LAN Yu-ling,FENG Lin-chun,WANG Yun-lai,CAI Bo-ning,GE Rui-gang,DAI Xiang-kun,XIE Chuan-bin,GONG Han-shun.Dosimetric evaluation of three techniques in postoperative radiotherapy for rectal cancer[J].Chinese Journal of Radiological Medicine and Protection,2012,32(6):616-620
Dosimetric evaluation of three techniques in postoperative radiotherapy for rectal cancer
Received:April 23, 2012  
DOI:10.3760/cma.j.issn.0254-5098.2012.06.014
KeyWords:Helical tomotherapy  Intensity-modulated radiation therapy  Three-dimensional conformal radiation therapy  Rectal neoplasms/radiotherapy  Dosimetry
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Author NameAffiliationE-mail
LAN Yu-ling Department of Radiation Oncology, People’s Liberation Army General Hospital, Beijing 100853, China  
FENG Lin-chun Department of Radiation Oncology, People’s Liberation Army General Hospital, Beijing 100853, China 301flc@163.com 
WANG Yun-lai Department of Radiation Oncology, People’s Liberation Army General Hospital, Beijing 100853, China  
CAI Bo-ning Department of Radiation Oncology, People’s Liberation Army General Hospital, Beijing 100853, China  
GE Rui-gang Department of Radiation Oncology, People’s Liberation Army General Hospital, Beijing 100853, China  
DAI Xiang-kun Department of Radiation Oncology, People’s Liberation Army General Hospital, Beijing 100853, China  
XIE Chuan-bin Department of Radiation Oncology, People’s Liberation Army General Hospital, Beijing 100853, China  
GONG Han-shun Department of Radiation Oncology, People’s Liberation Army General Hospital, Beijing 100853, China  
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Abstract::
      Objective To evaluate the dosimetric characteristics of helical tomotherapy (HT), intensity-modulated radiation therapy (IMRT) and three-dimensional conformal radiation therapy (3D-CRT) for postoperative radiotherapy of rectal cancer. Methods Ten male patients with stage Ⅱ or Ⅲ middle or low position rectal cancer were selected retrospectively. All of the 10 patients underwent Dixon surgery and CT simulation orientation. The target volumes and normal organs were drawn in the CT images and the plans for HT, IMRT and 3D-CRT were designed. The prescribed dose was given 50 Gy in 25 fractions, covering at least 95% of the planning target volume. Results All plans met the needs of the prescribed doses. The HT and IMRT plans met the needs of dose limit to organs at risk, however, the 3D-CRT plans failed to do that. The conformity indexes of HT, IMRT and 3D-CRT plans were 0.86, 0.82 and 0.62, respectively(F=206.81,P<0.001), and the homogeneity indexes were 0.001, 0.157, and 0.205, respectively (χ2=15.8,P<0.001). The 3D-CRT plans had larger volumes than the HT plans and IMRT plans in the high-dose regions such as pelvic V50, bladder V40, bowel V50 and femoral head D5(P<0.05), but the differences between the HT plans and IMRT plans were not statistically significant (P>0.05). The V15 value of bowel of HT plans were higher than those of the IMRT and 3D-CRT plans (71.1% vs. 63.3% and 67.7%, respectively). However, there was no significantly difference. Conclusions All of the HT, IMRT and 3D-CRT plans are able to meet the prescription dose requirement of the target regions of rectal cancer. The HT plans show the best dose homogeneity and target conformity, followed by the IMRT plans, and then the 3D-CRT plans. The HT plans meet the needs of all OARs slightly better than the IMRT plans. 3D-CRT plans are simple and practical with poor protective ability toward the OARs.
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