Comparison of Unblocked, Directionally Blocked and Full Blocked Plans in Helical Tomotherapy for Breast Cancer Radiotherapy

Journal of Nuclear Medicine and Radiation Therapy(2018)

Kanuni Research and Training Hospital Radiation Oncology | TC Ministry of Health Ankara Ataturk Training and Research Hospital | Adana City Hospital | Inonu University Turgut Ozal Medical Center | Karadeniz Technical University

Cited 0|Views12
Abstract
Introduction: The doses received by the contralateral breast, lung and heart either directionally or full blocked techniques in Hi-Art Tomotherapy systems in partial or whole breast radiotherapy has been studied. Method: In 20 breast cancer patients 3 plans with non-blocked, directionally blocked and full blocked methods were designed in Hi-Art planning system. In all planning method the dose received by the contralateral breast, the heart volume percentages V5 and V30 and the lung volume percentages V5 and V20 were compared. Results: The mean doses received by contralateral breast were 6.24 Gy (4.50-8.74 Gy) in unblocked group 3.85 Gy (2.08-5.81 Gy) in directionally blocked group and 0.99 Gy (0.69-1.39 Gy) in full blocked group. The mean Lung V5 values were 98% (79-100%) in unblocked group and it was 98% (91-100%) in directionally blocked group while it was 93% (89-97%) in full blocked group. The mean V20 values were 16% (7-23%), 20% (17-24%) and 22% (18-28%) in unblocked, directionally blocked and full blocked groups respectively. The mean Heart V5 value 100% (99-100%) in unblocked group, and it was 99% (85-100%) in directionally blocked group while it was 92% (73- 100%) in full blocked group. The mean V30 values were 11% (2-25%), 6% (0-12%) and 9% (1-22%) in unblocked, directionally blocked and full blocked groups respectively. The mean beam-on time was 261.6 s (237.6-318.2) for unblocked, 277.9 s (237.6-338.5) for directionally blocked and 314.2 s (272.6-429.1) full blocked group. The mean numbers of MUs were 3712 (3353-4536) for unblocked, 3951 (3357-4834) for directionally blocked and 4506 (3866- 6168) for full blocked group. In full blocked group both beam on time and MU values were higher. Conclusion: We propose that further efforts needed to reduce low dose volumes to normal tissues, meanwhile when using directionally and full blocked plans all parameters should be considered together.
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要点】:本文对比了在螺旋断层放疗中采用无遮挡、方向性遮挡和完全遮挡计划对乳腺癌放疗中对正常组织的影响,提出在考虑放疗计划时应综合考虑各参数以减少对正常组织的低剂量辐射。

方法】:研究对20名乳腺癌患者设计了三种放疗计划(无遮挡、方向性遮挡和完全遮挡),在Hi-Art规划系统中比较了每种计划对对侧乳腺、心脏和肺的剂量影响。

实验】:实验中比较了各组计划对侧乳腺的平均剂量、心脏和肺的V5和V20值,以及治疗时的照射时间和Monitor Units(MU)数。结果显示,完全遮挡组对侧乳腺的平均剂量最低,但照射时间和MU数最高。结论建议在制定放疗计划时需综合考虑各项参数。数据集为20名乳腺癌患者的放疗计划数据。