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題名 | 弧形刀與強度調控治療技術在攝護腺癌治療計劃之比較=Comparison of Treatment Planning for Prostate Cancer by Volumetric Modulated Arc Therapy vs. Intensity Modulated Radiation Therapy |
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作者姓名(中文) | 許義昌; 許義勇; 熊敬業; 曾千惠; 陳信雄; | 書刊名 | 臺灣應用輻射與同位素雜誌 |
卷期 | 10:3 2014.09[民103.09] |
頁次 | 頁911-919 |
分類號 | 416.36 |
關鍵詞 | 弧形刀; 強度調控放射治療; 靶體積; Volumetric modulated arc therapy; Intensity modulated radiation therapy; Planning target volume; |
語文 | 中文(Chinese) |
中文摘要 | 本研究目的以弧形刀(Volumetric Modulated Arc Therapy, VMAT)與強度調控治療(Intensity ModulatedRadiation Therapy, IMRT)技術在攝護腺癌劑量分布之比較。以回朔式挑選已完成治療之10位攝護腺癌病患,處方劑量皆為75.6 Gy,治療範圍包括攝護腺及儲精囊,能量維持10 MV。IMRT之治療計劃以直接機器參數最佳化演算法做為劑量之計算,旋轉臂以7個固定角度照射。VMAT之治療計劃分成兩種:旋轉臂360°照射1圈(SingleVMAT, SV)與旋轉臂360°照射2圈(Double VMAT, DV),並以SmartArc進行劑量計算。各個計劃是以五種指標來作分析:1.靶體積之平均劑量、最大劑量、最小劑量之比較。2.劑量順形指標(Conformal Index, CI)。3.劑量均勻指標(Homogeneity Index, HI)。4.監測單位(Monitor Unit, MU)、照射時間。5.正常組織所接受到的劑量。這3種治療技術與五種指標透過paired two-tailed student's t-test來評估,當P<0.05則有統計學上的意義。PTV之平均劑量、最大劑量、最小劑量,所得之P-value,皆大於0.05。比較CI之結果,IMRT vs. SV這組,P-value為0.027,而其他兩組皆大於0.05。比較HI之結果,以IMRT vs. SV、SV vs. DV這兩組其P-value,小於0.05。三種技術於正常組織之比較,膀胱V70於IMRT vs. SV這組,其P-value為0.046,而其餘皆大於0.05。三種技術於照射時間、MU值之比較,各組之P-value皆小於0.05。以鼻咽癌進行相同測試,發現相關數據不適用於鼻咽癌。經此研究可明確得到攝護腺癌使用IMRT、SV、DV與5大指標之關係,此三種治療技術都有其優勢存在。 |
英文摘要 | The goal of this study was to investigate the comparison in dose distribution of Volumetric Modulated Arc Therapy (VMAT) vs. Intensity Modulated Radiation Therapy (IMRT) for prostate carcinoma radiotherapy. Ten prostate carcinoma patients were retrospectively enrolled in this study. The planning target volume (PTV), which contained the prostate gland and seminal vesicles, received 75.6 Gy by 10 MV x-rays. For seven fixed fields IMRT, dose calculation was performed by Direct Machine Parameter Optimization. The VMAT had two parts. For single revolution VMAT(SV), gantry rotated from 180.0° to 179.9°; for double revolution VMAT(DV), gantry rotated from 180.0° to 179.9°, and then from 179.9° to 180.0°. For VMAT, dose calculation was performed by Smart Arc software. We evaluated the following five indications: (1) mean dose, maximum dose, and minimum dose in PTV (2) conformal index (CI) (3) homogeneity index(HI) (4) monitor units(MU) and delivery time (5) dose of normal tissue. To appraise the three kinds of techniques in five indications, the paired two-tail student's t-test was applied. It shows statistically significant if p-value is less than 0.05. The results showed that the p-values were greater than 0.05 for mean dose, maximum dose, and minimum dose in PTV. Comparison of the results of CI value, p-value was 0.027 for IMRT vs. SV group, while the other two groups were greater than 0.05. Comparing the results of HI values, IMRT vs. SV and SV vs. DV groups p-value were less than 0.05. Comparison of results in dose of normal tissues, p-value was 0.046 in bladder V70 for IMRT vs. SV group, while the other two groups were greater than 0.05. Comparison of results in delivery time and MU, p-value were less than 0.05 for all groups. In addition, we found the results were not available for the nasopharyngeal carcinoma by the same evaluation methods. We concluded the results that all treatment techniques, IMRT, SV, and DV, have the advantages to treat prostate carcinoma from the five indications. |
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