Dosimetric study of different radiotherapy planning approaches for hippocampal avoidance whole-brain radiation therapy (HA-WBRT) based on fused CT and MRI imaging
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- 作者：Bu-Hai Wang ; Wei Hua ; Xiang Gu…
- 关键词：Whole brain radiotherapy ; 3 ; Dimensional conformal radiotherapy ; dIMRT ; RapidArc ; Hippocampus ; Dosimetry
- 刊名：Australasian Physical & Engineering Sciences in Medicine
- 出版年：2015
- 出版时间：December 2015
- 年：2015
- 卷：38
- 期：4
- 页码：767-775
- 全文大小：1,958 KB
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Wei Hua (1)
Xiang Gu (1)
Xiao-Lei Wang (2)
Jun Li (1)
Li-Qin Liu (1)
Yu-Xiang Huang (1)
1. Cancer Institute of Northern Jiangsu People’s Hospital, Yangzhou, 225000, Jiangsu Province, China
2. Department of Respiratory of Traditional Chinese Medicine Hospital of Kunshan, Suzhou, Jiangsu Province, China - 刊物主题：Biomedicine general; Biophysics and Biological Physics; Medical and Radiation Physics; Biomedical Engineering;
- 出版者：Springer Netherlands
- ISSN：1879-5447
文摘
The purpose of this study was to compare the dosimetric characteristics for hippocampal avoidance (HA) between the treatment plans based on fused CT and MRI imaging during whole brain radiotherapy (WBRT) pertaining to: (1) 3-dimensional conformal radiotherapy (3D-CRT), (2) dynamic intensity modulated radiation therapy (dIMRT), and (3) RapidArc for patients with brain metastases. In our study, HA was defined as hippocampus beyond 5 mm, and planning target volume (PTV) was obtained subtracting HA volume from the volume of whole brain. There were 10 selected patients diagnosed with brain metastases receiving WBRT. These patients received plans for 3D-CRT (two fields), dIMRT (seven non-coplanar fields) and RapidArc (dual arc). The prescribed dose 30 Gy in 10 fractions was delivered to the whole-brain clinical target volume of patients. On the premise of meeting the clinical requirements, we compared target dose distribution, target coverage (TC), homogeneity index (HI), dose of organs at risk (OARs), monitor units (MU) and treatment time between the above three radiotherapy plans. V90 %, V95 % and TC of PTV for 3D-CRT plan were lowest of the three plans. V90 %, V95 % and HI of PTV in RapidArc plan were superior to the other two plans. TC of PTV in RapidArc plan was similar with dIMRT plan (P > 0.05). 3D-CRT was the optimal plan in the three plans for hippocampal protection. The median dose (Dmedian) and the maximum doses (Dmax) of hippocampus in 3D-CRT were 4.95, 10.87 Gy, which were lowest among the three planning approaches (P < 0.05). Dmedian and Dmax of hippocampus in dIMRT were 10.68, 14.11 Gy. Dmedian and Dmax of hippocampus in RapidArc were 10.30 gGy, 13.92 Gy. These parameters of the last two plans pertain to no significant difference (P > 0.05). When WBRT (30 Gy,10F) was equivalent to single dose 2 Gy,NTDmean of hippocampus in 3D-CRT, dIMRT and RapidArc were reduced to 3.60, 8.47, 8.20 Gy2, respectively. In addition, compared with dIMRT, MU of RapidArc was reduced and the treatment time was shortened by nearly 25 %. All three radiotherapy planning approaches in our study can meet the clinical requirements of HA. Although TC in 3D-CRT was lowest, hippocampus was protected best by this plan. So many radiation fields and the design of non-coplanar fields lead to the complication of dIMRT. TC and HI in RapidArc were superior to the other two plans with the precise of meeting the clinical requirements. The difference in protection for hippocampus between dIMRT and RapidArc was statistically significant. In addition, RapidArc can remarkably reduce MU and the treatment time. Keywords Whole brain radiotherapy 3-Dimensional conformal radiotherapy dIMRT RapidArc Hippocampus Dosimetry