Comparison of Unblocked, Directionally Blocked and Full Blocked Plans in Helical Tomotherapy for Breast Cancer Radiotherapy

Journal of Nuclear Medicine and Radiation Therapy Pub Date : 2018-03-08 DOI:10.4172/2155-9619.1000358

E. Kucuktulu, A. F. Yurekli, Eray Bilcan, Mahmut Serdar Sisecioglu, M. Topbaş, U. Kucuktulu

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Abstract

Introduction: The doses received by the contralateral breast, lung and heart either directionally or full blocked techniques in Hi-Art Tomotherapy systems in partial or whole breast radiotherapy has been studied. Method: In 20 breast cancer patients 3 plans with non-blocked, directionally blocked and full blocked methods were designed in Hi-Art planning system. In all planning method the dose received by the contralateral breast, the heart volume percentages V5 and V30 and the lung volume percentages V5 and V20 were compared. Results: The mean doses received by contralateral breast were 6.24 Gy (4.50-8.74 Gy) in unblocked group 3.85 Gy (2.08-5.81 Gy) in directionally blocked group and 0.99 Gy (0.69-1.39 Gy) in full blocked group. The mean Lung V5 values were 98% (79-100%) in unblocked group and it was 98% (91-100%) in directionally blocked group while it was 93% (89-97%) in full blocked group. The mean V20 values were 16% (7-23%), 20% (17-24%) and 22% (18-28%) in unblocked, directionally blocked and full blocked groups respectively. The mean Heart V5 value 100% (99-100%) in unblocked group, and it was 99% (85-100%) in directionally blocked group while it was 92% (73- 100%) in full blocked group. The mean V30 values were 11% (2-25%), 6% (0-12%) and 9% (1-22%) in unblocked, directionally blocked and full blocked groups respectively. The mean beam-on time was 261.6 s (237.6-318.2) for unblocked, 277.9 s (237.6-338.5) for directionally blocked and 314.2 s (272.6-429.1) full blocked group. The mean numbers of MUs were 3712 (3353-4536) for unblocked, 3951 (3357-4834) for directionally blocked and 4506 (3866- 6168) for full blocked group. In full blocked group both beam on time and MU values were higher. Conclusion: We propose that further efforts needed to reduce low dose volumes to normal tissues, meanwhile when using directionally and full blocked plans all parameters should be considered together.

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非阻断、定向阻断和完全阻断方案在乳腺癌放疗螺旋层析治疗中的比较

简介:研究了Hi-Art断层治疗系统中对侧乳腺、肺和心脏定向或全阻断技术在部分或全乳房放疗中的剂量。方法:对20例乳腺癌患者在Hi-Art计划系统中设计无阻断、定向阻断和全阻断3种方案。在所有计划方法中，比较对侧乳房接受的剂量、心脏容积百分比V5和V30以及肺容积百分比V5和V20。结果:未阻断组对侧乳腺接受的平均剂量为6.24 Gy (4.50 ~ 8.74 Gy)，定向阻断组为3.85 Gy (2.08 ~ 5.81 Gy)，完全阻断组为0.99 Gy (0.69 ~ 1.39 Gy)。无阻断组肺V5平均值为98%(79 ~ 100%)，定向阻断组肺V5平均值为98%(91 ~ 100%)，完全阻断组肺V5平均值为93%(89 ~ 97%)。未阻断组、定向阻断组和完全阻断组的平均V20值分别为16%(7-23%)、20%(17-24%)和22%(18-28%)。无阻断组心脏V5平均值为100%(99 ~ 100%)，定向阻断组为99%(85 ~ 100%)，完全阻断组为92%(73 ~ 100%)。未阻断组、定向阻断组和完全阻断组的平均V30值分别为11%(2 ~ 25%)、6%(0 ~ 12%)和9%(1 ~ 22%)。未阻断组平均光照时间261.6 s(237.6 ~ 318.2)，定向阻断组平均光照时间277.9 s(237.6 ~ 338.5)，完全阻断组平均光照时间314.2 s(272.6 ~ 429.1)。未阻断组平均有3712个(3353 ~ 4536个)，定向阻断组平均有3951个(3357 ~ 4834个)，完全阻断组平均有4506个(3866 ~ 6168个)。完全阻断组的波束时间和MU值均较高。结论:我们建议进一步减少正常组织的低剂量体积，同时在使用定向和全阻断方案时应综合考虑各项参数。

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Journal of Nuclear Medicine and Radiation Therapy

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