Comparıson of Simultaneous Integrated Boost Method for Different Treatments in Head and Neck Cancer Radiotherapy

Yıl 2017, Cilt: 29 Sayı: 1, 20 - 28, 21.04.2017

Bilgehan Çoşkun , Ayşe Yumak Yahşi , Ayşe Okumuş Şahin Aktaş , Fusun Tokatlı

https://doi.org/10.7240/marufbd.306338

Öz

A comparative planning study was undertaken to evaluate dosimetric differences between volumetric modulated arc therapy versus intensity
modulated radiation therapy in the treatment of head and neck. Patients were investigated, with a standard prescription of three dose
levels to the target volumes in 33 fractions. Simultaneous Integrated Boost technique was generated for all techniques, with similar planning
objectives. Plans were calculated for 6MV photon using anisotropic analytical algorithm implemented in Eclipse treatment planning
system. 9 field IMRT and 2 arc VMAT plans show superior dose homogeneity and dose conformity in PTVs. Doses to optic nerves, chiasm,
eyes, lenses and protists were slightly lower in 7, 9 field IMRT plans. Doses to the brain stem, spinal cord, mandibula and larynx were
better in the 2 arc VMAT techniques. Oral cavity dose reduced significantly with 1 arc VMAT. The high dose radiation volume to the normal
tissue and the mean normal tissue dose decreased, but the low dose radiation volume increased slightly in the 1 and 2 arc VMAT plans.
1, 2 arc VMAT and 7, 9 field IMRT plans produced clinically acceptable treatment plan for the head and neck cancer. VMAT represents an
attractive solution because of the shorter delivery time and the lower of monitor unit compared with IMRT.

Anahtar Kelimeler

Head and neck cancer, simultaneous integrated boost technique, volumetric modulated arc therapy, intensity modulated radiation therapy

Baş Boyun Radyoterapisinde Farklı Tedavi Teknikleri İle Simultane Integre Boost Yönteminin Karşılaştırılması

Öz

Bu
çalışmada, baş boyun kanserlerinin tedavisinde kullanılan yoğunluk ayarlı
radyoterapi ve yoğunluk ayarlı ark terapi tekniklerinin dozimetrik olarak
karşılaştırılması amaçlanmıştır. Planlarda benzer planlama hedefleri ile 33
günlük fraksiyonlarla eş zamanlı olarak hedef hacimlerde farklı doz
seviyelerinin sağlandığı Simultane Integre Boost tekniği
kullanılmıştır. Planlar, 6 MV
foton enerjisi kullanılarak, anisotropic analitic algoritması ile Eclipse tedavi
planlama bilgisayarında hesaplatılmıştır. 9 Alan YART ve 2 Ark YAAT
planlarının doz homojenitesi ve doz konformalitesi açısından daha üstün
oldukları görülmektedir. Kritik organların doz değerleri incelendiğinde optik
sinirler, kiazma, gözler, lensler ve parotisler için en düşük dozlar 7 ve 9
Alan YART planları ile elde edilirken beyin sapı, spinal kord, mandibula ve
larenks için en iyi dozlar 2 Ark YAAT planları ile elde edilmiştir. Oral kavite
dozu 1 Ark YAAT planları ile önemli ölçüde azaltılabilmektedir. Normal dokuda
yüksek doz alan hacim değerleri ve ortalama normal doku doz değerleri 1 ve 2
Ark YAAT planları ile azalırken, normal dokuda düşük doz alan hacim değerleri
azda olsa 1 ve 2 Ark planları ile artış göstermektedir. 1, 2 Ark YAAT ve 7, 9 Alan
YART planları baş boyun kanserlerinde klinik olarak kabul edilebilir tedavi
yöntemleridir. Tedavi süresinin kısalığı ve monitor unit değerlerinin düşük
olması açısından YAAT planları daha avantajlıdır.

Anahtar Kelimeler

Baş boyun kanserleri, simultane integre boost tekniği, yoğunluk ayarlı ark terapi, yoğunluk ayarlı radyoterapi

Kaynakça

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