PDF(Pubmed)
Abstract：
UNASSIGNED: The aim of our study was to compare dosimetric aspects of three radioablation modalities - direct high-dose-rate brachytherapy (HDR-BT) and virtually planned stereotactic body radiation therapy performed on CyberKnife (SBRTck) and Elekta Versa HD LINAC (SBRTe) applied in patients with liver metastases.
UNASSIGNED: We selected 30 patients with liver metastases, who received liver interstitial HDR-BT and virtually prepared plans for SBRTck and SBRTe. In all the cases, the prescribed dose was a single fraction of 25 Gy. Treatment delivery time, doses delivered to PTV and organs at risk, as well as conformity indices, were calculated and compared.
UNASSIGNED: The longest median treatment delivery time was observed in SBRTck in contrast to HDR-BT and SBRTe which were significantly shorter and comparable. HDR-BT plans achieved better coverage of PTV (except for D98%) in contrast to SBRT modalities. Between both SBRT modalities, SBRTck plans resulted in better dose coverage in Dmean, D50%, and D90% values compared to SBRTe without difference in D98%. The SBRTe was the most advantageous considering the PCI and R100%. SBRTck plans achieved the best HI, while R50% value was comparable between SBRTe and SBRTck. The lowest median doses delivered to uninvolved liver volume (V5Gy, V9.1Gy) were achieved with HDR-BT, while the difference between SBRT modalities was insignificant. SBRT plans were better regarding more favourable dose distribution in the duodenum and right kidney, while HDR-BT achieved lower doses in the stomach, heart, great vessels, ribs, skin and spinal cord. There were no significant differences in bowel and biliary tract dose distribution between all selected modalities.
UNASSIGNED: HDR-BT resulted in more favourable dose distribution within PTVs and lower doses in organs at risk, which suggests that this treatment modality could be regarded as an alternative to other local ablative therapies in carefully selected patients\' with liver malignancies. Future studies should further address the issue of comparing treatment modalities in different liver locations and clinical scenarios.
UNASSIGNED: We selected 30 patients with liver metastases, who received liver interstitial HDR-BT and virtually prepared plans for SBRTck and SBRTe. In all the cases, the prescribed dose was a single fraction of 25 Gy. Treatment delivery time, doses delivered to PTV and organs at risk, as well as conformity indices, were calculated and compared.
UNASSIGNED: The longest median treatment delivery time was observed in SBRTck in contrast to HDR-BT and SBRTe which were significantly shorter and comparable. HDR-BT plans achieved better coverage of PTV (except for D98%) in contrast to SBRT modalities. Between both SBRT modalities, SBRTck plans resulted in better dose coverage in Dmean, D50%, and D90% values compared to SBRTe without difference in D98%. The SBRTe was the most advantageous considering the PCI and R100%. SBRTck plans achieved the best HI, while R50% value was comparable between SBRTe and SBRTck. The lowest median doses delivered to uninvolved liver volume (V5Gy, V9.1Gy) were achieved with HDR-BT, while the difference between SBRT modalities was insignificant. SBRT plans were better regarding more favourable dose distribution in the duodenum and right kidney, while HDR-BT achieved lower doses in the stomach, heart, great vessels, ribs, skin and spinal cord. There were no significant differences in bowel and biliary tract dose distribution between all selected modalities.
UNASSIGNED: HDR-BT resulted in more favourable dose distribution within PTVs and lower doses in organs at risk, which suggests that this treatment modality could be regarded as an alternative to other local ablative therapies in carefully selected patients\' with liver malignancies. Future studies should further address the issue of comparing treatment modalities in different liver locations and clinical scenarios.
摘要：
■我们研究的目的是比较三种放射消融方式的剂量学方面-直接高剂量率近距离放射治疗（HDR-BT）和在Cyberknife（SBRTck）和ElektaVersaHDLINAC（SBRTTe）上进行的几乎计划的立体定向放射治疗。
■我们选择了30例肝转移患者，他们接受了肝脏间质HDR-BT，并为SBRTck和SBRTe准备了计划。在所有情况下,处方剂量为25Gy的单次剂量。治疗交付时间，传递给PTV和危险器官的剂量，以及合格指数，进行了计算和比较。
■在SBRTck中观察到最长的中位治疗递送时间,与显著较短且相当的HDR-BT和SBRTe形成对比。与SBRT模式相比，HDR-BT计划实现了更好的PTV覆盖率（D98％除外）。在两种SBRT模式之间，SBRTck计划导致Dmean更好的剂量覆盖率，D50%,和D90%值与SBRTe相比,D98%无差异。考虑到PCI和R100%,SBRTe是最有利的。SBRTck计划实现了最好的HI，而SBRTe和SBRTck之间的R50%值相当。递送至未受累肝脏体积的最低中位剂量(V5Gy，V9.1Gy)通过HDR-BT实现，而SBRT模式之间的差异不显著。关于十二指肠和右肾中更有利的剂量分布，SBRT计划更好，而HDR-BT在胃中达到较低的剂量，心,伟大的船只，肋骨,皮肤和脊髓。在所有选择的方式之间，肠和胆道剂量分布没有显着差异。
■HDR-BT在PTV内导致更有利的剂量分布，在危险器官中导致更低的剂量。这表明，这种治疗方式可以被视为在精心选择的肝脏恶性肿瘤患者中替代其他局部消融疗法。未来的研究应进一步解决比较不同肝脏位置和临床情况下的治疗方式的问题。
■我们选择了30例肝转移患者，他们接受了肝脏间质HDR-BT，并为SBRTck和SBRTe准备了计划。在所有情况下,处方剂量为25Gy的单次剂量。治疗交付时间，传递给PTV和危险器官的剂量，以及合格指数，进行了计算和比较。
■在SBRTck中观察到最长的中位治疗递送时间,与显著较短且相当的HDR-BT和SBRTe形成对比。与SBRT模式相比，HDR-BT计划实现了更好的PTV覆盖率（D98％除外）。在两种SBRT模式之间，SBRTck计划导致Dmean更好的剂量覆盖率，D50%,和D90%值与SBRTe相比,D98%无差异。考虑到PCI和R100%,SBRTe是最有利的。SBRTck计划实现了最好的HI，而SBRTe和SBRTck之间的R50%值相当。递送至未受累肝脏体积的最低中位剂量(V5Gy，V9.1Gy)通过HDR-BT实现，而SBRT模式之间的差异不显著。关于十二指肠和右肾中更有利的剂量分布，SBRT计划更好，而HDR-BT在胃中达到较低的剂量，心,伟大的船只，肋骨,皮肤和脊髓。在所有选择的方式之间，肠和胆道剂量分布没有显着差异。
■HDR-BT在PTV内导致更有利的剂量分布，在危险器官中导致更低的剂量。这表明，这种治疗方式可以被视为在精心选择的肝脏恶性肿瘤患者中替代其他局部消融疗法。未来的研究应进一步解决比较不同肝脏位置和临床情况下的治疗方式的问题。
