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DOSIMETRIC COMPARISON OF 3 DIMENSIONAL CONFORMAL RADIOTHERAPY (3DCRT) AND VOLUMETRIC MODULATED ARC THERAPY (VMAT) TECHNIQUE IN CASES OF DIAGNOSED THORACIC ESOPHAGEAL CANCER PATIENTS: A RETROSPECTIVE STUDY

Yıl 2018, Cilt: 44 Sayı: 2, 117 - 124, 01.08.2018
https://doi.org/10.32708/uutfd.431755

Öz

3BKRT and VMAT techniques used in radiotherapy
treatment of esophageal cancer to see the effects of protecting risk organs
while achieving target volume and obtain their own data, to compare there
retrospective dosimetric results with each other. For This study; 10 patient thoracic
esophageal cancer patients were selected that treated with curative
radiotherapy. Plans were prepared  the
fraction would be 1,8 Gy and totally 54 Gy. 
Critical organs, CI and HI were compared between two techniques. As a
result of the statistical comparisons showed no significant difference between
3BKRT and VMAT except for HI (p = 0,010) in the analysis of  the values of PTV54. For OAR doses; value of
the lung V10 was found to be supeior to the 3BKRT technique
(p=0,017). The V40 value of the heart was found to be low in the
VMAT technique (p = 0.002).
Additionally,
for spinal cord Dmax value, VMAT technique has lower values than 3BKRT
(p = 0.001).
  As  results of our study, although both
techniques could be used in terms of dose homogenity and risk of organs, the use
of  VMAT technique might be preferable to
consider of the comorbidities affecting these older patients.

Kaynakça

  • 1. Jemal A, Bray F, Center MM, et al. Global Cancer Statistics. CA: A Cancer Journal for Clinicians 2011;61(2):69-90.
  • 2. Howlader N, Noone AM, Krapcho M, et al. SEER Cancer Statistics, National Cancer Institute. Bethesda, MD, https://seer.cancer.gov/csr/1975_2014/, 28 Nisan 2018.
  • 3. Siegel R, Naishadham D, Jemal A. Cancer statistics. CA Cancer J Clin 2013;63(1):11-30.
  • 4. Alıcı S., İzmirli, M. ve Doğan, E. Yüzüncü Yıl Üniversitesi Tıp Fakültesi Tıbbi Onkoloji Bilim Dalı’na Başvuran Kanser Hastalarının Epidemiyolojik Değerlendirilmesi. Van Tıp Dergisi 2006;21(2): 87-97.
  • 5. Nart M. Ve İzmirli, M. Yassı Epitel Hücreli Özefagus Kanserli Hastalarda Küratif Kemoradyoterapi Sonuçları. Van Tıp Dergisi 2014;21.3: 154-163.
  • 6. Adaş Yasemin Güzle, Andrieu, Meltem Nalça. Özofagus Kanserinde Radyoterapi. Toraks Cerrahisi Bülteni 2012;4(1): 53.
  • 7. Tong DK, Law S, Kwong DL, et al. Current Management of Cervical Esophageal Cancer. World J Surg 2011;35:600-7.
  • 8. Bakiu E, Telhaj E, Kozma E, Ruçi F, & Malkaj P. Comparison of 3D CRT and IMRT Tratment Plans. Acta Informatica Medica 2013;21(3): 211.
  • 9. Çetin İA, Yumuk PFÖ, Atasoy BM, Lokal İleri Evre Özefagus Kanserinde Kemoradyoterapi Deneyimimiz. Marmara Medical Journal 2012;25(2): 74-77.
  • 10. Edge SB, & Compton, CC. The American Joint Committee on Cancer: the 7th Edition of the AJCC Cancer Staging Manual and the Future of TNM. Annals of Surgical Oncology 2010;17(6):1471-1474.
  • 11. Rice TW, Blackstone EH, & Rusch VW. 7th Edition of the AJCC Cancer Staging Manual: Esophagus and Esophagogastric Junction. Annals of Surgical Oncology 2010;17(7):1721-1724.
  • 12. Leinchman LP, Lenz HJ, Rajdev L, et al. (NRG Oncology Study Team), “ A Phase III Trial Evaluating the Addition of Trastuzumab to Trimodality Treatment of Her2-Overexpressing Esophageal Adenocarcinomaa (RTOG 1010) https://www.rtog.org/ClinicalTrials/ProtocolTable/StudyDetails.aspx?study=1010
  • 13. Marks LB, Yorke ED, Jackson A. Use of Normal Tissue Complication Probability Models in the Clinic. International Journal of Radiation Oncology Biology Physics 2010;76(3): S10-S19.
  • 14. Bilge H. Çetingöz R, Garipağaoğlu M, ve ark. (editörler). Tedavi Planlama. Temel ve Klinik Radyoterapi, 1.Baskı. İzmir, Hürriyet Matbaa; 2013;82-83.
  • 15. Drzymala RE, Mohan R, Brewster L, et al. Dose-Volume Histograms. International Journal of Radiation Oncology. Biology Physics 1991;21(1): 71-78
  • 16. Feuvret L, Noël G, Mazeron JJ, & Bey P. Conformity Index: A Review. International Journal of Radiation Oncology Biology Physics 2006;64(2): 333-342.
  • 17. Rodrigues G, Lock M, D'Souza D, Yu E, & Van Dyk J. Prediction of Radiation Pneumonitis By Dose–Volume Histogram Parameters In Lung Cancer—A Systematic Review. Radiotherapy And Oncology 2004:;71(2): 127-138.
  • 18. Kharofa J, Cohen EP, Tomic R, Xiang Q, & Gore E. Decreased Risk of Radiation Pneumonitis with Incidental Concurrent Use of Angiotensin-Converting Enzyme Inhibitors and Thoracic Radiation Therapy. International Journal of Radiation Oncology Biology Physics 2012;84(1):238-243.
  • 19. Ling Ted C, Slater Jerry M, Prashanth N, et al. Analysis of Intensity-Modulated Radiation Therapy (IMRT), Proton and Conformal radiotherapy (3D-CRT) for Reducing Perioperative Cardiopulmonary Complications in Esophageal Cancer Patients. Cancers 2014:6.4: 2356-2368.
  • 20. Kataria T. Govardhan H. B. Gupta D, Dosimetric Comparison Between Volumetric Modulated Arc Therapy (VMAT) vs Intensity Modulated Radiation Therapy (IMRT) for Radiotherapy of Mid Esophageal Carcinoma. Journal of Cancer Research and Therapeutics 2014;10(4): 871.
  • 21. Van Benthuysen L. Hales L, & Podgorsak MB, et al. Volumetric modulated arc Therapy vs. IMRT for the Treatment of Distal Esophageal Cancer. Medical Dosimetry 2011;36(4): 404-409.
  • 22. Chandra A, Guerrero TM., Liu HH, et al. Feasibility of Using Intensity-Modulated Radiotherapy to Improve Lung Sparing in Treatment Planning for Distal Esophageal Cancer. Radiotherapy and Oncology 2005;77(3): 247-253.
  • 23. Choi KH, Kim J, Lee SW, Kang YN, & Jang H. Dosimetric Comparison Between Modulated Arc Therapy and Static Intensity Modulated Radiotherapy In Thoracic Esophageal Cancer: A Single Institutional Experience. Radiation Oncology Journal 2018;36(1):63.
  • 24. Wang D, Yang Y, Zhu J, et al. 3D-Conformal RT, fixed-field IMRT and RapidArc, Which One is Better for Esophageal Carcinoma Treated with Elective Nodal Irradiation. Technology In Cancer Research & Treatment 2011;10(5):487-494.
  • 25. Martin S, Chen JZ, Dar AR, & Yartsev S. Dosimetric Comparison of Helical Tomotherapy, Rapidarc, and A Novel IMRT & Arc Technique for Esophageal Carcinoma. Radiotherapy and Oncology, 2011;101(3), 431-437.
  • 26. Lin CY, Huang WY, Jen YM et al. Dosimetric and Efficiency Comparison Of High-Dose Radiotherapy for Esophageal Cancer: Volumetric Modulated Arc Therapy Versus Fixed-Field Intensity-Modulated Radiotherapy. Diseases of The Esophagus 2014;27(6): 585-590.
  • 27. Jansen EP, Saunders MP, Boot H, et al. Prospective Study On Late Renal Toxicity Following Postoperative Chemoradiotherapy In Gastric Cancer. International Journal of Radiation Oncology Biology Physics 2007;67(3): 781-785.
  • 28. Welz S, Hehr T, Kollmannsberger C, et al. Renal Toxicity of Adjuvant Chemoradiotherapy With Cisplatin In Gastric Cancer. International Journal of Radiation Oncology• Biology• Physics 2007;69(5): 1429-1435.
  • 29. Chen H, Wang H, Gu H, et al Study For Reducing Lung Dose of Upper Thoracic Esophageal Cancer Radiotherapy by Auto-Planning: Volumetric-Modulated Arc Therapy vs Intensity-Modulated Radiation Therapy. (28.04.2018). https://doi.org/10.1016/j.meddos.2017.09.001
  • 30. Fu WH, Wang LH, Zhou ZM et al. Comparison of Conformal and Intensity-Modulated Techniques For Simultaneous Integrated Boost Radiotherapy of Upper Esophageal Carcinoma. World Journal of Gastroenterology 2004;10(8): 1098.
  • 31. Nicolini G, Ghosh-Laskar S, Shrivastava SK, et al. Volumetric Modulation Arc Radiotherapy With Flattening Filter-Free Beams Compared With Static Gantry IMRT and 3D Conformal Radiotherapy For Advanced Esophageal Cancer: A Feasibility Study. International Journal of Radiation Oncology Biology Physics 2012;84(2): 553-560.

Toraks Yerşimli Özofagus Kanseri Tanılı Olgularda 3 Boyutlu Konformal Radyoterapi (3BKRT) ve Hacimsel Ayarlı Ark Terapi (Vmat) Tekniğinin Dozimetrik Karşılaştırması: Retrospektif Çalışma

Yıl 2018, Cilt: 44 Sayı: 2, 117 - 124, 01.08.2018
https://doi.org/10.32708/uutfd.431755

Öz

Özofagus kanserinin radyoterapi ile tedavisinde
kullanılan 3BKRT ve VMAT tekniklerinin hedef hacmi sararken riskli organları
korumadaki etkilerini görmek ve kendi verilerini elde etmek; elde ettiğimiz bu
retrospektif dozimetrik sonuçları birbirleriyle karşılaştırmaktır. Bu çalışma için; 10 küratif radyoterapi
ile tedavi edilen toraks yerleşimli özofagus kanseri tanılı hasta seçildi. Fraksiyon
dozu 1,8 Gy ve toplam doz 54 Gy olacak şekilde planlar hazırlandı. İki teknik arasında
kritik organ dozu (OAR), CI ve HI karşılaştırıldı. Yapılan istatistiksel karşılaştırma sonucunda PTV54’e ait
değerlerin analizinde 3BKRT ve VMAT arasında HI (p=0,010)  dışında anlamlı fark görülmemiştir. OAR
dozları için; akciğerin V10 değeri  3BKRT tekniğinde üstün bulunmuştur (p=0,017).
Kalbin V40 değeri VMAT tekniğinde düşük bulunmuştur (p=0,002). Ayrıca,
Spinal Cord Dmax değeri için bakıldığında VMAT tekniği 3BKRT’ye göre
düşük değerlere sahiptir (p=0,001). Çalışmamızın sonucunda doz homojenliği ve riskli
organlar açısından her iki teknikte kullanılabilir görülmesine rağmen ileri yaştaki
bu hastalarda etki eden komorbiditeler göz önüne alındığında VMAT tekniği
kullanımının tercih olabileceği görülmüştür.



Kaynakça

  • 1. Jemal A, Bray F, Center MM, et al. Global Cancer Statistics. CA: A Cancer Journal for Clinicians 2011;61(2):69-90.
  • 2. Howlader N, Noone AM, Krapcho M, et al. SEER Cancer Statistics, National Cancer Institute. Bethesda, MD, https://seer.cancer.gov/csr/1975_2014/, 28 Nisan 2018.
  • 3. Siegel R, Naishadham D, Jemal A. Cancer statistics. CA Cancer J Clin 2013;63(1):11-30.
  • 4. Alıcı S., İzmirli, M. ve Doğan, E. Yüzüncü Yıl Üniversitesi Tıp Fakültesi Tıbbi Onkoloji Bilim Dalı’na Başvuran Kanser Hastalarının Epidemiyolojik Değerlendirilmesi. Van Tıp Dergisi 2006;21(2): 87-97.
  • 5. Nart M. Ve İzmirli, M. Yassı Epitel Hücreli Özefagus Kanserli Hastalarda Küratif Kemoradyoterapi Sonuçları. Van Tıp Dergisi 2014;21.3: 154-163.
  • 6. Adaş Yasemin Güzle, Andrieu, Meltem Nalça. Özofagus Kanserinde Radyoterapi. Toraks Cerrahisi Bülteni 2012;4(1): 53.
  • 7. Tong DK, Law S, Kwong DL, et al. Current Management of Cervical Esophageal Cancer. World J Surg 2011;35:600-7.
  • 8. Bakiu E, Telhaj E, Kozma E, Ruçi F, & Malkaj P. Comparison of 3D CRT and IMRT Tratment Plans. Acta Informatica Medica 2013;21(3): 211.
  • 9. Çetin İA, Yumuk PFÖ, Atasoy BM, Lokal İleri Evre Özefagus Kanserinde Kemoradyoterapi Deneyimimiz. Marmara Medical Journal 2012;25(2): 74-77.
  • 10. Edge SB, & Compton, CC. The American Joint Committee on Cancer: the 7th Edition of the AJCC Cancer Staging Manual and the Future of TNM. Annals of Surgical Oncology 2010;17(6):1471-1474.
  • 11. Rice TW, Blackstone EH, & Rusch VW. 7th Edition of the AJCC Cancer Staging Manual: Esophagus and Esophagogastric Junction. Annals of Surgical Oncology 2010;17(7):1721-1724.
  • 12. Leinchman LP, Lenz HJ, Rajdev L, et al. (NRG Oncology Study Team), “ A Phase III Trial Evaluating the Addition of Trastuzumab to Trimodality Treatment of Her2-Overexpressing Esophageal Adenocarcinomaa (RTOG 1010) https://www.rtog.org/ClinicalTrials/ProtocolTable/StudyDetails.aspx?study=1010
  • 13. Marks LB, Yorke ED, Jackson A. Use of Normal Tissue Complication Probability Models in the Clinic. International Journal of Radiation Oncology Biology Physics 2010;76(3): S10-S19.
  • 14. Bilge H. Çetingöz R, Garipağaoğlu M, ve ark. (editörler). Tedavi Planlama. Temel ve Klinik Radyoterapi, 1.Baskı. İzmir, Hürriyet Matbaa; 2013;82-83.
  • 15. Drzymala RE, Mohan R, Brewster L, et al. Dose-Volume Histograms. International Journal of Radiation Oncology. Biology Physics 1991;21(1): 71-78
  • 16. Feuvret L, Noël G, Mazeron JJ, & Bey P. Conformity Index: A Review. International Journal of Radiation Oncology Biology Physics 2006;64(2): 333-342.
  • 17. Rodrigues G, Lock M, D'Souza D, Yu E, & Van Dyk J. Prediction of Radiation Pneumonitis By Dose–Volume Histogram Parameters In Lung Cancer—A Systematic Review. Radiotherapy And Oncology 2004:;71(2): 127-138.
  • 18. Kharofa J, Cohen EP, Tomic R, Xiang Q, & Gore E. Decreased Risk of Radiation Pneumonitis with Incidental Concurrent Use of Angiotensin-Converting Enzyme Inhibitors and Thoracic Radiation Therapy. International Journal of Radiation Oncology Biology Physics 2012;84(1):238-243.
  • 19. Ling Ted C, Slater Jerry M, Prashanth N, et al. Analysis of Intensity-Modulated Radiation Therapy (IMRT), Proton and Conformal radiotherapy (3D-CRT) for Reducing Perioperative Cardiopulmonary Complications in Esophageal Cancer Patients. Cancers 2014:6.4: 2356-2368.
  • 20. Kataria T. Govardhan H. B. Gupta D, Dosimetric Comparison Between Volumetric Modulated Arc Therapy (VMAT) vs Intensity Modulated Radiation Therapy (IMRT) for Radiotherapy of Mid Esophageal Carcinoma. Journal of Cancer Research and Therapeutics 2014;10(4): 871.
  • 21. Van Benthuysen L. Hales L, & Podgorsak MB, et al. Volumetric modulated arc Therapy vs. IMRT for the Treatment of Distal Esophageal Cancer. Medical Dosimetry 2011;36(4): 404-409.
  • 22. Chandra A, Guerrero TM., Liu HH, et al. Feasibility of Using Intensity-Modulated Radiotherapy to Improve Lung Sparing in Treatment Planning for Distal Esophageal Cancer. Radiotherapy and Oncology 2005;77(3): 247-253.
  • 23. Choi KH, Kim J, Lee SW, Kang YN, & Jang H. Dosimetric Comparison Between Modulated Arc Therapy and Static Intensity Modulated Radiotherapy In Thoracic Esophageal Cancer: A Single Institutional Experience. Radiation Oncology Journal 2018;36(1):63.
  • 24. Wang D, Yang Y, Zhu J, et al. 3D-Conformal RT, fixed-field IMRT and RapidArc, Which One is Better for Esophageal Carcinoma Treated with Elective Nodal Irradiation. Technology In Cancer Research & Treatment 2011;10(5):487-494.
  • 25. Martin S, Chen JZ, Dar AR, & Yartsev S. Dosimetric Comparison of Helical Tomotherapy, Rapidarc, and A Novel IMRT & Arc Technique for Esophageal Carcinoma. Radiotherapy and Oncology, 2011;101(3), 431-437.
  • 26. Lin CY, Huang WY, Jen YM et al. Dosimetric and Efficiency Comparison Of High-Dose Radiotherapy for Esophageal Cancer: Volumetric Modulated Arc Therapy Versus Fixed-Field Intensity-Modulated Radiotherapy. Diseases of The Esophagus 2014;27(6): 585-590.
  • 27. Jansen EP, Saunders MP, Boot H, et al. Prospective Study On Late Renal Toxicity Following Postoperative Chemoradiotherapy In Gastric Cancer. International Journal of Radiation Oncology Biology Physics 2007;67(3): 781-785.
  • 28. Welz S, Hehr T, Kollmannsberger C, et al. Renal Toxicity of Adjuvant Chemoradiotherapy With Cisplatin In Gastric Cancer. International Journal of Radiation Oncology• Biology• Physics 2007;69(5): 1429-1435.
  • 29. Chen H, Wang H, Gu H, et al Study For Reducing Lung Dose of Upper Thoracic Esophageal Cancer Radiotherapy by Auto-Planning: Volumetric-Modulated Arc Therapy vs Intensity-Modulated Radiation Therapy. (28.04.2018). https://doi.org/10.1016/j.meddos.2017.09.001
  • 30. Fu WH, Wang LH, Zhou ZM et al. Comparison of Conformal and Intensity-Modulated Techniques For Simultaneous Integrated Boost Radiotherapy of Upper Esophageal Carcinoma. World Journal of Gastroenterology 2004;10(8): 1098.
  • 31. Nicolini G, Ghosh-Laskar S, Shrivastava SK, et al. Volumetric Modulation Arc Radiotherapy With Flattening Filter-Free Beams Compared With Static Gantry IMRT and 3D Conformal Radiotherapy For Advanced Esophageal Cancer: A Feasibility Study. International Journal of Radiation Oncology Biology Physics 2012;84(2): 553-560.
Toplam 31 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Özgün Araştırma Makaleleri
Yazarlar

Habibe Altaş

Meral Kurt

Sema Gözcü Tunç

Sibel Kahraman Çetintaş Bu kişi benim

Candan Demiröz Abakay Bu kişi benim

Burcu İbicioğlu

Ece Ayfer Cura Bu kişi benim

Abdulhamit Turan

Yayımlanma Tarihi 1 Ağustos 2018
Kabul Tarihi 16 Temmuz 2018
Yayımlandığı Sayı Yıl 2018 Cilt: 44 Sayı: 2

Kaynak Göster

APA Altaş, H., Kurt, M., Gözcü Tunç, S., Kahraman Çetintaş, S., vd. (2018). Toraks Yerşimli Özofagus Kanseri Tanılı Olgularda 3 Boyutlu Konformal Radyoterapi (3BKRT) ve Hacimsel Ayarlı Ark Terapi (Vmat) Tekniğinin Dozimetrik Karşılaştırması: Retrospektif Çalışma. Uludağ Üniversitesi Tıp Fakültesi Dergisi, 44(2), 117-124. https://doi.org/10.32708/uutfd.431755
AMA Altaş H, Kurt M, Gözcü Tunç S, Kahraman Çetintaş S, Demiröz Abakay C, İbicioğlu B, Cura EA, Turan A. Toraks Yerşimli Özofagus Kanseri Tanılı Olgularda 3 Boyutlu Konformal Radyoterapi (3BKRT) ve Hacimsel Ayarlı Ark Terapi (Vmat) Tekniğinin Dozimetrik Karşılaştırması: Retrospektif Çalışma. Uludağ Tıp Derg. Ağustos 2018;44(2):117-124. doi:10.32708/uutfd.431755
Chicago Altaş, Habibe, Meral Kurt, Sema Gözcü Tunç, Sibel Kahraman Çetintaş, Candan Demiröz Abakay, Burcu İbicioğlu, Ece Ayfer Cura, ve Abdulhamit Turan. “Toraks Yerşimli Özofagus Kanseri Tanılı Olgularda 3 Boyutlu Konformal Radyoterapi (3BKRT) Ve Hacimsel Ayarlı Ark Terapi (Vmat) Tekniğinin Dozimetrik Karşılaştırması: Retrospektif Çalışma”. Uludağ Üniversitesi Tıp Fakültesi Dergisi 44, sy. 2 (Ağustos 2018): 117-24. https://doi.org/10.32708/uutfd.431755.
EndNote Altaş H, Kurt M, Gözcü Tunç S, Kahraman Çetintaş S, Demiröz Abakay C, İbicioğlu B, Cura EA, Turan A (01 Ağustos 2018) Toraks Yerşimli Özofagus Kanseri Tanılı Olgularda 3 Boyutlu Konformal Radyoterapi (3BKRT) ve Hacimsel Ayarlı Ark Terapi (Vmat) Tekniğinin Dozimetrik Karşılaştırması: Retrospektif Çalışma. Uludağ Üniversitesi Tıp Fakültesi Dergisi 44 2 117–124.
IEEE H. Altaş, “Toraks Yerşimli Özofagus Kanseri Tanılı Olgularda 3 Boyutlu Konformal Radyoterapi (3BKRT) ve Hacimsel Ayarlı Ark Terapi (Vmat) Tekniğinin Dozimetrik Karşılaştırması: Retrospektif Çalışma”, Uludağ Tıp Derg, c. 44, sy. 2, ss. 117–124, 2018, doi: 10.32708/uutfd.431755.
ISNAD Altaş, Habibe vd. “Toraks Yerşimli Özofagus Kanseri Tanılı Olgularda 3 Boyutlu Konformal Radyoterapi (3BKRT) Ve Hacimsel Ayarlı Ark Terapi (Vmat) Tekniğinin Dozimetrik Karşılaştırması: Retrospektif Çalışma”. Uludağ Üniversitesi Tıp Fakültesi Dergisi 44/2 (Ağustos 2018), 117-124. https://doi.org/10.32708/uutfd.431755.
JAMA Altaş H, Kurt M, Gözcü Tunç S, Kahraman Çetintaş S, Demiröz Abakay C, İbicioğlu B, Cura EA, Turan A. Toraks Yerşimli Özofagus Kanseri Tanılı Olgularda 3 Boyutlu Konformal Radyoterapi (3BKRT) ve Hacimsel Ayarlı Ark Terapi (Vmat) Tekniğinin Dozimetrik Karşılaştırması: Retrospektif Çalışma. Uludağ Tıp Derg. 2018;44:117–124.
MLA Altaş, Habibe vd. “Toraks Yerşimli Özofagus Kanseri Tanılı Olgularda 3 Boyutlu Konformal Radyoterapi (3BKRT) Ve Hacimsel Ayarlı Ark Terapi (Vmat) Tekniğinin Dozimetrik Karşılaştırması: Retrospektif Çalışma”. Uludağ Üniversitesi Tıp Fakültesi Dergisi, c. 44, sy. 2, 2018, ss. 117-24, doi:10.32708/uutfd.431755.
Vancouver Altaş H, Kurt M, Gözcü Tunç S, Kahraman Çetintaş S, Demiröz Abakay C, İbicioğlu B, Cura EA, Turan A. Toraks Yerşimli Özofagus Kanseri Tanılı Olgularda 3 Boyutlu Konformal Radyoterapi (3BKRT) ve Hacimsel Ayarlı Ark Terapi (Vmat) Tekniğinin Dozimetrik Karşılaştırması: Retrospektif Çalışma. Uludağ Tıp Derg. 2018;44(2):117-24.

ISSN: 1300-414X, e-ISSN: 2645-9027

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