| Fuli Zhang,Weidong Xu,Huayong Jiang,Yadi Wang,Junmao Gao,Qingzhi Liu. Dosimetric evaluation of VMAT radiation therapy technique for breast cancer after conservative surgery based on three different types of multileaf collimators. Oncol Transl Med, 2018, 4: 208-214. |
| 基于不同类型多叶准直器乳腺癌保乳术后容积旋转调强放疗剂量学评估 |
| Dosimetric evaluation of VMAT radiation therapy technique for breast cancer after conservative surgery based on three different types of multileaf collimators |
| Received:September 17, 2018 Revised:November 26, 2018 |
| DOI：10.1007/s10330-018-0302-2 |
| 中文关键词: 多叶准直器;叶片宽度;容积旋转调强放疗;乳腺癌; Agility; MLCi2; Beam modulator |
| 英文关键词: multileaf collimator; leaf width; volumetric modulated arc therapy (VMAT); breast cancer; agility; MLCi2; beam modulator (BM) |
| 基金项目:北京市科技计划项目No.Z181100001718011 |
| Author Name | Affiliation | E-mail | | Fuli Zhang | Radiation Oncology Department,The PLA Army General Hospital of China,No. 5,Nanmencang,Dongcheng | radiozfli@163.com | | Weidong Xu | Radiation Oncology Department,The PLA Army General Hospital of China,No. 5,Nanmencang,Dongcheng | | | Huayong Jiang | Chinese PLA Army General Hospital, Beijing 100700, China | | | Yadi Wang* | Chinese PLA Army General Hospital, Beijing 100700, China | | | Junmao Gao | Chinese PLA Army General Hospital, Beijing 100700, China | | | Qingzhi Liu | Chinese PLA Army General Hospital, Beijing 100700, China | |
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| 中文摘要: |
| 目的:评估不同类型多叶准直器对乳腺癌保乳术后容积旋转调强放疗技术剂量学影响。方法: 选择15例乳腺癌患者行回顾性研究。基于三种类型多叶准直器 (4mm宽度的Beam Modulator (BM)、5mm宽度的Agility以及10mm宽度的MLCi2),为每一患者设计三个容积旋转调强放疗（VMAT）计划，根据剂量-体积直方图（DVH）比较靶区的均匀性指数（HI）、适形度指数（CI）等参数以及各危及器官的剂量-体积参数。此外，三种计划的实施效率和机器跳数（MUs）也进行了比较。结果:基于Agility and BM准直器的VMAT计划的靶区适形度和均匀性优于基于MLCi2的计划。无论在低剂量区还是在高剂量区，基于Agility的VMAT计划中各危及器官包括患侧肺、心脏、对侧肺和乳腺的剂量体积参数是三者中最低的，计划实施时间分别比基于MLCi2和BM的VMAT计划降低10.8%和32.1%。结论：Agility 多叶准直器能够显著改善乳腺癌保乳术后VMAT计划的剂量-体积参数，并能够提高计划实施效率。 |
| 英文摘要: |
| Objective Radiotherapy combined with conservative surgery plays an important role in the treatment
of early-stage breast cancer. Volumetric modulated arc therapy (VMAT) has been introduced into clinical
practice. The purpose of this study was to investigate the dosimetric effects of different multileaf collimators
(MLC) on VMAT radiotherapy plans for treating breast cancer.
Methods Fifteen breast cancer patients who were treated using a conventional technique in our
department were selected to participate in this retrospective analysis. VMAT plans based on three types of
Elekta MLCs [Beam Modulator (BM) with 4-mm leaf width, Agility with 5-mm leaf width and MLCi2 with 10-
mm leaf width] were independently generated for each patient. Plan comparisons were performed based
on dose-volume histogram (DVH) analysis including dosimetric parameters such as the homogeneity index
(HI), conformity index (CI), Dmax, Dmin, and Dmean for the planning treatment volume (PTV), in addition
to dose-volume parameters for the organs at risk (OARs). The delivery efficiency of the three types of MLCs
was compared in terms of the beam delivery time and the monitor units (MUs) per fraction for each plan.
Results Both target uniformity and conformity were improved in plans for Agility and BM MLC compared
with the plan using MLCi2. The mean HI decreased from 1.14 for MLCi2 to 1.13 for BM and 1.10 for Agility,
while the mean CI increased from 0.68 for MLCi2 to 0.73 for BM and 0.75 for Agility. Furthermore, at both
low and high dose levels, smaller volumes of ipsilateral lung, heart, contralateral lung, and breast were
irradiated with Agility MLC than with the other two types of MLCs. The delivery time with Agility MLC was
reduced by 10.8% and 32.1%, respectively, compared with that for MLCi2 and BM.
Conclusion Our results indicate that the Agility MLC exhibits a dosimetric advantage and a significant
improvement in delivery efficiency for the treatment of breast cancer using VMAT. |
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