| Fuli Zhang,Huayong Jiang,Weidong Xu,Yadi Wang,Junmao Gao,Qingzhi Liu,Na Lu,Diandian Chen,Bo Yao,Jun Hou,Jianping Chen. Dosimetric comparison of different multileaf collimators in volumetric modulated arc therapy for malignant pleural mesothelioma. Oncol Transl Med, 2015, 1: 186-189. |
| 基于不同多叶准直器的胸膜间皮瘤容积旋转调强放疗剂量学比较 |
| Dosimetric comparison of different multileaf collimators in volumetric modulated arc therapy for malignant pleural mesothelioma |
| Received:December 23, 2014 Revised:July 22, 2015 |
| DOI：10.1007/s10330-014-0042-z |
| 中文关键词: 多叶准直器 (MLC)； 胸膜间皮瘤； 容积旋转调强放疗 (VMAT) |
| 英文关键词: multileaf collimator (MLC); mesothelioma; volumetric modulated arc therapy (VMAT) |
| 基金项目:全军军事医学计量学专项课题（2011-JL2-005） |
| Author Name | Affiliation | E-mail | | Fuli Zhang | Department of Radiation Oncology, The Military General Hospital of Beijing PLA, Beijing 100700, China | radiozfli@163.com | | Huayong Jiang | Department of Radiation Oncology, The Military General Hospital of Beijing PLA, Beijing 100700, China | | | Weidong Xu | Department of Radiation Oncology, The Military General Hospital of Beijing PLA, Beijing 100700, China | | | Yadi Wang* | Department of Radiation Oncology, The Military General Hospital of Beijing PLA, Beijing 100700, China | wangyadi@hotmail.com | | Junmao Gao | Department of Radiation Oncology, The Military General Hospital of Beijing PLA, Beijing 100700, China | | | Qingzhi Liu | Department of Radiation Oncology, The Military General Hospital of Beijing PLA, Beijing 100700, China | | | Na Lu | Department of Radiation Oncology, The Military General Hospital of Beijing PLA, Beijing 100700, China | | | Diandian Chen | Department of Radiation Oncology, The Military General Hospital of Beijing PLA, Beijing 100700, China | | | Bo Yao | Department of Radiation Oncology, The Military General Hospital of Beijing PLA, Beijing 100700, China | | | Jun Hou | Department of Radiation Oncology, The Military General Hospital of Beijing PLA, Beijing 100700, China | | | Jianping Chen | Department of Radiation Oncology, The Military General Hospital of Beijing PLA, Beijing 100700, China | |
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| 中文摘要: |
| 目的: 比较基于两种类型多叶准直器（multileaf collimator, MLC）的胸膜间皮瘤容积旋转调强放疗(volumetric modulated arc therapy, VMAT)计划差异。材料与方法: 回顾性选取10 例因各种无法手术的胸膜间皮瘤患者CT图像，分别采用配置常规多叶准直器（standar MLC，sMLC）和微型多叶准直器（micro-MLC, mMLC）的医科达直线加速器进行容积旋转调强放疗的计划设计。比较两种计划在靶区（planning target volume, PTV）适形度（conformity index, CI）、均匀度（heterogeneity index, HI）以及危及器官 （organs at risk, OAR）剂量体积参数方面的异同。结果: 与基于sMLC的VMAT计划（sMLC-VMAT）相比，基于mMLC的VMAT计划（mMLC-VMAT）实施效率高（平均实施时间: 2.67min±1.49min vs 4.21±2.03) (p < 0.05). 此外，mMLC-VMAT计划靶区适形度和均匀度优于sMLC-VMAT (CI 0.75±0.08 vs 0.73±0.09/HI 1.09±0.02 vs 1.10±0.02) . 就OARs而言，除患侧肺的V20、V30 (p = 0.031, p =0.033)以外，其它各个OARs的剂量体积参数差异均无显著性意义（p >0.05）结论: 与sMLC-VMAT计划相比，mMLC-VMAT计划不仅缩短了治疗时间，提高靶区的覆盖度，而且显著降低了患侧肺的高剂量受照体积，有助于减小放射性肺损伤的发生风险。 |
| 英文摘要: |
| Objective?The aiom of the study was to compare the impacts of two types of multileaf collimators (MLC) [standard MLC with a width of 10 mm (sMLC) and micro-MLC with a width of 5 mm (mMLC)] on volumetric modulated arc therapy (VMAT) planning for malignant pleural mesothelioma.
Methods?VMAT for ten patients with inoperable malignant pleural mesotheliomas was retrospectively planned with the sMLC and mMLC. Histogram-based dose-volume parameters of the planning target volume (PTV) [conformity index (CI) and homogeneous index (HI)] and organs-at-risk were compared for VMAT plans with sMLC (sMLC-VMAT) and mMLC (mMLC-VMAT).
Results?The mMLC-VMAT plans were more efficient (average delivery time: 2.67±1.49 min) than the sMLC-VMAT plans (average delivery time: 4.21 ± 2.03 min; P < 0.05). Moreover, compared to the sMLC plans, the mMLC plans demonstrated advantages in the dose coverage of the PTV (CI 0.75 ± 0.08 vs 0.73 ± 0.09; HI 1.09 ± 0.02 vs 1.10 ± 0.02), although the difference was not statistically significant (P > 0.05). In addition, significant dose sparing in the fraction of the ipsilateral lung volume receiving > 20 Gy (V20; 54.72 ± 27.08 vs 58.52 ± 29.30) and > 30 Gy (V30; 42.74 ± 27.86 vs 46.86 ± 31.49) radiation, respectively, was observed for the mMLC plans (P < 0.05).
Conclusion?Comparing sMLC-VMAT and mMLC-VMAT not only demonstrated the higher efficiency and better optimal target coverage of mMLC-VMAT, but also considerably improved the dose sparing of the ipsilateral lung in the VMAT plans for malignant pleural mesothelioma. |
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