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Mide Kanserinde Adjuvan Radyoterapide Kullanılan Planlama Tekniğine Göre Kritik Organ Dozlarının Karşılaştırılması

Year 2020, Volume: 10 Issue: 2, 145 - 151, 01.08.2020

Alaettin Arslan Burak Şengül

Abstract

Amaç: Radyoterapi (RT), lokal ileri evre mide kanseri tanılı hastalarda uygulanan adjuvan tedavilerden biridir. Operasyon sebebiyle hem normal anatominin bozulmuş olması hem de yaygın lenf ağı nedeniyle RT planlaması oldukça zordur. Bu çalışmada farklı RT teknikleri kullanılarak hedef volüm değerlerinin uygunluğu ile kritik organların aldığı dozların karşılaştırılması amaçlanmıştır.
Materyal ve Metot: Adjuvan RT almış 10 hastanın planlama için çekilmiş olan bilgisayarlı tomografi (BT) görüntüleri retrospektif olarak değerlendirildi. Kontrastlı ve kontrastsız BT görüntülerden yararlanarak üç boyutlu konformal RT (3B-KRT), yoğunluk ayarlı RT (YART) ve volümetrik ark tedavisi (VMAT) planları yeniden yapıldı. Planlanan hedef volümün (PTV) %95’inin, dozun %95’ini alması hedeflendi. Üç ayrı teknikle yapılan planlamalar sonucu PTV değerleri ve kritik organ dozları istatistiksel olarak karşılaştırıldı.
Bulgular: D %2 (maksimuma yakın doz) ve D %98 (minimuma yakın doz) parametreleri YART ve VMAT tekniklerinde 3B-KRT’ye göre doz dağılımında daha iyi bulundu (p<0,05). Monitor unit (MU) değeri ise 3B-KRT’de YART ve VMAT tekniklerine göre düşük bulundu (p<0,05). Kritik organ dozlarının karşılaştırılmasında, spinal kord dozlarında teknikler arasında bir fark gözlenmedi (p>0,05). Karaciğerin aldığı dozlar YART ve VMAT tekniklerinde, 3B-KRT’den daha düşük bulundu (p<0,05). Sol böbrek dozlarında da YART ve VMAT, 3B-KRT tekniğine göre daha düşük doz sonuçları verdi (p<0,05). Body V5 volümü 3B-KRT’de diğer iki tekniğe kıyasla daha düşük bulundu (p<0,05).
Sonuç: Teknikler karşılaştırıldığında kritik organ dozlarında YART ve VMAT, 3B-KRT’ye göre daha uygun sonuçlar vermiştir. Body V5 volümü ile MU değerlerinde ise 3B-KRT üstün bulunmuştur

Keywords

mide kanseri adjuvan radyoterapi kritik organ dozları

References

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  • 2. Sano T. Gastric cancer: Asia and the world. Gastric Cancer 2017;20:1–2.
  • 3. Jiang F, Shen X. Current prevalence status of gastric cancer and recent studies on the roles of circular RNAs and methods used to investigate circular RNAs. Cell Mol Biol Lett 2019;24:53.
  • 4. Moehler M, Lyros O, Gockel I, Galle PR, Lang H. Multidisciplinary management of gastric and gastroesophageal cancers. World J Gastroenterol 2008;14:3773–80.
  • 5. Solomon NL, Cheung MC, Byrne MM, Zhuge Y, Franceschi D, Livingstone AS, et al. Does chemoradiotherapy improve outcomes for surgically resected adenocarcinoma of the stomach or esophagus? Ann Surg Oncol 2010;17:98–108.
  • 6. Songun I, Putter H, Kranenbarg EM, Sasako M, van de Velde CJ. Surgical treatment of gastric cancer:15-year follow-up results of the randomised nationwide Dutch D1D2 trial. Lancet Oncol 2010;11:439–49.
  • 7. Macdonald JS, Smalley S, Benedetti J, Hundahl SA, Estes NC, Stemmermann GN, et al. Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med 2001;345:725–30.
  • 8. Smalley S, Gunderson L, Tepper J, Martenson JA Jr, Minsky B, Willett C, et al. Gastric surgical adjuvant radiotherapy – rationale and treatment implementation. Int J Rad Oncol Biol Phys 2002;52:283–93.
  • 9. Hawrylewicz L, Leszczyński W, Namysł-Kaletka A, Bronclik I, Wydmański J. Protection of organs at risk during neoadjuvant chemoradiotherapy for gastric cancer based on a comparison between conformal and intensitymodulated radiation therapy. Oncol Lett 2016;12:692–8.
  • 10. Liu GF, Bair RJ, Bair E, Liauw SL, Koshy M. Clinical outcomes for gastric cancer following adjuvant chemoradiation utilizing intensity modulated versus three-dimensional conformal radiotherapy. PLoS One 2014;9:e82642.
  • 11. Chopra S, Agarwal A, Engineer R, Dora T, Thomas B, Sonawone S, et al. Intensity modulated radiation therapy (IMRT) is not superior to threedimensional conformal radiation (3DCRT) for adjuvant gastric radiation: a matched pair analysis. J Cancer Res Ther 2015;11:623–9.
  • 12. Ren F, Li S, Zhang Y, Zhao Z, Wang H, Cui Y, et al. Efficacy and safety of intensity-modulated radiation therapy versus threedimensional conformal radiation treatment for patients with gastric cancer: a systematic review and meta-analysis. Rad Oncol 2019;14:84.
  • 13. Li Z, Zeng J, Wang Z, Zhu H, Wei Y. Dosimetric comparison of intensity modulated and volumetric arc radiation therapy for gastric cancer. Oncol Lett 2014;8:1427–34.
  • 14. Zhang T, Liang ZW, Han J, Bi JP, Yang ZY, Ma H. Doublearc volumetric modulated therapy improves dose distribution compared to static gantry IMRT and 3D conformal radiotherapy for adjuvant therapy of gastric cancer. Rad Oncol 2015;19:114.
  • 15. Mondlane G, Gubanski M, Lind PA, Ureba A, Siegbahn A. Comparison of gastric-cancer radiotherapy performed with volumetric modulated arc therapy or single-field uniform-dose proton therapy. Acta Oncol 2017;56:832–8.
  • 16. Allal AS, Zwahlen D, Bründler MA, de Peyer R, Morel P, Huber O, et al. Neoadjuvant radiochemotherapy for locally advanced gastric cancer: Long-term results of a phase I trial. Int J Radiat Oncol Biol Phys 2005;63:1286–9.
  • 17. Öksüz DÇ. Mide Kanserinde Radyoterapi. Türkiye Klinikleri J Gen Surg-Special Topics 2013;6:120–5.
  • 18. Tahir Ç, Gökhan Y, Taylan T. Dosimetric Comparison of 3D-Conformal and IMRT Radiotherapy Techniques in Gastric Cancer. East J Med 2019;24:299–302.
  • 19. Zygogianni A, Fotineas A, Platoni K, Patatoukas G, Dilvoi M, Antypas C, et al. A five split-field three dimensional conformal technique versus an anterior-posterior on in postoperative radiotherapy for gastric carcinoma: a multicenter comparative study using quality of life measurements as well as clinical and dosimetric parameters. JBUON 2018;23:1020–8.
  • 20. Sharfo AWM, Stieler F, Kupfer O, Heijmen BJM, Dirkx MLP, Breedveld S, et al. Automated VMAT planning for postoperative adjuvant treatment of advanced gastric cancer. Rad Oncol 2018;13:74.
  • 21. Kucuktulu E, Yurekli AF, Topbas M, Kece C, Guner A, Kucuktulu U. Comparisons between the Dosimetric and Clinical Outcomes of Tomotherapy and 3D Conformal Radiotherapy in Gastric Cancer Treatment. Asian Pac J Cancer Prev 2019;20:595–9.
  • 22. Onal C, Dölek Y, Akkuş Yıldırım B. Dosimetric comparison of 3-dimensional conformal radiotherapy, volumetric modulated arc therapy, and helical tomotherapy for postoperative gastric cancer patients. Jpn J Radiol 2018;36:30–9.
  • 23. Ma H, Han J, Zhang T, Ke Y. Comparison of dosiology between three dimensional conformal and intensity-modulated radiotherapies (5 and 7 fields) in gastric cancer post-surgery. J Huazhong Univ Sci Tech Med Sci 2013;33:759–64.

Year 2020, Volume: 10 Issue: 2, 145 - 151, 01.08.2020

Alaettin Arslan Burak Şengül

Abstract

References

  • 1. Siegel R, Ma J, Zou Z, Jemal A. Cancer statistics, 2014. CA Cancer J Clin 2014;64:9.
  • 2. Sano T. Gastric cancer: Asia and the world. Gastric Cancer 2017;20:1–2.
  • 3. Jiang F, Shen X. Current prevalence status of gastric cancer and recent studies on the roles of circular RNAs and methods used to investigate circular RNAs. Cell Mol Biol Lett 2019;24:53.
  • 4. Moehler M, Lyros O, Gockel I, Galle PR, Lang H. Multidisciplinary management of gastric and gastroesophageal cancers. World J Gastroenterol 2008;14:3773–80.
  • 5. Solomon NL, Cheung MC, Byrne MM, Zhuge Y, Franceschi D, Livingstone AS, et al. Does chemoradiotherapy improve outcomes for surgically resected adenocarcinoma of the stomach or esophagus? Ann Surg Oncol 2010;17:98–108.
  • 6. Songun I, Putter H, Kranenbarg EM, Sasako M, van de Velde CJ. Surgical treatment of gastric cancer:15-year follow-up results of the randomised nationwide Dutch D1D2 trial. Lancet Oncol 2010;11:439–49.
  • 7. Macdonald JS, Smalley S, Benedetti J, Hundahl SA, Estes NC, Stemmermann GN, et al. Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med 2001;345:725–30.
  • 8. Smalley S, Gunderson L, Tepper J, Martenson JA Jr, Minsky B, Willett C, et al. Gastric surgical adjuvant radiotherapy – rationale and treatment implementation. Int J Rad Oncol Biol Phys 2002;52:283–93.
  • 9. Hawrylewicz L, Leszczyński W, Namysł-Kaletka A, Bronclik I, Wydmański J. Protection of organs at risk during neoadjuvant chemoradiotherapy for gastric cancer based on a comparison between conformal and intensitymodulated radiation therapy. Oncol Lett 2016;12:692–8.
  • 10. Liu GF, Bair RJ, Bair E, Liauw SL, Koshy M. Clinical outcomes for gastric cancer following adjuvant chemoradiation utilizing intensity modulated versus three-dimensional conformal radiotherapy. PLoS One 2014;9:e82642.
  • 11. Chopra S, Agarwal A, Engineer R, Dora T, Thomas B, Sonawone S, et al. Intensity modulated radiation therapy (IMRT) is not superior to threedimensional conformal radiation (3DCRT) for adjuvant gastric radiation: a matched pair analysis. J Cancer Res Ther 2015;11:623–9.
  • 12. Ren F, Li S, Zhang Y, Zhao Z, Wang H, Cui Y, et al. Efficacy and safety of intensity-modulated radiation therapy versus threedimensional conformal radiation treatment for patients with gastric cancer: a systematic review and meta-analysis. Rad Oncol 2019;14:84.
  • 13. Li Z, Zeng J, Wang Z, Zhu H, Wei Y. Dosimetric comparison of intensity modulated and volumetric arc radiation therapy for gastric cancer. Oncol Lett 2014;8:1427–34.
  • 14. Zhang T, Liang ZW, Han J, Bi JP, Yang ZY, Ma H. Doublearc volumetric modulated therapy improves dose distribution compared to static gantry IMRT and 3D conformal radiotherapy for adjuvant therapy of gastric cancer. Rad Oncol 2015;19:114.
  • 15. Mondlane G, Gubanski M, Lind PA, Ureba A, Siegbahn A. Comparison of gastric-cancer radiotherapy performed with volumetric modulated arc therapy or single-field uniform-dose proton therapy. Acta Oncol 2017;56:832–8.
  • 16. Allal AS, Zwahlen D, Bründler MA, de Peyer R, Morel P, Huber O, et al. Neoadjuvant radiochemotherapy for locally advanced gastric cancer: Long-term results of a phase I trial. Int J Radiat Oncol Biol Phys 2005;63:1286–9.
  • 17. Öksüz DÇ. Mide Kanserinde Radyoterapi. Türkiye Klinikleri J Gen Surg-Special Topics 2013;6:120–5.
  • 18. Tahir Ç, Gökhan Y, Taylan T. Dosimetric Comparison of 3D-Conformal and IMRT Radiotherapy Techniques in Gastric Cancer. East J Med 2019;24:299–302.
  • 19. Zygogianni A, Fotineas A, Platoni K, Patatoukas G, Dilvoi M, Antypas C, et al. A five split-field three dimensional conformal technique versus an anterior-posterior on in postoperative radiotherapy for gastric carcinoma: a multicenter comparative study using quality of life measurements as well as clinical and dosimetric parameters. JBUON 2018;23:1020–8.
  • 20. Sharfo AWM, Stieler F, Kupfer O, Heijmen BJM, Dirkx MLP, Breedveld S, et al. Automated VMAT planning for postoperative adjuvant treatment of advanced gastric cancer. Rad Oncol 2018;13:74.
  • 21. Kucuktulu E, Yurekli AF, Topbas M, Kece C, Guner A, Kucuktulu U. Comparisons between the Dosimetric and Clinical Outcomes of Tomotherapy and 3D Conformal Radiotherapy in Gastric Cancer Treatment. Asian Pac J Cancer Prev 2019;20:595–9.
  • 22. Onal C, Dölek Y, Akkuş Yıldırım B. Dosimetric comparison of 3-dimensional conformal radiotherapy, volumetric modulated arc therapy, and helical tomotherapy for postoperative gastric cancer patients. Jpn J Radiol 2018;36:30–9.
  • 23. Ma H, Han J, Zhang T, Ke Y. Comparison of dosiology between three dimensional conformal and intensity-modulated radiotherapies (5 and 7 fields) in gastric cancer post-surgery. J Huazhong Univ Sci Tech Med Sci 2013;33:759–64.
There are 23 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Research Article
Authors

Alaettin Arslan This is me

Burak Şengül This is me

Publication Date August 1, 2020
Published in Issue Year 2020 Volume: 10 Issue: 2

Cite

APA Arslan, A., & Şengül, B. (2020). Mide Kanserinde Adjuvan Radyoterapide Kullanılan Planlama Tekniğine Göre Kritik Organ Dozlarının Karşılaştırılması. Kafkas Journal of Medical Sciences, 10(2), 145-151.
AMA Arslan A, Şengül B. Mide Kanserinde Adjuvan Radyoterapide Kullanılan Planlama Tekniğine Göre Kritik Organ Dozlarının Karşılaştırılması. KAFKAS TIP BİL DERG. August 2020;10(2):145-151.
Chicago Arslan, Alaettin, and Burak Şengül. “Mide Kanserinde Adjuvan Radyoterapide Kullanılan Planlama Tekniğine Göre Kritik Organ Dozlarının Karşılaştırılması”. Kafkas Journal of Medical Sciences 10, no. 2 (August 2020): 145-51.
EndNote Arslan A, Şengül B (August 1, 2020) Mide Kanserinde Adjuvan Radyoterapide Kullanılan Planlama Tekniğine Göre Kritik Organ Dozlarının Karşılaştırılması. Kafkas Journal of Medical Sciences 10 2 145–151.
IEEE A. Arslan and B. Şengül, “Mide Kanserinde Adjuvan Radyoterapide Kullanılan Planlama Tekniğine Göre Kritik Organ Dozlarının Karşılaştırılması”, KAFKAS TIP BİL DERG, vol. 10, no. 2, pp. 145–151, 2020.
ISNAD Arslan, Alaettin - Şengül, Burak. “Mide Kanserinde Adjuvan Radyoterapide Kullanılan Planlama Tekniğine Göre Kritik Organ Dozlarının Karşılaştırılması”. Kafkas Journal of Medical Sciences 10/2 (August 2020), 145-151.
JAMA Arslan A, Şengül B. Mide Kanserinde Adjuvan Radyoterapide Kullanılan Planlama Tekniğine Göre Kritik Organ Dozlarının Karşılaştırılması. KAFKAS TIP BİL DERG. 2020;10:145–151.
MLA Arslan, Alaettin and Burak Şengül. “Mide Kanserinde Adjuvan Radyoterapide Kullanılan Planlama Tekniğine Göre Kritik Organ Dozlarının Karşılaştırılması”. Kafkas Journal of Medical Sciences, vol. 10, no. 2, 2020, pp. 145-51.
Vancouver Arslan A, Şengül B. Mide Kanserinde Adjuvan Radyoterapide Kullanılan Planlama Tekniğine Göre Kritik Organ Dozlarının Karşılaştırılması. KAFKAS TIP BİL DERG. 2020;10(2):145-51.
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