| GONG Guan-zhong,YIN Yong,LIU Tong-hai,CHEN Jin-hu,SONG Jin-long,LU Jie,MA Chang-sheng,SUN Tao,BAI Tong.Dosimetric differences among RapidArc plans based on different target volumes in radiotherapy of hepatocelluar carcinoma[J].Chinese Journal of Radiological Medicine and Protection,2012,32(3):289-293 |
| Dosimetric differences among RapidArc plans based on different target volumes in radiotherapy of hepatocelluar carcinoma |
| Received:July 13, 2011 |
| DOI：10.3760/cma.j.issn.0254-5098.2012.03.017 |
| KeyWords:Hepatocelluar carcinoma Radiotherapy Intensity-modulated arc radiotherapy Dosimetry |
| FundProject:山东省自然科学基金(ZR2010HM071) |
| Author Name | Affiliation | E-mail | | GONG Guan-zhong | Department of Radiation Oncology, Shandong Cancer Hospital, Shandong Provincial Key Laboratory of Radiation Oncology, Shandong Academy of Medical Sciences, Jinan 250117, China | | | YIN Yong | Department of Radiation Oncology, Shandong Cancer Hospital, Shandong Provincial Key Laboratory of Radiation Oncology, Shandong Academy of Medical Sciences, Jinan 250117, China | yinyongsd@yahoo.com.cn | | LIU Tong-hai | Department of Radiation Oncology, Shandong Cancer Hospital, Shandong Provincial Key Laboratory of Radiation Oncology, Shandong Academy of Medical Sciences, Jinan 250117, China | | | CHEN Jin-hu | Department of Radiation Oncology, Shandong Cancer Hospital, Shandong Provincial Key Laboratory of Radiation Oncology, Shandong Academy of Medical Sciences, Jinan 250117, China | | | SONG Jin-long | Department of Radiation Oncology, Shandong Cancer Hospital, Shandong Provincial Key Laboratory of Radiation Oncology, Shandong Academy of Medical Sciences, Jinan 250117, China | | | LU Jie | Department of Radiation Oncology, Shandong Cancer Hospital, Shandong Provincial Key Laboratory of Radiation Oncology, Shandong Academy of Medical Sciences, Jinan 250117, China | | | MA Chang-sheng | Department of Radiation Oncology, Shandong Cancer Hospital, Shandong Provincial Key Laboratory of Radiation Oncology, Shandong Academy of Medical Sciences, Jinan 250117, China | | | SUN Tao | Department of Radiation Oncology, Shandong Cancer Hospital, Shandong Provincial Key Laboratory of Radiation Oncology, Shandong Academy of Medical Sciences, Jinan 250117, China | | | BAI Tong | Department of Radiation Oncology, Shandong Cancer Hospital, Shandong Provincial Key Laboratory of Radiation Oncology, Shandong Academy of Medical Sciences, Jinan 250117, China | |
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| Abstract:: |
| Purpose To investigate the dosimetric differences among RapidArc (RA) plans which were designed on different target volumes in hepatocellular carcinoma (HCC).Methods A total of 10 HCC patients underwent 3D-CT scan under free breathing (FB), end inspiration hold (EIH) associated with active breath coordinator (ABC) and 4D-CT scan. The 4D-CT were sorted into 10 sets of CT images according to respiratory cycle. The gross tumor volume (GTV) was manually contoured on different CT images. The individual internal gross target volume (IGTV1) was obtained from 4D-CT, and the individual margins from GTVFB to IGTV1. IGTV2 were obtained from GTVFB using individual margins. The planned target volumes (PTV-1, PTV-2, PTV-3 and PTV-4) were obtained from GTVFB, IGTV1, IGTV2 and GTVEIH applying different margins. The RA plans (RA1, RA2, RA3 and RA4) were designed from different PTVs, and for RA1, RA2 and RA3 the simple 358° arc were used,while three 135° arcs were used for RA4.The dosimetric differences were compared. Results The PTV-1 and PTV-3 were larger than PTV-2 and PTV-4; the mean values of PTV-1/PTV-2 and PTV-1/PTV-4 were 2.5 and 1.9, respectively. There were no significant differences in conformal index, homogeneity index, maximum dose, and minimum dose of PTV among 4 RA plans. The irradiation dose of normal liver of RA3 and RA4 were 8.23 Gy and 7.63 Gy respectively, both significantly lower than those of RA1 and RA2 (10.21 Gy, 9.62 Gy, χ2=10.68, P<0.05), and the V30 of RA3 and RA4 were 5.24% and 5.05% respectively, both significantly lower than those of RA1 and RA2 (7.76%, 6.12%, χ2=14.76, P<0.05). There were no significant differences in irradiation doses of stomach and duodenum among different plans.Conclusions Using 4D-CT or ABC technology with RapidArc in HCC can define the target volume accurately and achieve prefect dose distribution sparing more normal liver volume, compared to the traditional margins. 4D-CT and ABC play similar roles in sparing normal liver. |
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