Jonathan Robert Gabriel, Angela Mariah Locke, Brian William Miller, Jared Rex Robbins
{"title":"不同全脑放射治疗计划方法的剂量学分析:三种类型的三维与海马回避。","authors":"Jonathan Robert Gabriel, Angela Mariah Locke, Brian William Miller, Jared Rex Robbins","doi":"10.3857/roj.2023.01039","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Our purpose was to compare four whole brain radiotherapy (WBRT) delivery types: opposed lateral (OL) 3-dimensional-conformal radiotherapy (3D-CRT), a novel opposed lateral sparing (OLS) 3D-CRT technique, 3D optimized dynamic conformal arcs (optDCA), and hippocampal-avoidant WBRT (HA-WBRT).</p><p><strong>Materials and methods: </strong>Ten patients previously undergoing HA-WBRT were retrospectively planned using OL, OLS, and optDCA techniques. OLS technique involved multi-leaf collimator (MLC) modifications to protect the lacrimal and parotid glands. OptDCA was inverse-planned 3D-CRT with dynamic conformal arcs. A dosimetric, cost, and resource utilization comparison was performed.</p><p><strong>Results: </strong>Planning target volume coverage to prescription dose between 3D planning techniques was not significantly different between OL and OLS techniques (96.8% vs. 96.6%, p = 0.855), or between OL, OLS, and optDCA (95.0%) techniques (p = 0.079). There was no difference in the heterogeneity index between 3D plans (p = 0.482); all were less heterogeneous than HA-WBRT (p < 0.001). OptDCA was more conformal than OL and OLS, and similar in conformity to HA-WBRT. OLS achieved significant sparing of lacrimal and parotid glands over OL. There were significant step-function reductions in organ at risk (OAR) dose when comparing OL to OLS to optDCA to HA-WBRT plans. HA-WBRT was 57% more expensive than OL and OLS technique. HA-WBRT took approximately six times longer to plan.</p><p><strong>Conclusion: </strong>We showed adequate and equivalent target coverage using OL, OLS, and optDCA techniques. Lacrimal and parotid dosages can be greatly reduced with the implementation of minor MLC adjustments. OptDCA therapy represented further improvement of these modifications, and was comparable to HA-WBRT in terms of OAR dose, while being about two-thirds the cost and more efficient to plan.</p>","PeriodicalId":94184,"journal":{"name":"Radiation oncology journal","volume":"43 2","pages":"63-72"},"PeriodicalIF":0.0000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12215341/pdf/","citationCount":"0","resultStr":"{\"title\":\"Dosimetric analysis of different whole brain radiotherapy treatment planning methods: three types of 3-dimensional versus hippocampal avoidant.\",\"authors\":\"Jonathan Robert Gabriel, Angela Mariah Locke, Brian William Miller, Jared Rex Robbins\",\"doi\":\"10.3857/roj.2023.01039\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Our purpose was to compare four whole brain radiotherapy (WBRT) delivery types: opposed lateral (OL) 3-dimensional-conformal radiotherapy (3D-CRT), a novel opposed lateral sparing (OLS) 3D-CRT technique, 3D optimized dynamic conformal arcs (optDCA), and hippocampal-avoidant WBRT (HA-WBRT).</p><p><strong>Materials and methods: </strong>Ten patients previously undergoing HA-WBRT were retrospectively planned using OL, OLS, and optDCA techniques. OLS technique involved multi-leaf collimator (MLC) modifications to protect the lacrimal and parotid glands. OptDCA was inverse-planned 3D-CRT with dynamic conformal arcs. A dosimetric, cost, and resource utilization comparison was performed.</p><p><strong>Results: </strong>Planning target volume coverage to prescription dose between 3D planning techniques was not significantly different between OL and OLS techniques (96.8% vs. 96.6%, p = 0.855), or between OL, OLS, and optDCA (95.0%) techniques (p = 0.079). There was no difference in the heterogeneity index between 3D plans (p = 0.482); all were less heterogeneous than HA-WBRT (p < 0.001). OptDCA was more conformal than OL and OLS, and similar in conformity to HA-WBRT. OLS achieved significant sparing of lacrimal and parotid glands over OL. There were significant step-function reductions in organ at risk (OAR) dose when comparing OL to OLS to optDCA to HA-WBRT plans. HA-WBRT was 57% more expensive than OL and OLS technique. HA-WBRT took approximately six times longer to plan.</p><p><strong>Conclusion: </strong>We showed adequate and equivalent target coverage using OL, OLS, and optDCA techniques. Lacrimal and parotid dosages can be greatly reduced with the implementation of minor MLC adjustments. OptDCA therapy represented further improvement of these modifications, and was comparable to HA-WBRT in terms of OAR dose, while being about two-thirds the cost and more efficient to plan.</p>\",\"PeriodicalId\":94184,\"journal\":{\"name\":\"Radiation oncology journal\",\"volume\":\"43 2\",\"pages\":\"63-72\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12215341/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Radiation oncology journal\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.3857/roj.2023.01039\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/4/2 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Radiation oncology journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3857/roj.2023.01039","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/2 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
目的:我们的目的是比较四种全脑放疗(WBRT)的输送方式:对侧(OL)三维适形放疗(3D- crt)、一种新的对侧保留(OLS) 3D- crt技术、3D优化动态适形弧线(optDCA)和海马回避型WBRT (HA-WBRT)。材料和方法:采用OL、OLS和optDCA技术对10例既往接受HA-WBRT的患者进行回顾性计划。OLS技术涉及多叶准直器(MLC)修饰,以保护泪腺和腮腺。OptDCA是具有动态共形弧的逆规划3D-CRT。进行了剂量学、成本和资源利用比较。结果:3D规划技术在OL和OLS技术之间(96.8% vs. 96.6%, p = 0.855),在OL、OLS和optDCA技术之间(95.0%)(p = 0.079),规划靶体积对处方剂量的覆盖率无显著差异。三维方案间异质性指数差异无统计学意义(p = 0.482);均低于HA-WBRT异质性(p < 0.001)。OptDCA的适形性高于OL和OLS,与HA-WBRT的适形性相似。OLS对泪腺和腮腺的保护效果显著。当比较OL、OLS、optDCA和HA-WBRT计划时,器官危险(OAR)剂量有显著的阶梯功能降低。HA-WBRT比OL和OLS技术贵57%。HA-WBRT的计划花费了大约6倍的时间。结论:我们使用OL, OLS和optDCA技术显示了足够和等效的目标覆盖。泪腺和腮腺的剂量可以大大减少与实施轻微的MLC调整。OptDCA治疗进一步改善了这些修饰,在OAR剂量方面与HA-WBRT相当,而成本约为计划的三分之二,效率更高。
Dosimetric analysis of different whole brain radiotherapy treatment planning methods: three types of 3-dimensional versus hippocampal avoidant.
Purpose: Our purpose was to compare four whole brain radiotherapy (WBRT) delivery types: opposed lateral (OL) 3-dimensional-conformal radiotherapy (3D-CRT), a novel opposed lateral sparing (OLS) 3D-CRT technique, 3D optimized dynamic conformal arcs (optDCA), and hippocampal-avoidant WBRT (HA-WBRT).
Materials and methods: Ten patients previously undergoing HA-WBRT were retrospectively planned using OL, OLS, and optDCA techniques. OLS technique involved multi-leaf collimator (MLC) modifications to protect the lacrimal and parotid glands. OptDCA was inverse-planned 3D-CRT with dynamic conformal arcs. A dosimetric, cost, and resource utilization comparison was performed.
Results: Planning target volume coverage to prescription dose between 3D planning techniques was not significantly different between OL and OLS techniques (96.8% vs. 96.6%, p = 0.855), or between OL, OLS, and optDCA (95.0%) techniques (p = 0.079). There was no difference in the heterogeneity index between 3D plans (p = 0.482); all were less heterogeneous than HA-WBRT (p < 0.001). OptDCA was more conformal than OL and OLS, and similar in conformity to HA-WBRT. OLS achieved significant sparing of lacrimal and parotid glands over OL. There were significant step-function reductions in organ at risk (OAR) dose when comparing OL to OLS to optDCA to HA-WBRT plans. HA-WBRT was 57% more expensive than OL and OLS technique. HA-WBRT took approximately six times longer to plan.
Conclusion: We showed adequate and equivalent target coverage using OL, OLS, and optDCA techniques. Lacrimal and parotid dosages can be greatly reduced with the implementation of minor MLC adjustments. OptDCA therapy represented further improvement of these modifications, and was comparable to HA-WBRT in terms of OAR dose, while being about two-thirds the cost and more efficient to plan.