Abstract Objective To study the dose characteristics of Body γ Knife and Tomotherapy treatment plans for hepatocellular carcinoma, and compare their differences between organs at risk (OAR) dose and the range of low dose. Methods CT simulation images of twelve patients with hepatocellular carcinoma were selected, the target volume and OAR were drew by doctor. Body γ Knife and Tomotherapy treatment plans were optimized with their own planning station. The dosimetric characteristics were evaluated by dose volume histograms and were compared. To analyze the difference between the two techniques, the paired t-test was applied. Results The Dmax and Dmean of target with Body γ Knife were higher than Tomotherapy (P=0.002,0.000), but the conformal index of PTV of Tomotherapy was superior to the Body γ Knife (P=0.001). The Dmax of spinal cord and left kidney with Body γ Knife was lower than Tomotherapy (P=0.013,0.012), and it was also in the Dmean of stomach and left kidney (P=0.010,0.023). In the volume dose comparison, the V40, V35, V30, V25 and V20 of normal tissue (all Body-PTV) and liver (all liver-GTV) with Body γ Knife were higher than Tomotherapy (P=0.001,0.001,0.001,0.007,0.029), but the V10 and V5 were lower (P=0.019,0.031), the Dmax of stomach, Dmean of right kidney and liver were no statistical difference (P=0.247,0.308,0.401). Conclusions Both treatment plans could meet the clinical dosimetric need, by the same prescription dose, Dmax and Dmean of target of Body γ Knife were higher than Tomotherapy. Tomotherapy had excellent dose-target conformal and could reduce the range of V25-V40 of OAR and normal tissue, but the range of V5-V10 was increased obviously.
Zhu Fuhai,Wu Weizhang,Ren Gang et al. Analysis on the dose characteristics of Body γ Knife and Tomotherapy treatment for hepatocellular carcinoma[J]. Chinese Journal of Radiation Oncology, 2015, 24(2): 189-192.
Zhu Fuhai,Wu Weizhang,Ren Gang et al. Analysis on the dose characteristics of Body γ Knife and Tomotherapy treatment for hepatocellular carcinoma[J]. Chinese Journal of Radiation Oncology, 2015, 24(2): 189-192.
[1]康静波,孙守歧,李平,等.肝癌[A]//夏廷毅,康静波.体部肿瘤伽玛刀治疗学[M].北京:人民卫生出版社,2010:159-169. [2]Mackie TR, Kapatoes J, Ruchala K, et al. Image guidance for precise conformal radiotherapy[J]. Int J Radiat Oncol Biol Phys,2003,56(1):89-106. [3]Qi XS, Li XA (李晓川).结构和原理[A]//马林,王连元,周桂霞.肿瘤断层放射治疗[M].成都:四川科学技术出版社,2010:26-48. [4]Ji JS, Han CW, Jang JW, et al. Helical tomotherapy with concurrent capecitabine for the treatment of inoperable pancreatic cancer[J/OL]. Radiat Oncol,2010,5:60[2013-11-25].http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2903902/. DOI:10.1186/1748-717X-5-60. [5]夏廷毅.γ(X)-线立体定向放射治疗临床应用规范和治疗进展[J].中国癌症杂志,2006,16(6):454-458. [6]夏廷毅,周文静.头、体γ刀的临床应用[A]//申文江,王绿化,夏廷毅.放射治疗学新技术进展-体部γ-刀的例的临床应用[M].北京:北京科学技术出版社,2003:70-73. [7]吴伟章,朱夫海,常冬姝,等.胰腺癌伽马刀和螺旋断层放疗治疗计划剂量学比较[J].中国医疗器械杂志,2013,37(3):232-234.DOI:10.3969/j.issn.1671-7104.2013.03.022. [8]于湧,周助明,常冬姝.体部γ刀治疗原发性肝癌47例临床报告[J].实用肿瘤学杂志,2005,19(3):220-221. [9]康静波,聂青,张丽萍,等.立体定向放射(体部γ刀)治疗原发性肝癌的疗效分析[J].海军总医院学报,2005,18(1):16-19. [10]王玉洲,丁广成,秦德华.全身伽玛刀治疗肝癌30例[J].现代医学,2003,31(3):741. [11]Jang JW, Kay CS, You CR, et al. Simultaneous multitarget irradiation using helical tomotherapy for advanced hepatocellular carcinoma with multiple extrahepatic metastases[J]. Int J Radiat Oncol Biol Phys,2009,74(2):412-418.DOI:10.1016/j.ijrobp.2008.08.034. [12]Kim JY, Kay CS, Kim YS, et al. Helical tomotherapy for simultaneous multitarget radiotherapy for pulmonary metastasis[J]. Int J Radiat Oncol Biol Phys,2009,75(3):703-710.DOI:10.1016/j.ijrobp.2008.11.065. [13]Kim JY, Yoo EJ, Jang JW, et al. Hypofractionated radiotherapy using helical tomotherapy for advanced hepatocellular carcinoma with portal vein tumor thrombosis[J/OL]. Radiat Oncol,2013,8:15[2013-11-25].http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3570396/.DOI:10.1186/1748-717X-8-15. [14]Aoyama H, Westerly D C, Mackie T R, et al. Integral radiation dose to normal structures with conformal external beam radiation[J]. Int J Radiat Oncol Biol Phys,2006,64(3):962-967. [15]杨瑞杰,徐寿平,姜伟娟,等.子宫内膜癌术后适形与调强及螺旋断层放疗的非肿瘤组织积分剂量比较[J].中华肿瘤防治杂志,2009,16(20):1605-1609.