So sánh kỹ thuật xạ trị 3d-crt, imrt và vmat trong điều trị ung thư phổi sử dụng xạ trị lập thể định vị thân

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Tác giả: Quang Trung Pham, Ngoc Mai Quach, Thi Mai Trinh, Duc Khai Van

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Journal of Clinical Medicine – Hue Central Hospital, 2020

Mô tả vật lý: tr.126-136

Bộ sưu tập: Metadata

ID: 379371

Thêm vào giỏ Liên kết toàn văn

Nghiên cứu so sánh, đánh giá sự khác biệt của phân bố liều và các đặc trưng vật lý trên các kế hoạch điều trị sử dụng kỹ thuật xạ trị theo hình dạng khối u (Three Dimension Conformal Radiation Therapy - 3DCRT), xạ trị điều biến liều (Intensity Modulated Radiation Therapy - IMRT) và điều biến thể tích cung tròn (Volumetric Modulated Arc Therapy - VMAT) trong điều trị ung thư phổi sử dụng xạ trị lập thể định vị thân (Stereotactic Body Radiation Therapy-SBRT). Nghiên cứu cho thấy VMAT và IMRT có độ bao phủ thể tích CI tốt hơn so với 3D-CRT (p<
0,01), giảm liều phổi đáng kể ở V5 (p<
0,05). VMAT cải thiện liều da tới 23% so với 3D-CRT (p<
0,05) và 20% so với IMRT (p<
0,05). Tuy nhiên, 3D-CRT lại có lợi thế khi có lượng MU thấp hơn nhiều so với VMAT và IMRT. Không có khác biệt có ý nghĩa trên các cơ quan lành như tim, thực quản, tuỷ sống, xương sườn. Kết luận: Kỹ thuật VMAT giúp cải thiện độ bao phủ CI lên thể tích điều trị và giảm đáng kể liều phổi V5 so với 2 kỹ thuật IMRT và 3D-CRPurpose: To compare the difference of dose distribution and physical characteristics on treatment plansusing Three-Dimensional Conformal Radiation Therapy (3D-CRT), Intensity Modulated Radiation Therapy (IMRT) and Volumetric Modulated Arc Therapy (VMAT) techniques in the treatment of lung cancer usingStereotactic Body Radiation Therapy (SBRT).Materials and method: 9 lung cancer patients who previously underwent with SBRT using VMATon TrueBeam STx linear accelerator were selected. Average CT obtained from 4 Dimension ComputedTomography Simulation (4D-CT) of patients were used to plan on Eclipse v13.6 by 3D-CRT, IMRT, andVMAT (CP and NCP) techniques. The prescription dose 48Gy in 4 was delivered for the Planning TargetVolume (PTV). All plans were optimized and evaluated based on the criteria in RTOG 0915 [1]. The dosedistribution of OARs in DVH (Dose Volume Histogram) and the targets at Conformity Index (CI), GradientIndex (GI), Homogeneity Index (HI), Monitor Unit (MU) were used to comparing between conformal andmodulated techniques.Results: Using VMAT and IMRT, the volume conformity was better than 3D-CRT(p<
0,01), reducedsignificant lung dose at V5 (p<
0,05). VMAT improved skin dose (23%) than 3D-CRT and IMRT. However,3D-CRT have much lower MU number than VMAT and IMRT techniques. There were no significantdifferences in OARs such as the heart, esophagus, spinal cord, chest wall.Conclusions: VMAT improves the treatment volume coverage and significantly reduces the lung dosevolume at V5 than 3D-CRT and IMRT techniques.

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