PDF(Pubmed)
Abstract：
UNASSIGNED: There is no consensus on the best photon radiation technique for non-small cell lung cancer (NSCLC). This study quantified the differences between commonly used treatment techniques in NSCLC to find the optimal technique.
UNASSIGNED: Treatment plans were retrospectively generated according to clinical guidelines for 26 stage III NSCLC patients using intensity modulated radiation therapy (IMRT), hybrid, and volumetric modulated arc therapy (VMATC, and VMATV5 optimized for lower lung and heart dose). Plans were evaluated for target coverage, organs at risk dose (including heart substructures) and normal tissue complication probabilities (NTCP).
UNASSIGNED: The comparison showed significant and largest median differences (>1 Gy or >5%) in favor of IMRT for the mediastinal envelope and heart (maximum dose), in favor of the hybrid technique for the lungs (V5Gy of the total lungs and V5Gy of the contralateral lung) and in favor of VMATC for the heart (Dmean), most of the substructures of the heart, and the spinal cord (maximum dose). The VMATV5 technique had significantly lower heart dose compared to the hybrid technique and significantly lower lung dose compared to the VMATC, combining both advantages in one technique. The mean ΔNTCP did not exceed the 2 percent point (pp) for grade 5 (mortality), and 10 pp for grade ≥2 toxicities (radiation pneumonitis and acute esophageal toxicity), but ΔNTCP was mostly in favor of VMATC/V5 for individual patients.
UNASSIGNED: This planning study showed that VMATV5 was preferred as it achieved low lung and heart doses, as well as low NTCPs, simultaneously.
UNASSIGNED: Treatment plans were retrospectively generated according to clinical guidelines for 26 stage III NSCLC patients using intensity modulated radiation therapy (IMRT), hybrid, and volumetric modulated arc therapy (VMATC, and VMATV5 optimized for lower lung and heart dose). Plans were evaluated for target coverage, organs at risk dose (including heart substructures) and normal tissue complication probabilities (NTCP).
UNASSIGNED: The comparison showed significant and largest median differences (>1 Gy or >5%) in favor of IMRT for the mediastinal envelope and heart (maximum dose), in favor of the hybrid technique for the lungs (V5Gy of the total lungs and V5Gy of the contralateral lung) and in favor of VMATC for the heart (Dmean), most of the substructures of the heart, and the spinal cord (maximum dose). The VMATV5 technique had significantly lower heart dose compared to the hybrid technique and significantly lower lung dose compared to the VMATC, combining both advantages in one technique. The mean ΔNTCP did not exceed the 2 percent point (pp) for grade 5 (mortality), and 10 pp for grade ≥2 toxicities (radiation pneumonitis and acute esophageal toxicity), but ΔNTCP was mostly in favor of VMATC/V5 for individual patients.
UNASSIGNED: This planning study showed that VMATV5 was preferred as it achieved low lung and heart doses, as well as low NTCPs, simultaneously.
摘要：
■关于非小细胞肺癌（NSCLC）的最佳光子辐射技术尚无共识。这项研究量化了NSCLC常用治疗技术之间的差异，以找到最佳技术。
■根据临床指南，对26例III期NSCLC患者使用调强放疗（IMRT）进行回顾性治疗。混合动力车,和体积调制电弧疗法(VMATC，和VMATV5优化用于较低的肺和心脏剂量)。评估了计划的目标覆盖率，危险器官剂量(包括心脏亚结构)和正常组织并发症概率(NTCP)。
■比较显示，纵隔包膜和心脏（最大剂量）的IMRT差异显著且最大（>1Gy或>5％），有利于肺的混合技术（全肺的V5Gy和对侧肺的V5Gy），有利于心脏的VMATC（Dmean），心脏的大部分子结构，和脊髓（最大剂量）。与混合技术相比，VMATV5技术的心脏剂量显着降低，与VMATC相比，肺剂量显着降低，将两种优势结合在一种技术中。5级（死亡率）的平均ΔNTCP不超过2％点（pp），≥2级毒性（放射性肺炎和急性食管毒性）为10页，但ΔNTCP对个体患者大多支持VMATC/V5。
■这项计划研究表明，VMATV5是首选，因为它实现了低肺和心脏剂量，以及低NTCP，同时。
■根据临床指南，对26例III期NSCLC患者使用调强放疗（IMRT）进行回顾性治疗。混合动力车,和体积调制电弧疗法(VMATC，和VMATV5优化用于较低的肺和心脏剂量)。评估了计划的目标覆盖率，危险器官剂量(包括心脏亚结构)和正常组织并发症概率(NTCP)。
■比较显示，纵隔包膜和心脏（最大剂量）的IMRT差异显著且最大（>1Gy或>5％），有利于肺的混合技术（全肺的V5Gy和对侧肺的V5Gy），有利于心脏的VMATC（Dmean），心脏的大部分子结构，和脊髓（最大剂量）。与混合技术相比，VMATV5技术的心脏剂量显着降低，与VMATC相比，肺剂量显着降低，将两种优势结合在一种技术中。5级（死亡率）的平均ΔNTCP不超过2％点（pp），≥2级毒性（放射性肺炎和急性食管毒性）为10页，但ΔNTCP对个体患者大多支持VMATC/V5。
■这项计划研究表明，VMATV5是首选，因为它实现了低肺和心脏剂量，以及低NTCP，同时。
