A comparison of liver protection among 3-D conformal radiotherapy, intensity-modulated radiotherapy and RapidArc for hepatocellular carcinoma

Radiation Oncology

Xue Dou¹  Kunli Zhu²  Xiaoqing Xu²  Shumei Jiang²  Shangang Liu¹  Rui Feng²  Hongjiang Yan²  Tonghai Liu²  Xiangjiao Meng²  Renben Wang²  Dong Chen¹ 

[1] School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Shandong Cancer Hospital, Jinan, Shandong 250117, China;Department of Radiation Oncology, Shandong Cancer Hospital, Jinan, Shandong 250117, China

关键词: Liver protection;    Radiation-induced liver disease;    Dosimetry;    Radiotherapy;    Hepatocellular carcinoma;   

Others  :  814793
DOI  :  10.1186/1748-717X-9-48

 received in 2013-10-06, accepted in 2014-02-02,  发布年份 2014

【 摘 要 】

Purpose

The analysis was designed to compare dosimetric parameters among 3-D conformal radiotherapy (3DCRT), intensity-modulated radiotherapy (IMRT) and RapidArc (RA) to identify which can achieve the lowest risk of radiation-induced liver disease (RILD) for hepatocellular carcinoma (HCC).

Methods

Twenty patients with HCC were enrolled in this study. Dosimetric values for 3DCRT, IMRT, and RA were calculated for total dose of 50 Gy/25f. The percentage of the normal liver volume receiving >40, >30, >20, >10, and >5 Gy (V₄₀, V₃₀, V₂₀, V₁₀ and V₅) were evaluated to determine liver toxicity. V₅, V₁₀, V₂₀, V₃₀ and D_mean of liver were compared as predicting parameters for RILD. Other parameters included the conformal index (CI), homogeneity index (HI), and hot spot (V_110%) for the planned target volume (PTV) as well as the monitor units (MUs) for plan efficiency, the mean dose (D_mean) for the organs at risk (OARs) and the maximal dose at 1% volume (D_1%) for the spinal cord.

Results

The D_mean of IMRT was higher than 3DCRT (p = 0.045). For V₅, there was a significant difference: RA > IMRT >3DCRT (p <0.05). 3DCRT had a lower V₁₀ and higher V₂₀, V₃₀ values for liver than RA (p <0.05). RA and IMRT achieved significantly better CI and lower V_110% values than 3DCRT (p <0.05). RA had better HI, lower MUs and shorter delivery time than 3DCRT or IMRT (p <0.05).

Conclusion

For right lobe tumors, RapidArc may have the lowest risk of RILD with the lowest V₂₀ and V₃₀ compared with 3DCRT or IMRT. For diameters of tumors >8 cm in our study, the value of D_mean for 3DCRT was lower than IMRT or RapidArc. This may indicate that 3DCRT is more suitable for larger tumors.

【 授权许可】

   
2014 Chen et al.; licensee BioMed Central Ltd.

【 图 表 】

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