Liao Xiongfei, Li Churong, Li Ninshan, Li Jie, Chen Yazheng, Yuan Ke, Wang Pei
Department of Radiation Oncology,Sichuan Cancer Hospital (Institute); Sichuan Cancer Center;Affiliated Hospital,School of Medicine,University of Electronic and Technology of China,Chengdu 610041,China
AbstractObjective To compare dosimetric parameters between automatic three-dimensional conformal radiotherapy (a3DCRT),inverse three-dimensional conformal radiotherapy (i3DRT),inverse intensity-modulated radiotherapy (iIMRT). Methods Ten lung cancer patients with a single target and 10 intracranial tumor patients also with a single target,who were treated in our radiotherapy center from 2014 to 2015,were included in the study. Their image data were transferred to RayStation 4.5 via network,and then the treatment plans for a3DCRT,i3DCRT,and iIMRT were designed for the 20 patients. The dosimetric parameters for planning target volume (PTV) and organs at risk (OAR) were compared between the three plans using multiple dependent variables and two dependent variables. Results For lung cancer patients,iIMRT achieved better Results in D98%,D50%,D2%,conformity index (CI),and homogeneity index (HI) than i3DCRT and a3DCRT (P=0.007,0.001,0.002,0.000,and 0.000),and the CI of a3DCRT was superior to that of i3DCRT (P=0.000);there were no significant differences in heart D33,spinal cord Dmax and D1 cm3,and both lungs between the three plans (P=0.702,0.237,0.163,0.739,0.908,0.832,0.886,0.722,0.429,0.840,and 0.702). For intracranial tumor patients,there were no significant differences in dosimetric parameters between the three plans,except that the CI of iIMRT and a3DCRT was superior to that of i3DCRT (P=0.648,0.783,0.256,0.931,0.002,and 0.034);there were no significant differences in whole brain irradiation dose between the three plans (P=0.446,0.755,0.772,0.0266,0.440,0.290,and 0.939). Conclusions For the single target in patients with lung cancer and intracranial tumors,a3DCRT can improve the CI of PTV compared with i3DCRT,and shows no significant dosimetric disadvantage for OARs compared with iIMRT. Considering the simplicity and low cost of 3DCRT,a3DCRT holds promise as a novel radiotherapy technique.
[1] 王闯.适形放疗中射野方向优化的研究[D].北京:中国协和医科大学,2004. Wang C.A study on optimization of beam orientations and beam weights for conformal radiotherapy[D].Beijing:Peking Union Medical College,2004 [2] 杨瑞杰.IMRT中射野方向优化的研究[D].北京:中国协和医科大学,2007. Yang RJ.Beam orientation optimization for intensity-modulated radiation therapy[D].Beijing:Peking Union Medical College,2007 [3] Wang XC,Zhang XD,Dong L,et al. Effectiveness of noncoplanar IMRT planning using a parallelized multiresolution beam angle optimization method for paranasal sinus carcinoma[J].Int J Radiat Oncol Biol Phys,2005,63(2):594-601.DOI:10.1016/j.ijrobp.2005.06.006 [4] Craft D.Local beam angle optimization with linear programming and gradient search[J].Phys Med Biol,2007,52(7):N127-N35.DOI:10.1088/0031-9155/52/7/N02 [5] Zarepisheh M,Long T,Li N,et al. A DVH-guided IMRT optimization algorithm for automatic treatment planning and adaptive radiotherapy replanning[J].Med Phys,2014,41(6):061711.DOI:10.1118/1.4875700 [6] Li N,Zarepisheh M,Uribe-Sanchez A,et al. Automatic treatment plan re-optimization for adaptive radiotherapy guided with the initial plan DVHs[J].Phys Med Biol,2013,58(24):8725-8738.DOI:10.1088/0031-9155/58/24/8725 [7] Zhang XD,Li XQ,Quan EM,et al. A methodology for automatic intensity-modulated radiation treatment planning for lung cancer[J].Phys Med Biol,2011,56(13):3873-3893.DOI:10.1088/0031-9155/56/13/009 [8] 王若峥,秦永辉,尹勇,等.非小细胞肺癌3D-CRT与IMRT立体定向放疗剂量学比较[J].中华肿瘤防治杂志,2013,20(14):1098-1101. Wang RZ,Qin YH,Yin Y,et al. Dosimetric differences between three dimensional radiotherapy and intensity modulated radiotherapy in stereotactic body radiation therapy of non-small cell lung cancer[J].Chin J Cancer Prev Treat,2013,20(14):1098-1101 [9] 朱正飞,傅小龙,徐志勇,等.调强放疗与3DCRT放疗在非小细胞肺癌中的剂量学比较[J].中华放射肿瘤学杂志,2009,18(5):352-356.DOI:10.3760/cma.j.issn.1004-4221.2009.05.352. Zhu ZF,Fu XL,Xu ZY,et al. Dosimetric comparison between intensity modulated therapy and three-dimensional conformal radiotherapy in non-small cell lung cancer[J].Chin J Radiat Oncol,2009,18(5):352-356.DOI:10.3760/cma.j.issn.1004-4221.2009.05.352. [10] 陈金梅,张纬建,林育毅,等.3DCRT放疗与调强放疗在不同肺叶非小细胞肺癌中的剂量学研究[J].肿瘤基础与临床,2011,24(6):499-502.DOI:10.3969/j.issn.1673-5412.2011.06.013. Chen JM,Zhang WJ,Lin YY,et al. A dosimetric study of three dimensional conformal radiotherapy and intensity modulated radiotherapy for different pulmonary lobes of non-small cell lung cancer[J].J Basic Clin Oncol,2011,24(6):499-502.DOI:10.3969/j.issn.1673-5412.2011.06.013. [11] 张富利,许卫东,高军茂,等.逆向3D-CRT与IMRT计划设计方法在非小细胞肺癌放疗中的剂量学比较[J].中国医学物理学杂志,2010,27(2):1704-1707,1720.DOI:10.3969/j.issn.1005-202X.2010.02.002. Zhang FL,Xu WD,Gao JM,et al. Dosimetric comparison of inverse three-dimensional conformal radiotherapy and intensity modulated radiotherapy for non-ssmall cell lung cancer[J].Chin J Med Phys,2010,27(2):1704-1707,1720.DOI:10.3969/j.issn.1005-202X.2010.02.002. [12] Bortfeld T,Schlegel W.Optimization of beam orientations in radiation therapy:some theoretical considerations[J].Phys Med Biol,1993,38(2):291-304.DOI:10.1088/0031-9155/38/2/006. [13] Jia X,Men CH,Lou YF,et al. Beam orientation optimization for intensity modulated radiation therapy using adaptive l2,1-minimization[J].Phys Med Biol,2011,56(19):6205-6222.DOI:10.1088/0031-9155/56/19/004. [14] Hou Q,Wang J,Chen Y,et al. Beam orientation optimization for IMRT by a hybrid method of the genetic algorithm and the simulated dynamics[J].Med Phys, 2003,30(9):2360-2367.DOI:10.1118/1.1601911.
2017, Vol. 26 
