국소진행성 비소세포폐암 치료에 대한 나선형단층치료와 기존의 세기조절방사선치료의 선량비교

Title
국소진행성 비소세포폐암 치료에 대한 나선형단층치료와 기존의 세기조절방사선치료의 선량비교
Authors
송창훈
Keywords
국소진행성비소세포폐암치료에대한나선형단층치료와기존의세기조절방사선치료의선량비교
Issue Date
2012
Publisher
인하대학교
Abstract
Purpose: To compare helical tomotherapy (HT) and conventional Intensity-modulated radiotherapy (IMRT) using a variety of dosimetric indexes in locally advanced non-small cell lung cancer (NSCLC) patients and to determine tumor-specific factors that can be used to predict which patients harm most from HT. Materials and methods: Twenty patients with Stage III NSCLC were included. HT plans were generated using Hi-Art III TomoTherapy, and four to six coplanar beams IMRT plans were generated using Varian Eclipse system. Dose distributions and dosimetric indexes for the tumors and critical structures in both plans were computed and compared. Results: Both modalities created highly conformal plans that met the planning goals. The volume of lung irradiated to ≥ 20 Gy was equivalent between two modalities. The average mean lung dose, volume receiving ≥ 30 Gy, and volume receiving ≥ 10 Gy with HT was 18.3 Gy, 18.5%, and 57.1%, respectively, compared with 19.4 Gy, 25.4%, and 48.9% with IMRT (p = 0.004, p < 0.001, and p < 0.001, respectively). The differences of lung volume receiving ≥ 10&#8211;20 Gy between HT and IMRT increased significantly as the planning target volume (PTV) increased. In most patients with PTV over 700 cm3, IMRT was superior to HT in terms of lung volume receiving ≥ 5&#8211;20 Gy. The integral dose to entire thorax with HT was significantly higher than with IMRT. Conclusions: HT gave significantly better control of mean lung dose and volume receiving ≥ 30&#8211;40 Gy, whereas IMRT provided better control of the lung volume receiving ≥ 5&#8211;15 Gy and the integral dose to entire thorax. Caution is therefore advised in applying HT to large-sized LA-NSCLC.
Description
Contents List of Tables ii List of Figures iii Abstract iv 국문요약 vi Introduction 1 Materials and methods 3 Results 7 Discussion 11 Conclusion 14 References 15 List of Tables Table 1. Patient and tumor characteristics 20 Table 2. Normal tissue constraints 21 Table 3. Summary of results for PTV between HT and IMRT plans 22 Table 4A. Summary of the total lung parameters for HT and IMRT plans 23 Table 4B. Summary of the ipsilateral lung parameters for HT and IMRT plans 24 Table 4C. Summary of the contralateral lung parameters for HT and IMRT plans 25 Table 5. Summary of the normal thoracic tissue parameters for HT and IMRT plans 26 Table 6. Summary of the heart, spinal cord, and esophagus parameters for HT and IMRT plans 27 List of Figures Fig. 1. Increase of differences of total lung V10, V13, V15, and V20 in HT and IMRT plans as a function of planning target volume 28 Fig. 2. Increase of differences of contralateral lung V10, V13, V15, and V20 in HT and IMRT plans as a function of planning target volume 29
URI
http://dspace.inha.ac.kr/handle/10505/23466
Appears in Collections:
Medical School/College of Medicine (의학전문대학원/의과대학) > Medical Science (의학) > Theses(의학 석박사 학위논문)
Files in This Item:
24548.pdfDownload

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse