Can carotid-sparing radiotherapy approaches replace with conventional techniques for the patients with T1 glottic laryngeal cancer?
Küçük Resim Yok
Tarih
2012
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: T1N0 glottik larenks kanseri tedavisinde çeşitli radyoterapi teknikleri arasında karotis arterlerinin maruz kaldıkları dozlar karşılaştırıldı. Hastalar ve Yöntemler: Bilgisayarlı tomografi (BT) kullanılarak beş hasta simüle edildi. T1N0 glottik larenks kanseri için klinik (KHV) ve planlanan hedef volümler (PHV) oluşturuldu. Karotis arterleri ve spinal kord için planlanan risk volümleri (PRV) çizildi. Her hasta için iki boyutlu radyoterapi (2DRT), üç boyutlu konformal radyoterapi (3DCRT) ve basit yoğunluk ayarlı radyoterapi (IMRT) şeklinde üç planlama yapıldı. Planlanan hedef volümlerin %95’den fazlası tanımlanan dozu (2.25 Gy günlük fraksiyon dozundan 62.25 Gy toplam doz) aldı. Bulgular: Üçü sağ ikisi sol vokal kord yerleşimli beş T1 glottik kanserli olgunun tedavi planları karşılaştırıldığında, karotislerin koruması en iyi basit karotis koruyucu IMRT tekniği ile sağlandı. 2DRT, 3DCRT ve IMRT tekniklerine ait karotis ortalama V35, V50 ve V63 değerleri sırasıyla; %70, %47, %35; %55, %15, %5 ve %28, %6, %0 bulundu. V35, V50 ve V63 arasında yapılan istatistiksel karşılaştırmada, 2DRT ve IMRT için anlamlı değerler saptandı. Spinal kord dozu hiçbir planda 45 Gy’i aşmadı. Her üç planlama tekniğinde uygunluk indeksi arasında anlamlı fark saptanmadı ve homojen doz dağılımı elde edildi. Sonuç: Erken evre glottik larenks kanserli hastalarda karotis arterlerinin maruz kaldığı radyasyon dozunu IMRT’nin azaltabildiğine şüphe yoktur.
Objectives: This study aims to compare the carotid artery doses applied with various radiotherapy techniques for the treatment of T1N0 glottic laryngeal cancer. Patients and Methods: Five patients were simulated with using computed tomography (CT). Clinical (CTV) and planning target volumes (PTV) were created for T1N0 glottic laryngeal cancer. Planning risk volumes (PRV) were constructed for carotid arteries and spinal cord. Three irradiation planning, two dimension radiation therapy (2DRT), three dimension conformal radiation therapy (3DCRT), intensity modulated radiation therapy (IMRT) were done for each patient. Over 95% of planned target volumes were loaded with predetermined dose (a total of 62.25 Gy of 2.25 Gy daily dose). Results: The comparison of the treatment planning of five T1 glottic laryngeal cancer, three involving the right vocal cord and two involving the left vocal cord, the technique of IMRT planning was provided the best carotid-sparing doses. Mean carotid V35, V50, and V63 values including 2DRT, 3DCRT, and IMRT were 70%, 47%, 35%; 55%, 15%, 5% and 28%, 6%, 0%, respectively. The statistical comparison of V35, V50 and V63 revealed significant values for 2DRT and IMRT. Dose of spinal cord did not exceed 45 Gy for any of radiation treatment planning. Between the three techniques, there was no significant difference in terms of conformity index and dose distribution was homogenous with all techniques. Conclusion: It is obvious that IMRT planning technique can decrease the carotid artery radiation doses in early stage glottic laryngeal cancer.
Objectives: This study aims to compare the carotid artery doses applied with various radiotherapy techniques for the treatment of T1N0 glottic laryngeal cancer. Patients and Methods: Five patients were simulated with using computed tomography (CT). Clinical (CTV) and planning target volumes (PTV) were created for T1N0 glottic laryngeal cancer. Planning risk volumes (PRV) were constructed for carotid arteries and spinal cord. Three irradiation planning, two dimension radiation therapy (2DRT), three dimension conformal radiation therapy (3DCRT), intensity modulated radiation therapy (IMRT) were done for each patient. Over 95% of planned target volumes were loaded with predetermined dose (a total of 62.25 Gy of 2.25 Gy daily dose). Results: The comparison of the treatment planning of five T1 glottic laryngeal cancer, three involving the right vocal cord and two involving the left vocal cord, the technique of IMRT planning was provided the best carotid-sparing doses. Mean carotid V35, V50, and V63 values including 2DRT, 3DCRT, and IMRT were 70%, 47%, 35%; 55%, 15%, 5% and 28%, 6%, 0%, respectively. The statistical comparison of V35, V50 and V63 revealed significant values for 2DRT and IMRT. Dose of spinal cord did not exceed 45 Gy for any of radiation treatment planning. Between the three techniques, there was no significant difference in terms of conformity index and dose distribution was homogenous with all techniques. Conclusion: It is obvious that IMRT planning technique can decrease the carotid artery radiation doses in early stage glottic laryngeal cancer.
Açıklama
Anahtar Kelimeler
Cerrahi
Kaynak
Kulak Burun Boğaz İhtisas Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
22
Sayı
5
