한국의학물리학회지:의학물리 (Progress in Medical Physics)

  • 제25권2호
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  • Pages.110-115
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  • 2014
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  • 2508-4445(pISSN)
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  • 2508-4453(eISSN)
한국의학물리학회 (Korean Society of Medical Physics)
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원발성 폐암에서 정위적 체부 방사선치료의 빔 배열에 따른 선량분포의 비교

Comparison of the Dose Distributions with Beam Arrangements in the Stereotactic Body Radiotherapy (SBRT) for Primary Lung Cancer

  • 예지원 (영남대학교 의과대학 방사선종양학교실)
  • Yea, Ji Woon (Department of Radiation Oncology, Yeungnam University College of Medicine)
  • 투고 : 2014.04.30
  • 심사 : 2014.06.02
  • 발행 : 2014.06.30
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초록

원발성 폐암의 정위적 체부 방사선치료(Stereotatic Body Radiation Therapy; SBRT)시에, 종양주위의 빔 배열을 균등하게 한 $360^{\circ}$회전각도(Equally angles; EA)와 종양주위의 빔 배열을 부분각도(Partially angles; PA)로 배열한 치료계획의 선량차이를 확인하기 위하여, 세기조절방사선치료(Intensity-modulated radiation therapy, IMRT)와 체적변조회전치료(Volumetric-modulated arc therapy, VMAT)의 종양의 선량, 동측 폐의 선량, 반대측 폐의 선량, 손상위험장기(Organ at risk, OAR)의 선량, 치료효율 등을 비교분석 하였다. 12명의 환자에서 각각 4종류($IMRT_{EA}$, $IMRT_{PA}$, $VMAT_{EA}$, $VMAT_{PA}$)의 치료계획을 생성하였으며, 처방선량은 총 선량 60 Gy, 4회 분할치료로 표적체적 95%에 대해 100% 선량이 포함되게 하였다. IMRT와 VMAT의 치료계획 평가에서 $360^{\circ}$회전각도의 빔 균등배열과 부분각도 빔 배열에서 변수중 선량일치지수, 균질성지수, 고선량 유출, $D_{2cm}$, $R_{50}$은 빔 배열에 따라 크게 차이가 나지 않았다. 또한 손상위험장기인 척수, 기관지, 식도의 최고선량은 각각의 방법에 따라 차이를 나타내었다. 특히 $HDS_{location}$에서 21.63%와 26.46%의 큰 차이를 나타내었다.

To compare 2 beam arrangements, circumferential equally angles (EA) beams or partially angles (PA) beams for stereotactic body radiation therapy (SBRT) of primary lung cancer for intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) delivery techniques with respect to target, ipsilateral lung, contralateral lung, and organs-at-risk (OAR) dose-volume metrics, as well as treatment delivery efficiency. Data from 12 patients, four treatment plans were generated per data sets ($IMRT_{EA}$, $IMRT_{PA}$, $VMAT_{EA}$, $VMAT_{PA}$). The prescribed dose (PD) was 60 Gy in 4 fractions to 95% of the planning target volume (PTV) for a 6-MV photon beam. When compared with the IMRT and VMAT treatment plan for 2 beams, conformity index, homogeneity index, high dose spillage, D2 cm (Dmax at a distance ${\geq}2cm$ beyond the PTV), R50 (ratio of volume circumscribed by the 50% isodose line and the PTV), resulted in similar. But Dmax of the Organ at risk (OAR), spinal cord, trachea, resulted in differ between four treatment plans. Especially $HDS_{location}$ showed big difference in 21.63% vs. 26.46%.

키워드

참고문헌

  1. Robert D, Timmerman MD, Brain D, et al: Stereotactic Body Radiation Therapy in Multiple Organ Sites. Journal of Clinical Oncology 25:947-52 (2007) https://doi.org/10.1200/JCO.2006.09.7469
  2. Oh SA, Kang MK, Kim SK, Yea JW: Comparison of IMRT and VMAT techniques in spine stereotactic radiosurgery with international spine radiosurgery consortium consensus guidelines. Prog Med Phys 24(3):145-153 (2013) https://doi.org/10.14316/pmp.2013.24.3.145
  3. Lim DH, YI BY, Mirmiran A, et al: Optimal beam arrangement for stereotactic body radiation therapy delivery in lung tumors. Acta Oncologica 49:219-224 (2010) https://doi.org/10.3109/02841860903302897
  4. Mara WR, Catherine MK, Kelly MPC, et al: Circumferential or sectored beam arrangements for stereotactic body radiation therapy (SBRT) of primary lung tumors: Effect on target and normal-structure dose-volume metrics. Med Dos 38:407-412 (2013) https://doi.org/10.1016/j.meddos.2013.05.002
  5. Robert T, Rebecca P, James G, et al: Stereotactic Body Radiation Therapy for Inoperable Early Stage Lung Cancer, JAMA 303(11):1070-1076 (201)
  6. Nagata Y, Takayama K, Matsuo Y, et al: Clinical outcomes of a phase I/II study of 48 Gy of stereotactic body radiotherapy in 4 fractions for primary lung cancer using a stereotactic body frame. Int J Radiat Oncol Biol Phys 63(5):1427-1431 (2005) https://doi.org/10.1016/j.ijrobp.2005.05.034
  7. Timmerman R, Galvin J, Michalski J, et al: Accreditation and quality assurance for Radiation Therapy Oncology Group: multicenter clinical trials using stereotactic body radiation therapy in lung cancer. Acta Oncol 45(7):779-786 (2006) https://doi.org/10.1080/02841860600902213
  8. Dirk De R, Corinne FF, Ursula N, et al: European Organization for Research and Treatment of Cancer Recommendations for Planning and Delivery of High-Dose, High-Precision Radiotherapy for Lung Cancer. 28(36):5301-5310 (2010)
  9. RTOG 0813: Seamless Phase I/II Study of Stereotactic Lung Radiotherapy (SBRT) for Early Stage, Centrally Located, Non-Small Cell Lung Cancer (NSCLC) in Medically Inoperable Patients. http://www.rtog.org/ClinicalTrials/ProtocolTable/StudyDetails.aspx?study=0813.
  10. RTOG 0915: A randomized phase II study comparing 2 stereotactic body radiation therapy (SBRT) schedules for medically inoperable patients with stage I peripheral non-small cell lung cancer. http://www.rtog.org/ClinicalTrials/ProtocolTable/StudyDetails.aspx?study=0915.
  11. Benedict SH, Yenice KM, Followill D, et al: Stereotactic body radiation therapy: The report of AAPM task group 101. Med Phys 37:4078-101 (2010) https://doi.org/10.1118/1.3438081
  12. Oh SA, Kang MK, Yea JW, Kim SH, Kim KH, Kim SK: Comparison of intensity modulated radiation therapy dose calculations with a PBC and AAA algorithms in the lung cancer. Korea J Med Phys 23:48-53 (2012)
  13. Feuvret L, Noel G, Mazeron JJ, Bey P: Conformity index: a review. Int J Radiat Oncol Biol Phys 64:333-342 (2006) https://doi.org/10.1016/j.ijrobp.2005.09.028
  14. Ong CL, Verbakel WF, Cuijpers JP, et al: Stereotactic radiotherapy for peripheral lung tumors: A comparison of volumetric modulated arc therapy with 3 other delivery techniques Radiother Oncol 97:437-42 (2010) https://doi.org/10.1016/j.radonc.2010.09.027
  15. Holt A, van Vliet-Vroegindeweij C, Mans A, et al: Volumetric-Modulated Arc Therapy for Stereotactic body radiotherapy of lung tumors: A comparison with intensity-modulated radiotherapy techniques. Int J Radiat Oncol Biol Phys 81:1560-7 (2011) https://doi.org/10.1016/j.ijrobp.2010.09.014

피인용 문헌

  1. Texture analysis on the edge-enhanced fluence of VMAT vol.10, pp.None, 2014, https://doi.org/10.1186/s13014-015-0382-z
  2. Dosimetric effects of roll rotational setup errors on lung stereotactic ablative radiotherapy using volumetric modulated arc therapy. vol.88, pp.1055, 2015, https://doi.org/10.1259/bjr.20140862