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題名 | 惡性間皮細胞瘤應用銳速刀與強度調控放射治療計劃之比較=RapidArc Radiotherapy Compared with IMRT for Malignant Mesothelioma |
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作者姓名(中文) | 賴鵬安; 劉芳慧; 賴耿光; 葉啟源; | 書刊名 | 放射治療與腫瘤學 |
卷期 | 21:2 2014.06[民103.06] |
頁次 | 頁121-129 |
分類號 | 416.36 |
關鍵詞 | 惡性間皮細胞瘤; 銳速刀; 強度調控放射治療; Malignant pleural mesothelioma; MPM; RapidArc; Intensity-modulated radiotherapy; IMRT; |
語文 | 中文(Chinese) |
中文摘要 | 目的:針對惡性胸膜間皮瘤(Malignant Pleural Mesothelioma, MPM)應用銳速刀(RapidArc)與強度調控放射治療(Intensity-modulated Radiotherapy, IMRT)治療計劃的結果進行比較。材料與方法:利用本科二例MPM的病患分別執行RapidArc以及IMRT治療計劃優化的程序,再對計劃結果進行腫瘤高劑量覆蓋率、正常器官接受劑量、治療監測單位及治療時間以及治療計劃品質保證結果分析,比較二種不同治療計劃結果的差異。結果:CTV最大劑量的部份IMRT和RapidArc分別是65.78 Gy、67.09 Gy,RapidArc略高於IMRT。COIN以及HI計算結果則是RapidArc優於IMRT。周邊的正常器官所接受的劑量都可以符合治療計劃的限制,但是RapidArc的表現一般都優於IMRT。治療計劃MU平均值分別為1799 ± 367以及828 ± 24.75,IMRT明顯高於RapidArc大約二倍的量。二例IMRT病患完成治療所需的時間平均為11.96 ± 1.0分鐘,RapidArc完成治療所需的時間平均為4.0 ± 0.71分鐘。MatriXX QA測量結果,在距離3 mm和劑量3%誤差的閾值之下IMRT和RapidArc治療計劃與測量值比對的伽碼值通過率分別為91.06%以及92.65%。結論:利用大範圍照野治療MPM的病患,RapidArc治療技術可以提供很好的腫瘤高劑量覆蓋率,同時降低正常器官接受的輻射劑量,和IMRT比較也可以減少治療所需的MU和花費的時間達50%以上,可以預防繼發性腫瘤的可能性以及每天治療中不自主運動所造成的誤差。 |
英文摘要 | Purpose: A treatment planning study comparing volumetric arc modulation with RapidArc and intensity-modulated radiotherapy (IMRT) for malignant pleural mesothelioma (MPM). Materials and Methods: For both IMRT and RapidArc, the dose calculations and optimizations were performed using the Eclipse treatment planning system. The plans for IMRT with nine fixed beams were compared against four partial arcs with a single isocenter. All plans were optimized for 6 MV photon beams. The dose prescription was 60 Gy to the planning target volume. For organs at risk, the mean and maximum doses were constrained and additional objectives were set on various volume thresholds. The monitor units (MUs) and delivery time were scored to measure the treatment efficiency. The treatment planning dosimetry scored delivery to the calculation agreement with the passing rate of gamma index. Results: RapidArc and IMRT provided equivalent coverage, the average of maximum dose of CTV for IMRT and RapidArc were 65.78 Gy, 67.09 Gy, respectively. The conformity index (COIN) and homogeneity index (HI) of RapidArc were better than IMRT. Both techniques accomplished objectives on organs at risk with a tendency of RA to improve sparing. The number of MUs was 828 ± 24.75 for RapidArc and 1799 ± 367 for IMRT. Treatment plan delivery time was 4.0 ± 0.71 min for RapidArc and 11.96 ± 1.0 min for IMRT. The agreement between planning and measurement showed the passing rate of gamma index for IMRT of 91.06% and for RapidArc of 92.65%. Conclusion: Compared with IMRT, RapidArc treatment technique can provide similar target coverage and better dose sparing to the organs at risks for MPM patients. RapidArc can also reduce the treatment MU and treatment time more than 50% to prevent the possibility of secondary tumors and uncertainty from daily treatment of involuntary movement. |
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