2016,36(12):917-921.DOI:10.3760/cma.j.issn.0254-5098.2016.12.008. [13] Crowe SB,Kairn T,Middlebrook N,et al. Examination of the properties of IMRT and VMAT beams and evaluation against pretreatment quality assurance results[J].Phys Med Biol,2015,60(6):2587-2601.DOI:10.1088/0031-9155/60/6/2587.
2018, Vol. 27 
