TY - JOUR T1 - Lokal ileri evre serviks kanserlerinde yoğunluk ayarlı radyoterapi ve volumetrik ayarlı ark tedavinin dozimetrik karşılaştırılması TT - The dosimetric comparison of ıntensity modulated radiotherapy and volumetric arc therapy in locally advanced uterine cervix cancer AU - Sert, Fatma AU - Nalbant, Berna AU - Tavlayan, Emin AU - Olacak, Nezahat AU - Özsaran, Zeynep PY - 2018 DA - June DO - 10.19161/etd.414954 JF - Ege Journal of Medicine JO - EJM PB - Ege University WT - DergiPark SN - 1016-9113 SP - 82 EP - 87 VL - 57 IS - 2 LA - tr AB - Amaç: Radyokemoterapi lokal ileri evre serviks kanserinin tedavisinde standart yaklaşımdır. Amacımız, servikskanseri tedavisinde modern tekniklerden yoğunluk ayarlı radyoterapi (YART) ve volumetrik ark terapi (VMAT)tekniklerini dozimetrik olarak karşılaştırmaktır.Gereç ve Yöntem: Kliniğimizde tedavi edilmiş 10 lokal ileri evre serviks kanseri hastasının bilgisayarlı tomografi(BT)’leri kullanılmıştır. Hastalarda gross tümör hacmi (GTV), klinik tümör hacmi (CTVtm) ve lenf nodları (CTV lenfnodu) ve komşu risk altındaki organları konturlanmıştır. CTVtm ve CTV lenf nodlarına 1.5 cm sınır verilerek tedavihacimleri oluşturulmuştur. Total doz 50.4 Gy olacak şekilde günlük 1.8 Gy fraksiyon dozu ile tedavi planlamalarıyapılmıştır. İki teknik, Doz volüm histogramı, homojenite indeks (HI), konformite indeks (KI), monitör ünit (MU),segment sayısı değerlendirmeleri yapılmıştır.Bulgular: İnce bağırsak için, 40 Gy doz alan hacim yüzdeliğinin YART tekniğinde medyan değeri %14.24 iken,VMAT tekniğinde %11.28 olarak hesaplanmıştır (p=0.022). VMAT tekniğinde %12.39 olarak hesaplanan femurbaşları 30 Gy doz alan hacim değerleri, YART tekniğinde ortanca değeri %7.80 olarak bulunmuştur (p=0.007). VMATtekniği istatistiksel anlamlı seviye kısa sürede tamamlanırken, fraksiyon başına MU değeri anlamlı olarak fazlabulunmuştur. Her iki tedavi tekniğinin de HI ve KI değerleri açısından aralarında farklılık gösterilememiştir.Sonuç: Hasta konforuna ve cihaz performansına açısından VMAT tekniğinde kısa tedavi süresi avantaj olarakgörülmektedir. Kliniğimizin mevcut cihaz durumuna göre her iki tedavi modeli de kullanılabilir KW - Radyoterapi KW - YART KW - serviks kanseri KW - VMAT KW - delta-4 fantom. N2 - Aim: The standard treatment approach for locally advanced stage uterine cervix cancer is radio-chemotherapy. Newradiotherapy techniques provide appropriate dose distributions with maximum tumor dose and minimum organ at riskdoses. We aim to compare intensity modulated radiotherapy (IMRT) and volumetric arc therapy techniques in thecervix cancer treatment.Materials and Methods: Ten computed tomographies (CT) of treated patients were used. Gross tumor volume(GTV), clinical tumor volume (CTV) both for tumor and lymph nodes and organ at risks were contoured. Treatmentvolumes were created by adding 1.5 cm margins to CTV tumor and lymph nodes. Totally 50.4 Gy doses with 1.8 Gydaily fraction were applied. Two techniques were compared in terms of dose volume histograms, homogenity index(HI), conformity Index (CI), monitory unit (MU) and segment numbers.Results: For intestines, V40 Gy were 14.24% and 11.28% with IMRT and VMAT, respectively (p=0.022). For femoralheads, V30 Gy were 7.8% and 12.39% with IMRT and VMAT, respectively (p=0.007). The duration time of treatmentwas significantly short but MU value for each fraction was significantly high with VMAT technique. On the other hand,there could not find any difference in terms of HI and CI between two techniques.Conclusion: The shortness of treatment duration can be seen as an advantage in terms of both patient comfort andmachine performance in VMAT technique. IMRT and VMAT can be preferred for the treatment of locally advancedcervix cancer by taking into the conditions of our department. 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