| Liu Zhijie,Zhu Xiaodong,Yang Haiming,Fu Qingguo,Hong Chaoshan,Deng Ye,Yang Zujin,Yang Chaofeng,Rong Xianbing.The dosimetric comparison of different craniospinal irradiation plans and impact of setup error on target dose distribution[J].Chinese Journal of Radiological Medicine and Protection,2014,34(7):526-529,558 |
| The dosimetric comparison of different craniospinal irradiation plans and impact of setup error on target dose distribution |
| Received:October 25, 2013 |
| DOI：10.3760/cma.j.issn.0254-5098.2014.07.012 |
| KeyWords:Craniospinal irradiation Dosimetry Setup errors Radiotherapy |
| FundProject: |
| Author Name | Affiliation | E-mail | | Liu Zhijie | Department of Radiation Oncology, Tumor Hospital of Guangxi Medical University, Guangxi 530021, China | | | Zhu Xiaodong | Department of Radiation Oncology, Tumor Hospital of Guangxi Medical University, Guangxi 530021, China | zhuxiaodong83@163.com | | Yang Haiming | Department of Radiation Oncology, Tumor Hospital of Guangxi Medical University, Guangxi 530021, China | | | Fu Qingguo | Department of Radiation Oncology, Tumor Hospital of Guangxi Medical University, Guangxi 530021, China | | | Hong Chaoshan | Department of Radiation Oncology, Tumor Hospital of Guangxi Medical University, Guangxi 530021, China | | | Deng Ye | Department of Radiation Oncology, Tumor Hospital of Guangxi Medical University, Guangxi 530021, China | | | Yang Zujin | Department of Radiation Oncology, Tumor Hospital of Guangxi Medical University, Guangxi 530021, China | | | Yang Chaofeng | Department of Radiation Oncology, Tumor Hospital of Guangxi Medical University, Guangxi 530021, China | | | Rong Xianbing | Department of Radiation Oncology, Tumor Hospital of Guangxi Medical University, Guangxi 530021, China | |
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| Abstract:: |
| Objective To make a dosimetric comparison of different craniospinal irradiation (CSI) plans and to explore the impacts of setup error on target dose distribution.Methods Five radiotherapy plans[2D-conventional,single filed 3D(3D-1),three fields 3D(3D-3),IMRT and electron] were made from 9 patients' CT images, who received CSI from July 2011 to October 2012. The target coverage (V95), hot spot(V107), maximum dose (Dmax), conformal index (CI) and dose homogeneity index (HI) of the target of each plan were compared. The volume of thyroid, heart, lungs, small intestine, kidney and normal tissue irradiated by 5,15,25 Gy were observed. The setup errors of the three treatment centers(head, upper spinal, lower spinal) per week were recorded and the treatment centers of the five plan in the week were moved according to the collected data to make a new plan, then the comparison of the target doses with the original plans were performed. Results The V95 of electron was lower than the other groups (q=11.2-11.7,P<0.05), the difference between the rest of the group was not statistically significant (q=0.00-0.01,P> 0.05). IMRT had the smallest V107 (q=4.3-11.6,P<0.05), followed by the 3D-3 (q=4.3-7.1,P<0.05), 2D had the largest Dmax (q=2.4-2.7,P<0.05). The differences from HI in each group was not statistically significant.CIs from high to low were IMRT> 3D-3> 2D, 3D-1 and electron (q=7.1-14.3, 7.1-9.6, 0.00-0.01, P<0.05). IMRT and electron could significantly reduce the volume irradiated by 15 Gy and 25 Gy and 3D-3 was the second. However, compared with 2D and 3D-1, there were 5 Gy irradiation volume increased in 3D-3 and IMRT. When setup errors were taken into account, there was the smallest difference between the dose distribution of 3D-1, 3D-3 and the original plan(q=2.8-4.1,P<0.05). Conclusions For those spinal cord depth<4.5 cm, electron could be regarded as a kind of safe and reliable way of CSI. Although the CI of 3D-1 is slightly less, it still could be used as the choice of CSI with the trend of less being affected by setup errors and reducing low dose volume. While the 3D-3 and IMRT have better target dose distribution, the large volume of low dose region is a thought-provoking problem. |
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