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1
題名:螺旋式斷層強度調控放射治療與固定角度強度調控放射治療在肺部劑量上的比較     (18點)
THE COMPARISON OF LUNG DOSE BETWEEN FIXED-ANGLE IMRT AND TOMOTHERAPY
著者:許仲賢(Chung-Hsien Hsu) ;曾玉華(Yuk-Wah Tsang) ;葉恬綺(Tien-Chi Yeh) ;吳任弘(Ren-Hong Wu) ;溫嘉綺(Chia-Chi Wen) ;季匡華(Kwan-Hwa Chi)
出版地區:台灣
出版城市:台北市
學科:醫學綜合
關鍵字:螺旋式斷層強度調控放射治療 ; 肺平均劑量 ; 強度調控放射治療 ; 肺癌 ; Tomotherapy ; Mean lung dose ; IMRT ; Lung cancer
刊名:放射治療與腫瘤學
頁碼:223-231
語言:繁體中文
摘要: 中文摘要PDF ; 英文摘要PDF

目的:本實驗之目的是探討螺旋式斷層強度調控放射治療(Tomotherapy)是否能進一步地減少肺部劑量。 材料與方法:本實驗選取 8 位肺癌病人,其中 5 位只有一處原發癌需要照射,其他 3 位除了原發癌外,合併有 2 到 3 處肺部淋巴轉移,每位病人同時做出兩個治療計畫,包括 Tomotherapy 與固定旋轉臂(gantry)角度的強度調控放射治療(fixed gantry angle IMRT),最後評估兩個治療計畫,在雙側正常肺、腫瘤同側正常肺與對側正常肺之劑量。除肺癌原發病人外,肺部多發性轉移、乳癌與胸骨轉移病人,各有一位,以初步探討胸部照射的病人,在兩種不同治療技術下肺劑量之優劣。 結果:在 8 位肺癌病人的治療計畫中,Tomotherapy 平均可以減少雙側正常肺的平均劑量 4.0%( 中位數 -2.5%, 範圍 -0.2%~-7.2%,p = 0.006), 若分為同側正常肺與對側正常肺來看,tomotherpy 平均可以減少同側正常肺約 7.7% 的平均劑量(中位數 -7.6%,範圍 -17.8% ~-1.0%,p = 0.003),但對對側正常肺,使用 Tomotherapy 並沒有明顯的統計意義(平均+8.0%,中位數 -3.1%,範圍 -22.3% ~ +63.2%,p = 0.20)。對於肺部多發性轉移、乳癌及胸骨轉移的三位病人,Tomotherapy 減少肺部平均劑量達 27.3%、3.6%、10.2%。 結論與討論:經過仔細的計畫後,對於照射肺部的病人,使用 Tomotherapy 有潛力減少或維持與IMRT 一樣的雙側正常肺與同側正常肺的平均劑量,不過仍須進一步的研究來確認。
Purpose : The purpose of this experiment is to compare the lung dose between fixed-angle IMRT technique and Tomotherapy. We also explore the possibility to lower the lung dose with Tomotherapy. Material and Method : Eight patients were selected for this study. Five of them only have one primary tumor. The others have one primary tumor with two or three lymph node metastasis. All of them were both planned by fixed gantry angle IMRT technique and Tomotherapy technique. The dose distributions and the mean dose to ipsilateral, contralateral and both normal lungs were evaluated and compared between two plans. For completeness, we also evaluate the lung mean dose for a sternum metastasis patient, a multiple lung metastasis patient and a breast cancer patient between fixed-angle IMRT technique and Tomotherapy technique. Result : By comparing the isodose plan of eight patients, Tomotherapy group has lowered mean dose to both normal lung (4.0% lower in average, median: -2.5%, range: -0.2% ~ -7.2%, p = 0.006) and to ipsilateral normal lung (7.7% lower in average, median: -7.6%, range: -17.8% ~ -1.0%, p = 0.003). But for the contralateral normal lung, Tomotherapy technique doesn’t show the statistically significant superiority than fixed-angle IMRT technique (median: -3.1%, range: -22.3% ~ +63.2%, p = 0.20). For patients with multiple lung metastasis, with sternum metastases and with breast cancer, Tomotherpy can reduce the mean dose for whole normal lung by 27.3%, 3.6% and 10.2% respectively. Conclusion and Discussion : With carefully planning, the Tomotherapy plan could have the same or lower mean dose of ipsilateral and both normal lungs than fixed-angle IMRT. Tomotherapy may have potential to reduce more mean dose to lung than fixed-angle IMRT. We need further investigation to verify this potential.


    

本卷期目次
放射治療與腫瘤學
螺旋式斷層強度調控放射治療與固定角度強度調控放射治療在肺部劑量上的比較/ 許仲賢曾玉華葉恬綺吳任弘溫嘉綺季匡華
Retrospective Study of the Concurrent Intraarterial Chemo-Radiotherapy for Locally Advanced or al Cancers/ Chun-Ming HuangChih-Jen HuangMing-Yii HuangHsin-Hua LeeChih-Fung WuCHUNG-HO CHENMaw-Chang SheenShi-Long Lian
The Experience of Endobronchial Brachytherapy in Lung Cancer/ Shih-Tshung ChangWen-Shan LiuHsi-Chang Chang
Comparing Intensity-Modulated Radiation Therapy with Conventional Tangential Technique in Treating Left-Sided Breast Cancer/ Chun-Shu LinYee-Min JenWei-Yuan NienChih-Hung KuHsiu-Wen LeeChih-Yun LinHsing-Lung ChaoChang-Ming ChenWen-Yen HuangJing-Min HwangChing-Jung Wu
強度調控綜合治療計畫之整體的評估/ 梁永昌胡尹薰羅素花郭珍妮林奎利
Prognostic Factors Affecting the Outcome of Oropharyngeal Carcinoma/ Li-Chung HungMu-Tai LiuMu-Kuan ChenCheng-Chuan ChangChia-Chun HuangChao-Yuan HuangChu-Ping PiTung-Hao ChangChih-Chieh Hsu
Whole Brain Radiotherapy Followed by Boost to Individual Brain Metastases: A Case Report of Radiotherapy for Disseminated Brain Metastases Using Tomotherapy/ Le-Jung WuHsing-Yi LeePei-Wei Shueng
The Comparison of Nodal Stage Determined by Magnetic Resonance Imaging and Clinical Palpation for Nasopharyngeal Carcinoma Patients with Bulky Lymph Node Metastasis/ Jia-Shing WuCheng-Fang HorngStella Y.C. TsaiYih-Lin ChungJames Jer-Min JianSkye Hongiun Cheng
Metronomic Cyclophosphamide Enhances Response of Murine Subcutaneous Melanoma to Radiation/ Keng-Li LanHow-Ling ShihSang-Hue Yen
PROGNOSTIC FACTORS AFFECTING THE OUTCOME OF OROPHARYNGEAL CARCINOMA/ Li-Chung HungMu-Tai LiuMu-Kuan ChenCheng-Chuan ChangChia-Chun HuangChao-Yuan HuangChu-Ping PiTung-Hao ChangChih-Chieh Hsu
COMPARING INTENSITY-MODULATED RADIATION THERAPY WITH CONVENTIONAL TANGENTIAL TECHNIQUE IN TREATING LEFT-SIDED BREAST CANCER/ Chun-Shu LinYee-Min JenWei-Yuan NienChih-Hung KuHsiu-Wen LeeChih-Yun LinHsing-Lung ChaoChang-Ming ChenWen-Yen HuangJing-Min HwangChing-Jung Wu
THE COMPARISON OF NODAL STAGE DETERMINED BY MAGNETIC RESONANCE IMAGING AND CLINICAL PALPATION FOR NASOPHARYNGEAL CARCINOMA PATIENTS WITH BULKY LYMPH NODE METASTASIS/ Jia-Shing WuCheng-Fang HorngStella Y. C. TsaiYih-Lin ChungJames Jer-Min JianSkye Hon-Giun Cheng
RETROSPECTIVE STUDY OF THE CONCURRENT INTRAARTERIAL CHEMO-RADIOTHERAPY FOR LOCALLY ADVANCED OR AL CANCERS/ Chun-Ming HuangChih-Jen HuangMing-Yii HuangHsin-Hua LeeChih-Fung WuChung-Ho ChenMaw-Chang SheenShi-Long Lian
METRONOMIC CYCLOPHOSPHAMIDE ENHANCES RESPONSE OF MURINE SUBCUTANEOUS MELANOMA TO RADIATION/ Keng-Li LanHow-Ling ShihSang-Hue Yen
螺旋式斷層強度調控放射治療與固定角度強度調控放射治療在肺部劑量上的比較/ 許仲賢曾玉華葉恬綺吳任弘溫嘉綺季匡華
強度調控綜合治療計畫之整體的評估/ 梁永昌胡尹薰羅素花郭珍妮林奎利
THE EXPERIENCE OF ENDOBRONCHIAL BRACHYTHERAPY IN LUNG CANCER/ Shih-Tshung ChangWen-Shan LiuHsi-Chang Chang
WHOLE BRAIN RADIOTHERAPY FOLLOWED BY BOOST TO INDIVIDUAL BRAIN METASTASES: A CASE REPORT OF RADIOTHERAPY FOR DISSEMINATED BRAIN METASTASES USING TOMOTHERAPY/ Le-Jung WuHsing-Yi LeePei-Wei Shueng
 
   
 
   

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