Accelerated large volume irradiation with dynamic Jaw/Dynamic Couch Helical Tomotherapy

Radiation Oncology

Florian Sterzing¹  Juergen Debus¹  Klaus Herfarth¹  Susanta Hui²  Steffen Lissner¹  Kai Schubert¹  Sebastian Beck¹  Sonja Krause¹ 

[1]Department of Radiation Oncology, University Hospital Heidelberg, INF 400, 69120, Heidelberg, Germany

[2]Department of Therapeutic Radiology, University of Minnesota, 420 Delaware St. SE, Mayo Mail Code 494, Minneapolis, , MN 55455, USA

关键词: Total marrow irradiation;    Whole abdominal irradiation;    Hemithoracic irradiation;    Large volumes;    Helical tomotherapy;    Dynamic jaw/dynamic couch;   

Others  :  1155071
DOI  :  10.1186/1748-717X-7-191

 received in 2012-05-03, accepted in 2012-11-05,  发布年份 2012

【 摘 要 】

Background

Helical Tomotherapy (HT) has unique capacities for the radiotherapy of large and complicated target volumes. Next generation Dynamic Jaw/Dynamic Couch HT delivery promises faster treatments and reduced exposure of organs at risk due to a reduced dose penumbra.

Methods

Three challenging clinical situations were chosen for comparison between Regular HT delivery with a field width of 2.5 cm (Reg 2.5) and 5.0 cm (Reg 5.0) and DJDC delivery with a maximum field width of 5.0 cm (DJDC 5.0): Hemithoracic Irradiation, Whole Abdominal Irradiation (WAI) and Total Marrow Irradiation (TMI). For each setting, five CT data sets were chosen, and target coverage, conformity, integral dose, dose exposure of organs at risk (OAR) and treatment time were calculated.

Results

Both Reg 5.0 and DJDC 5.0 achieved a substantial reduction in treatment time while maintaining similar dose coverage. Treatment time could be reduced from 10:57 min to 3:42 min / 5:10 min (Reg 5.0 / DJDC 5.0) for Hemithoracic Irradiation, from 18:03 min to 8:02 min / 8:03 min for WAI and to 18:25 min / 18:03 min for TMI. In Hemithoracic Irradiation, OAR exposure was identical in all modalities. For WAI, Reg 2.5 resulted in lower exposure of liver and bone. DJDC plans showed a small but significant increase of ∼ 1 Gy to the kidneys, the parotid glans and the thyroid gland. While Reg 5.0 and DJDC were identical in terms of OAR exposure, integral dose was substantially lower with DJDC, caused by a smaller dose penumbra.

Conclusions

Although not clinically available yet, next generation DJDC HT technique is efficient in improving the treatment time while maintaining comparable plan quality.

【 授权许可】

   
2012 Sonja et al.; licensee BioMed Central Ltd.

【 图 表 】

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