{"title":"食管癌放射治疗中使用动态摆动弧线改善冠状动脉剂量分布。","authors":"Kouta Hirotaki, Kenji Makita, Masashi Wakabayashi, Hidehiro Hojo, Satoe Kitou, Kento Tomizawa, Masashi Ito, Takeji Sakae","doi":"10.21873/invivo.14082","DOIUrl":null,"url":null,"abstract":"<p><strong>Background/aim: </strong>The dose to the left anterior descending coronary artery (LAD) is associated with mortality in patients with esophageal cancer (EC) who underwent radiotherapy. The aim of this study was to compare the dose distributions to the LAD region achieved through volumetric-modulated arc therapy (VMAT) planning using a dynamic swing arc in OXRAY (DSA-VMAT) and conventional coplanar (Conv-VMAT) planning.</p><p><strong>Patients and methods: </strong>Ten patients with EC who had undergone radiotherapy (60 Gy in 30 fractions) at our Institution were selected for inclusion in the study. Two virtual plans (DSA-VMAT and Conv-VMAT) were created to compare the dose distributions of the LAD region, heart, lungs, and planning target volume (PTV). All plans were analyzed using paired <i>t</i>-tests.</p><p><strong>Results: </strong>The mean values±standard deviation for 15 Gy to the LAD region (V15) were 10.48±13.04% for DSA-VMAT and 30.28±23.56% for Conv-VMAT. Compared with Conv-VMAT, DSA-VMAT significantly improved V15 of the LAD region (<i>p</i>=0.01). In addition, DSA-VMAT significantly reduced the mean heart dose (8.64±5.37 <i>vs.</i> 11.23±7.37 Gy), heart V40 (17.55±4.76% <i>vs.</i> 20.44±6.06%), lung V20 (14.87±5.93% <i>vs.</i> 17.81±7.70%), and lung V5 (57.27±8.24% <i>vs.</i> 61.15±9.97%) compared to Conv-VMAT (all <i>p</i>≤0.01). In contrast, there were no significant differences between the two groups in PTV dose coverage [D95 (<i>p</i>=0.61), D50 (<i>p</i>=0.62)], or conformity index (<i>p</i>=0.91).</p><p><strong>Conclusion: </strong>Compared with Conv-VMAT, DSA-VMAT improved the dose distribution of the LAD region without impairing the PTV dose coverage. Thus, DSA-VMAT may reduce radiation-induced heart disease in patients with EC without loss of efficacy.</p>","PeriodicalId":13364,"journal":{"name":"In vivo","volume":"39 5","pages":"2824-2831"},"PeriodicalIF":1.8000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12396035/pdf/","citationCount":"0","resultStr":"{\"title\":\"Improvement in Coronary Dose Distribution Using Dynamic Swing Arc in Volumetric-modulated Arc Therapy During Esophageal Cancer Radiotherapy.\",\"authors\":\"Kouta Hirotaki, Kenji Makita, Masashi Wakabayashi, Hidehiro Hojo, Satoe Kitou, Kento Tomizawa, Masashi Ito, Takeji Sakae\",\"doi\":\"10.21873/invivo.14082\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background/aim: </strong>The dose to the left anterior descending coronary artery (LAD) is associated with mortality in patients with esophageal cancer (EC) who underwent radiotherapy. The aim of this study was to compare the dose distributions to the LAD region achieved through volumetric-modulated arc therapy (VMAT) planning using a dynamic swing arc in OXRAY (DSA-VMAT) and conventional coplanar (Conv-VMAT) planning.</p><p><strong>Patients and methods: </strong>Ten patients with EC who had undergone radiotherapy (60 Gy in 30 fractions) at our Institution were selected for inclusion in the study. Two virtual plans (DSA-VMAT and Conv-VMAT) were created to compare the dose distributions of the LAD region, heart, lungs, and planning target volume (PTV). All plans were analyzed using paired <i>t</i>-tests.</p><p><strong>Results: </strong>The mean values±standard deviation for 15 Gy to the LAD region (V15) were 10.48±13.04% for DSA-VMAT and 30.28±23.56% for Conv-VMAT. Compared with Conv-VMAT, DSA-VMAT significantly improved V15 of the LAD region (<i>p</i>=0.01). In addition, DSA-VMAT significantly reduced the mean heart dose (8.64±5.37 <i>vs.</i> 11.23±7.37 Gy), heart V40 (17.55±4.76% <i>vs.</i> 20.44±6.06%), lung V20 (14.87±5.93% <i>vs.</i> 17.81±7.70%), and lung V5 (57.27±8.24% <i>vs.</i> 61.15±9.97%) compared to Conv-VMAT (all <i>p</i>≤0.01). In contrast, there were no significant differences between the two groups in PTV dose coverage [D95 (<i>p</i>=0.61), D50 (<i>p</i>=0.62)], or conformity index (<i>p</i>=0.91).</p><p><strong>Conclusion: </strong>Compared with Conv-VMAT, DSA-VMAT improved the dose distribution of the LAD region without impairing the PTV dose coverage. Thus, DSA-VMAT may reduce radiation-induced heart disease in patients with EC without loss of efficacy.</p>\",\"PeriodicalId\":13364,\"journal\":{\"name\":\"In vivo\",\"volume\":\"39 5\",\"pages\":\"2824-2831\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2025-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12396035/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"In vivo\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.21873/invivo.14082\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"MEDICINE, RESEARCH & EXPERIMENTAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"In vivo","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.21873/invivo.14082","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
Improvement in Coronary Dose Distribution Using Dynamic Swing Arc in Volumetric-modulated Arc Therapy During Esophageal Cancer Radiotherapy.
Background/aim: The dose to the left anterior descending coronary artery (LAD) is associated with mortality in patients with esophageal cancer (EC) who underwent radiotherapy. The aim of this study was to compare the dose distributions to the LAD region achieved through volumetric-modulated arc therapy (VMAT) planning using a dynamic swing arc in OXRAY (DSA-VMAT) and conventional coplanar (Conv-VMAT) planning.
Patients and methods: Ten patients with EC who had undergone radiotherapy (60 Gy in 30 fractions) at our Institution were selected for inclusion in the study. Two virtual plans (DSA-VMAT and Conv-VMAT) were created to compare the dose distributions of the LAD region, heart, lungs, and planning target volume (PTV). All plans were analyzed using paired t-tests.
Results: The mean values±standard deviation for 15 Gy to the LAD region (V15) were 10.48±13.04% for DSA-VMAT and 30.28±23.56% for Conv-VMAT. Compared with Conv-VMAT, DSA-VMAT significantly improved V15 of the LAD region (p=0.01). In addition, DSA-VMAT significantly reduced the mean heart dose (8.64±5.37 vs. 11.23±7.37 Gy), heart V40 (17.55±4.76% vs. 20.44±6.06%), lung V20 (14.87±5.93% vs. 17.81±7.70%), and lung V5 (57.27±8.24% vs. 61.15±9.97%) compared to Conv-VMAT (all p≤0.01). In contrast, there were no significant differences between the two groups in PTV dose coverage [D95 (p=0.61), D50 (p=0.62)], or conformity index (p=0.91).
Conclusion: Compared with Conv-VMAT, DSA-VMAT improved the dose distribution of the LAD region without impairing the PTV dose coverage. Thus, DSA-VMAT may reduce radiation-induced heart disease in patients with EC without loss of efficacy.
期刊介绍：
IN VIVO is an international peer-reviewed journal designed to bring together original high quality works and reviews on experimental and clinical biomedical research within the frames of physiology, pathology and disease management.
The topics of IN VIVO include: 1. Experimental development and application of new diagnostic and therapeutic procedures; 2. Pharmacological and toxicological evaluation of new drugs, drug combinations and drug delivery systems; 3. Clinical trials; 4. Development and characterization of models of biomedical research; 5. Cancer diagnosis and treatment; 6. Immunotherapy and vaccines; 7. Radiotherapy, Imaging; 8. Tissue engineering, Regenerative medicine; 9. Carcinogenesis.
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