Angiosarcoma of the Scalp and Face: A Dosimetric Comparison of HDR Surface Applicator Brachytherapy and VMAT.

Q2 Medicine

Sarcoma Pub Date : 2020-08-25 eCollection Date: 2020-01-01 DOI:10.1155/2020/7615248

Devarati Mitra, Yaguang Pei, Ivan Buzurovic, Phillip M Devlin, Katherine Thornton, Chandrajit P Raut, Elizabeth H Baldini, Miranda B Lam

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引用次数: 4

Abstract

Purpose: Angiosarcoma of the face and scalp is a rare disease with high rates of recurrence. The optimal treatment approach is not well defined. This study presents a dosimetric comparison of high-dose-rate surface applicator (HDR-SA) brachytherapy to volumetric-modulated arc therapy (VMAT).

Methods: Between 2011 and 2018, 12 patients with primary or recurrent angiosarcoma of the face or scalp were treated with HDR-SA brachytherapy using CT-based planning at our institution. For comparison, deliverable VMAT plans for each patient were generated, and dose distribution was compared to the delivered HDR-SA brachytherapy plans.

Results: Both VMAT and HDR-SA brachytherapy plans delivered good coverage of the clinical target. However, the dose distribution of VMAT was significantly different from HDR-SA brachytherapy across a variety of parameters. Mean doses to the lacrimal gland, orbit, lens, and cochlea were significantly higher with HDR-SA brachytherapy vs. VMAT. Brain Dmax, V80%, and V50% were also significantly higher with HDR-SA brachytherapy.

Conclusions: There may be dosimetric advantages to VMAT over HDR-SA brachytherapy for many patients. However, individual tumor location, patient anatomy, and treatment reproducibility may result in HDR-SA brachytherapy being the preferred technique in a subset of patients. Ultimately, a personalized approach is likely to be the optimal treatment plan.

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头皮和面部血管肉瘤:HDR表面涂抹器近距离放疗和VMAT的剂量学比较。

目的:面部和头皮血管肉瘤是一种罕见的疾病，复发率高。最佳治疗方法尚不明确。本研究提出了高剂量率表面涂抹器(HDR-SA)近距离放射治疗与体积调制电弧治疗(VMAT)的剂量学比较。方法:2011年至2018年，12例面部或头皮原发性或复发性血管肉瘤患者采用基于ct的计划接受HDR-SA近距离放疗。为进行比较，生成每位患者可交付的VMAT计划，并将剂量分布与交付的HDR-SA近距离治疗计划进行比较。结果:VMAT和HDR-SA近距离治疗方案均能很好地覆盖临床靶点。然而，VMAT的剂量分布在各种参数上与HDR-SA近距离放疗有显著差异。与VMAT相比，HDR-SA近距离放疗对泪腺、眼眶、晶状体和耳蜗的平均剂量明显更高。HDR-SA近距离治疗的脑Dmax、V80%和V50%也显著提高。结论:对许多患者来说，VMAT可能比HDR-SA近距离放疗有剂量学上的优势。然而，个体肿瘤位置、患者解剖结构和治疗可重复性可能导致HDR-SA近距离放疗成为部分患者的首选技术。最终，个性化的方法可能是最佳的治疗方案。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Sarcoma Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

5.00

自引率

0.00%

发文量

审稿时长

14 weeks

期刊介绍： Sarcoma is dedicated to publishing papers covering all aspects of connective tissue oncology research. It brings together work from scientists and clinicians carrying out a broad range of research in this field, including the basic sciences, molecular biology and pathology and the clinical sciences of epidemiology, surgery, radiotherapy and chemotherapy. High-quality papers concerning the entire range of bone and soft tissue sarcomas in both adults and children, including Kaposi"s sarcoma, are published as well as preclinical and animal studies. This journal provides a central forum for the description of advances in diagnosis, assessment and treatment of this rarely seen, but often mismanaged, group of patients.