The Journal of the Korea Contents Association (한국콘텐츠학회논문지)

The Korea Contents Association (한국콘텐츠학회)
권호 표지
DOI QR코드

DOI QR Code

Radiation Treatment Planning Evaluation by Internal Target Volume Settings

내부표적체적 설정을 통한 방사선치료계획 평가

  • 박호춘 (동신대학교 방사선학과) ;
  • 한재복 (동신대학교 방사선학과) ;
  • 최남길 (동신대학교 방사선학과)
  • Received : 2015.02.23
  • Accepted : 2015.07.03
  • Published : 2015.08.28
Download PDF
⟨ Previous Next ⟩

Abstract

The study was conducted targeting 25 patients who underwent the respiratory gated radiation therapy in the abdominal region at Radiation Oncology of a University Hospital from December 2013 to June 2014 and types of cancer included liver(64%), CBD(8%), gastric(8%), GB(8%), pancreas(8%), SMA(4%). The means of ITV and PTV volume are 471.44 cm3 and 425.48 cm3, showing an increase in volume. Normal tissue volume was also found to have increased due to the increase of the section selected from PTV section to ITV section. Right kidney showed a significant increase in differences between increase in normal tissue volume, increase in target volume and increase in therapy irradiation area and difference between the means of dose applied to normal tissue. There was no significant difference in the mean dose applied to normal tissue according to the respiratory average. Both kidneys showed a significant difference in the difference between mean doses of target moving and normal tissue. In this study, both therapy methods through PTV section and ITV section volume setting were appropriate for protection doses of normal tissue and distributed over 95% of the prescribed dose and therefore, it is considered to be okay to be optionally used depending on the patient's therapeutic purpose. But in order to minimize the unexpected side effect, the plan of PTV section and ITV section should be established and used by evaluating normal tissue protection dose.

본 연구에서는 내부표적체적을 통한 방사선치료계획을 분석하여 호흡연동방사선치료에 주로 이용되는 호기상태의 치료계획체적과 비교 분석하여 정상조직이 받은 선량을 알아보았다. 2013년 12월부터 2014년 6월까지 모 대학교병원 방사선종양학과에서 복부부위에 호흡연동방사선치료를 받은 환자 25명을 대상으로 하였으며, 암의 종류는 liver(64%), CBD(8%), gastric(8%), GB(8%), pancreas(8%), SMA(4%)이었다. ITV와 PTV 체적의 평균치는 $471.44cm^3$, $425.48cm^3$ 로 체적의 증가를 알 수 있었고, PTV구간에서 ITV구간으로 선택한 구간의 증가로 인해 정상조직체적 또한 증가함을 알 수 있었다. 그리고 정상조직체적의 증가, target volume 증가, 치료조사야 면적증가의 차이와 정상조직이 받은 선량평균치의 차이에서는 right kidney가 유의한 증가를 보였다. 호흡평균치에 따른 정상조직이 받은 선량평균치의 차이는 없었고 target moving과 정상조직의 선량평균치의 차이에서는 both kidney가 유의한 차이를 나타내었다. 결론적으로 PTV구간과 ITV구간 체적 설정을 통한 치료방법이 모두 정상조직의 보호선량에 적합하였으며, 처방선량의 95% 이상이 분포하였으므로 환자의 치료목적에 따라 선택적으로 사용되어도 무방할 것이라 사료된다.

Keywords

References

  1. Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2011 Cancer Res Treat, Vol.46, No.2, 2014.
  2. 김용배, 서창옥, "Evolution of Radiotherapy: High-precision Radiotherapy," J Korean Med, Vol.51, No.7, 2008.
  3. 김종훈, "LINAC-based High-precision Radiotherapy: Radiosurgery, Image-guided Radiotherapy, and Respiratory-gated Radiotherapy," Vol.51, No.7, 2008.
  4. 동경래, 박병수, 김새싹, "Target motion analysis of the respiratorygated guided radiotherapy in liver cancer patients using 4D-CT", 대한방사선방어학회, pp.63-68, 2010.
  5. A. J. Cole, G. G. Hanna, and S. Jain, "Motion Management for Radical Radiotherapy in Non-small Cell Lung Cancer," Clinical Oncology, No.26, 2014.
  6. htttp://www.varian.com/us/oncology
  7. Tomoki Kimura, Ikuno Nishibuchi, and Yuji Murakami, "Functional mage-Guided Radiotherapy Planning in Respiratory-GatedIntensity-Modulated Radiotherapy for Lung Cancer Patients With Chronic Obstructive Pulmonary Disease," Int. J. Radiation Oncology Biol. Phys, Accepted for publication Aug 5, 2011.
  8. Chrlie C. Pan, Brian D. Kavanagh, and Laura. Dawson, "Radiation-Associated Liver Injury," Int. J. Radiation Oncology Biol. Phys, Vol.76, No.3, 2010.
  9. Lawrence B. Marks, Ellen D. Yorke, and Andrw Jackson, "Use od Normal Tissue Complication Probability Models in the Clinic," Int. J. Radiation Oncology Biol. Phys, Vol.76, No.3, 2010.
  10. 송주영, 호흡연동 방사선치료를 위한 측정기술 개발, 교육과학기술부, 2009.
  11. Mian Xi, Meng-Zhong Liu, Li Zhang, and Qiao-Qiao Li, "How many sets of 4DCT images are sufficient to determine internal target volume for liver radiotherapy?," Radiotherapy and Oncology, Vol.92, 2007.
  12. Mian Xi, Meng-Zhong Liu, and Xiao-Wu, "Defining internal target volume (ITV) for hepatocellular carcinoma using four-dimensional CT," Radiotherapy and Oncology, Vol.84, No.3, 2007.
  13. Determination of Internal Target Volume for Radiation Treatment Planning of Esophageal Cancer by Using 4-Dimensional Computed Tomography(4DCT)," Int J Radiation Oncol Biol Phys, Vol.90, No.1, pp.102-109, 2014. https://doi.org/10.1016/j.ijrobp.2014.05.015
  14. 김영재, "Evaluation on Usefulness of Applying Body-fix to Four Dimensional Radiation Therapy", 한국콘텐츠학회논문지, Vol.13, No.10, pp.419-426, 2013. https://doi.org/10.5392/JKCA.2013.13.10.419