容积调强弧形治疗与质子调强放疗在室性心动过速放射消融中的计划对比研究

doi:10.3760/cma.j.cn113030-20200331-00149

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Abstract Objective To evaluate the dosimetric properties of intensity-modulated proton therapy (IMPT) plans for simulated treatment planning in patients with ventricular tachycardia (VT) using stereotactic ablative body radiotherapy (SABR), in comparison with the volumetric-modulated arc therapy (VMAT).Methods A total of 25 gross target volume (GTV) of the apical, anterior, septal, inferior and lateral wall of the left ventricle (LV) were delineated on the CT simulation images of 5 patients with complete data. An additional 5 mm GTV margin was added to the internal target volume (ITV), and an additional 3 mm ITV margin was added to the planning target volume (PTV). VMAT and IMPT plans were designed in each target area. Dose prescription was 25 Gy (RBE) in a single fraction. The dosimetric differences of ITV and organ at risk (OAR) were compared between VMAT and IMPT.Results The median volume of ITV was 45.40 cm³(26.72-67.59 cm³). All plans had adequate target coverage(V95%Rx≥99%). Compared with the VMAT plans, IMPT reduced the Dmean of whole heart, pericardium and non-target cardiac tissues (relative difference) by 44.52%, 44.91% and 60.16%, respectively, which also reduced D0.03 cm³ of the left anterior descending artery by 17.58%(P<0.05). After stratified analysis according to the lesion sites, IMPT could still reduce the dose of most OAR. However, the D0.03 cm³ of LAD and LCX for the lesions in the anterior wall of LV, the D0.03 cm³ of LCX in the inferior wall and D0.03 cm³ of LAD in the apical wall did not significantly differ (both P>0.05).Conclusions Both VMAT and IMPT plans can meet the clinical dosimetric requirements when SABR is simulated in patients with VT. However, IMPT can lower the dose of normal heart tissues, which has the potential benefit of reducing the risk of complications, such as ischemic heart disease, pericarditis/pericardial effusion, etc.

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	Articles by authors
	Ren Xueying
	Gao Xianshu
	He Pengkang
	Zhao Zhilei
	Zhao Bo
	Bai Yun
	Ma Mingwei
	Qin Shangbin
	Zhang Min
	Zhou Jing

Key words： Ventricular tachycardia Stereotactic ablative body radiotherapy Volumetric-modulated arc radiotherapy Intensity-modulated proton therapy Dosimetry

Received: 31 March 2020

Fund:Beijing Natural Science Foundation (7182164);Supported by Beijing Municipal Science Technology Commission (Z161100000516041)

Corresponding Authors: Gao Xianshu, Email:doctorgaoxs@126.com

Cite this article:

Ren Xueying,Gao Xianshu,He Pengkang et al. Dosimetric comparison between volumetric-modulated arc radiotherapy and intensity-modulated proton therapy in patients with ventricular tachycardia using stereotactic ablative radiotherapy[J]. Chinese Journal of Radiation Oncology, 2020, 29(6): 466-471.

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http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.cn113030-20200331-00149 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2020/V29/I6/466

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