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Study the feasibility in the application of RapidArc associated with active breath coordinator for radiotherapy of hepatocelluar carcinoma
GONG Guan-zhong*, YIN Yong, LIU Tong-hai, SONG Jin-long, LU Jie, CHEN Jin-hu, MA Chang-sheng, SHANG Dong-ping,WANG Ruo-zheng
*Department of Radiation Oncology, Shandong Cancer Hospital;Shandong Provincial Key Laboratory of Radiation Oncology;Shandong Academy of Medical Sciences;Jinan 250117, China
Abstract Objective To study the feasibility of RapidArc (RA) associated with active breath coordinator (ABC) for hepatocelluar carcinoma (HCC) radiotherapy comparing of three-dimensional conformal radiotherapy (3DCRT), intensity modulated radiotherapy (IMRT), RA treatment plans in different breath status. Methods 12 HCC cases were selected. Three series CT scanning were completed in Free Breathing (FB), End Inspiration Hold (EIH) and End Expiration Hold (EEH) associated with ABC device. 3DCRT, IMRT and RA (three 135° arcs) treatment plans were respectively designed on planning target volume (PTV) in different breath status. The dosimetric differences among 3DCRT, IMRT and RA, among RA plans under different breath status were compared. Results The PTV in FB was larger than in EEH and EIH (160.8 cm3, 89.5 cm3,83.1 cm3,F= 6.63,P=0.004). The conformity index and homogeneity index of RA plans were better than IMRT and 3DCRT (0.92,0.90,0.77,F=72.55,P=0.000;0.90,0.89,0.84,F=125.49,P=0.000);the V20, V30, V40 of normal liver in 3DCRT were higher than IMRT and RA (24%,20%,19%,F=3.56,P=0.032;13%,10%,10%,F=5.74,P=0.004;8%, 5%,6%,F=3.72,P=0.027).The normal liver mean dose, V10, V20, V30, V40 of RA plans in FB were higher than in EEH and EIH (13.46 Gy,10.25 Gy,9.48 Gy,F=3.627,P=0.038;46%,35%,32%,F=2.96,P=0.066;24%,16%,16%,F=3.69,P=0.036;13%,8%,8%,F=4.28,P=0.022;8%,5%,5%,F=2.39,P=0.108).The duodenum D5 cm3 of RA in EEH was lower than in FB and EIH (8.78 Gy,19.35 Gy and 11.67 Gy,F=1.56,P=0.224). The mean monitor units for 3DCRT,IMRT,RA was 254.06 MU,626.33 MU and 550.28 MU (F=147.35,P=0.000),while the mean treatment time was 135 s,540 s and 130 s respectively (F=62.83,P=0.000). Conclusions The RapidArc applying three 135°arcs with ABC in HCC radiotherapy can achieve better PTV coverage than IMRT with fewer monitor units, shorter treatment time and sparing more normal liver.
GONG Guan-zhong*,YIN Yong,LIU Tong-hai et al. Study the feasibility in the application of RapidArc associated with active breath coordinator for radiotherapy of hepatocelluar carcinoma[J]. Chinese Journal of Radiation Oncology, 2012, 21(1): 63-67.
GONG Guan-zhong*,YIN Yong,LIU Tong-hai et al. Study the feasibility in the application of RapidArc associated with active breath coordinator for radiotherapy of hepatocelluar carcinoma[J]. Chinese Journal of Radiation Oncology, 2012, 21(1): 63-67.
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2012, Vol. 21 
