The Dosimetric Comparison of the Different Photon Energy of Radiotherapy Techniques Used in the Treatment of Cervical Cancer

Yıl 2019, , 163 - 168, 01.08.2019

Abdulhamit Turan , Ece Ayfer Cura Burcu İbicioğlu Sema Gözcü Tunç Candan Demiröz Abakay Sibel Kahraman Cetintaş Meral Kurt Zenciye Kıray

https://doi.org/10.32708/uutfd.549879

Öz

In this study, it was evaluated
retrospectively the result of  10
patients with cervical cancer who treated with radiotherapy treatment in Bursa Uludağ
University between 2014-2017 years. Four different plans were performed using 6
MV and 15 MV photon energies both for volumetric modulated arc therapy (VMAT)
and intensity modulated arc therapy (IMRT) 7 field technique used in the treatment
planning. All patient were to receive  50.4
Gy dose from 28 fractions. Our aim to organ at risks(OAR) such as; the rectal,
bladder, small intestine, right and left femoral heads also Conformity Index(CI)
and Homogeneity Index(HI) and total numbers of monitor units  were evaluated. As a result of the comparison,
the optimal PTV dose homogeneity, the CI value was better in VMAT 15 MV plans
and IMRT 15 MV plans showed the best HI values. Bladder and rectum doses were
obtained in VMAT 6 MV technique,small intestine doses in IMRT 15 MV technique. Regarding
to all planning techniques, dose distributions were within acceptable limits.
VMAT 6 MV technique is superior to other techniques when considering the
scattered dose and the risk of secondary cancer. Therefore, considering side
effects and double effect, VMAT may be preferred as a treatment technique.

Anahtar Kelimeler

Cervix Cancer, Radyoterapy, VMAT, IMRT, Low and High Energy

Serviks Kanseri Tedavisinde Kullanılan Radyoterapi Tekniklerinin Farklı Foton Enerjilerinin Dosimetrik Karşılaştırılması

Öz

Bu çalışma 2014-2017 yılları arasında Bursa Uludağ Üniversitesinde radyoterapi tedavisi almış,  serviks kanseri tanılı 10 hastanın arşiv materyali
kullanılarak retrospektif olarak yapılmıştır. Serviks kanseri radyoterapisinde
kullanılan enerji seviyelerinin kullanılması amaçlanmıştır. Tedavi
planlamasında kullanılan volumetrik ayarlı ark terapi (VMAT) ve yoğunluk ayarlı
ark terapi(YART) 7 alan tekniği için 6 MV 
ve  15 MV  enerjili foton enerjisi kullanılarak her
hastaya özel 4 farklı planlama yapılmıştır. Planlanan hedef hacme 28
fraksiyondan 50.4 Gy doz verilmiş ve kritik organ olarak rektum, mesane, ince
bağırsak, sağ ve sol femur başları konturlanarak dozimetrik karşılaştırma
amaçlanmıştır. Ayrıca tedavi planı değerlendirme parametrelerinden Conformite
İndeksi ve Homojenite İndeksi verileri de değerlendirilmiştir. Karşılaştırmalar
sonucunda en uygun PTV doz homojenitesi, CI değerini VMAT 15 MV, en iyi HI
değerini YART 15 MV sağlamıştır. Mesane ve Rectum D_ort  dozları açısından en iyi VMAT 6 MV tekniği,
ince bağırsak D_max değeri YART 15 MV tekniğinde elde edilmiştir. Tüm
tekniklerde doz dağılımları kabul edilebilir sınır içerisinde olduğu
gözlemlenmiştir Saçılan doz ve ikincil kanser riski düşünüldüğünde VMAT 6 MV
tekniği diğer tekniklere oranla daha üstün bulundu. Bu yüzden yan etkiler ve
çift oluşum meydana gelme ihtimali göz önüne alındığında tedavi tekniği olarak
VMAT 6 MV tekniğinin uygun olduğunu desteklemekteyiz.

Anahtar Kelimeler

Serviks kanser, Radyoterapi, VMAT, YART, Düşük ve Yüksek Enerji

Kaynakça

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