Quantifying the effect of eccentric ruthenium plaque placement on tumor volume dose

IF 1.1 4区 医学 Q4 ONCOLOGY
Jeremy P. M. Flanagan, William H. F. Udovenya, Melvin A. Astrahan, Daniel McKay, Claire Phillips, John D. McKenzie, Roderick O’Day, Lotte S. Fog
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Abstract

Purpose:
Ruthenium-106 brachytherapy is a common treatment for small to medium-sized uveal melanomas. In certain clinical contexts, plaques may be placed eccentrically to tumor center. The effect of plaque decentration, a common radiation dose measurement in radiotherapy: D98%, the percentage of the tumor volume receiving at least 98% of the prescribed dose (a commonly used term in radiation oncology), is unknown. We investigated this using two commonly used plaques (CCA and CCB; Eckert & Ziegler, BEBIG GmbH) in silico.

Material and methods:
Using a Plaque Simulator™ (Eye Physics) plaque modelling software, treatment time required to deliver 100 Gy D98% with central plaque placement was calculated for both plaque models, treating tumors with basal dimensions of 10 mm (CCB plaque only) and 7 mm (CCA and CCB plaques), and a range of thicknesses. D98% was calculated for plaque-tumor edge distances of 0-5 mm. Additionally, we defined minimum plaque-tumor edge distances, at which D98% fell by 10% and 5% (safety margins).

Results:
D98% decreased as plaque-tumor edge distance decreased, i.e. as plaque eccentricity increased. Minor (< 1 mm) plaque decentration caused minimal D98% changes across tumor thicknesses. Safety margins did not follow a consistent pattern.

Conclusions:
Eccentric plaque placement reduces the radiation dose delivered to choroidal tumors. Both tumor (thickness, diameter) and plaque (size, location) characteristics are important D98% modulators. Further investigation of the effect of these characteristics and dose to organs at risk is essential.

量化偏心钌斑块放置对肿瘤体积剂量的影响
目的:钌-106近距离放射治疗是治疗中小型葡萄膜黑色素瘤的常用方法。在某些临床情况下,可将斑块置于肿瘤中心的偏心位置。斑块分散的影响是放射治疗中常用的辐射剂量测量方法:D98%是指肿瘤体积接受至少98%的规定剂量的百分比(放射肿瘤学常用术语)。我们使用两种常用斑块(CCA 和 CCB;Eckert & Ziegler, BEBIG GmbH)对这一问题进行了硅学研究。材料和方法:使用斑块模拟器™(Eye Physics)斑块建模软件,计算了两种斑块模型的中心斑块置放 100 Gy D98% 所需的治疗时间,治疗的肿瘤基底尺寸分别为 10 毫米(仅 CCB 斑块)和 7 毫米(CCA 和 CCB 斑块),厚度不等。斑块-肿瘤边缘距离为 0-5 毫米时计算 D98%。此外,我们还定义了斑块-肿瘤边缘的最小距离,在此距离上,D98%下降了10%和5%(安全系数)。结果:随着斑块-肿瘤边缘距离的减小,即斑块偏心率的增加,D98%也随之减小。轻微(1 毫米)的斑块分散导致不同肿瘤厚度的 D98% 变化极小。结论:偏心斑块放置降低了脉络膜肿瘤的辐射剂量。肿瘤(厚度、直径)和斑块(大小、位置)的特征都是重要的 D98% 调节因素。进一步研究这些特征和剂量对危险器官的影响至关重要。
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来源期刊
Journal of Contemporary Brachytherapy
Journal of Contemporary Brachytherapy ONCOLOGY-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
CiteScore
2.40
自引率
14.30%
发文量
54
审稿时长
16 weeks
期刊介绍: The “Journal of Contemporary Brachytherapy” is an international and multidisciplinary journal that will publish papers of original research as well as reviews of articles. Main subjects of the journal include: clinical brachytherapy, combined modality treatment, advances in radiobiology, hyperthermia and tumour biology, as well as physical aspects relevant to brachytherapy, particularly in the field of imaging, dosimetry and radiation therapy planning. Original contributions will include experimental studies of combined modality treatment, tumor sensitization and normal tissue protection, molecular radiation biology, and clinical investigations of cancer treatment in brachytherapy. Another field of interest will be the educational part of the journal.
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