- 作者：Mete Yeginer Ph.D.‡ ; ; John C. Roeske Ph.D.§ ; ; James A. Radosevich Ph.D.‡ ; ; Bulent Aydogan Ph.D.* ; † ; ; baydogan@radonc.bsd.uchicago.edu
- 刊名：International Journal of Radiation Oncology*Biology*Physics
- 出版年：2011
- 出版时间：15 March 2011
- 年：2011
- 卷：79
- 期：4
- 页码：1256-1265
- 全文大小：1252 K
Purpose
To investigate the dosimetric feasibility of linear accelerator-based intensity-modulated total marrow irradiation (IM-TMI) in patients with hematologic malignancies.Methods and Materials
Linear accelerator-based IM-TMI treatment planning was performed for 9 patients using the Eclipse treatment planning system. The planning target volume (PTV) consisted of all the bones in the body from the head to the mid-femur, except for the forearms and hands. Organs at risk (OAR) to be spared included the lungs, heart, liver, kidneys, brain, eyes, oral cavity, and bowel and were contoured by a physician on the axial computed tomography images. The three-isocenter technique previously developed by our group was used for treatment planning. We developed and used a common dose–volume objective method to reduce the planning time and planner subjectivity in the treatment planning process.
Results
A 95 % PTV coverage with the 99 % of the prescribed dose of 12 Gy was achieved for all nine patients. The average dose reduction in OAR ranged from 19 % for the lungs to 68 % for the lenses. The common dose–volume objective method decreased the planning time by an average of 35 % and reduced the inter- and intra- planner subjectivity.
Conclusion
The results from the present study suggest that the linear accelerator-based IM-TMI technique is clinically feasible. We have demonstrated that linear accelerator-based IM-TMI plans with good PTV coverage and improved OAR sparing can be obtained within a clinically reasonable time using the common dose–volume objective method proposed in the present study.