A method of determining the prescription isodose line for stereotactic radiotherapy VMAT plan
10.3760/cma.j.issn.0254-5098.2020.06.011
- VernacularTitle:一种确定立体定向放疗VMAT计划处方等剂量线的方法
- Author:
Yuan XU
1
;
Pan MA
;
Yingjie XU
;
Kuo MEN
;
Jianrong DAI
Author Information
1. 国家癌症中心 国家肿瘤临床医学研究中心 中国医学科学院北京协和医学院肿瘤医院放疗科 100021
- From:
Chinese Journal of Radiological Medicine and Protection
2020;40(6):477-480
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To establish a method of determining the prescription isodose line for steretactic radiotherapy (SRT) volumetric modulated arc radiotherapy (VMAT) plan.Methods:Eight patients with brain metastases treated with SRT were enrolled. The volume of planning target volume (PTV) ranged from 3.5 to 11.7 cm 3 (median 6.1 cm 3). Reference VMAT plans were designed for each patient with identical prescription dose. Then, the original PTV was contracted by a few millimeters to form a new target for optimization to get plans with different IDLs. The minimum margin which was needed to be contracted to achieve optimal IDL range for each PTV was also studied. Results:To achieve the optimal IDL range, 4 or 5 mm PTV contraction was needed for all patients, and the average IDL was (66.05±0.02)%. Compared with reference plans, the average gradient index (GI) of optimal IDL plans decreased by 20% from 4.05±0.39 to 3.37±0.24 ( Z=-2.521, P<0.05). The V40, V30, V5 and mean dose in normal brain tissue decreased by 11.5% ( Z=-1.973, P<0.05), 7.2% ( Z=-2.105, P<0.05), 12.8% ( Z=-2.521, P<0.05) and 8.1%, respectively ( Z=-2.382, P<0.05), and there was no statistically significant difference with V20, V10 and conformity index ( P>0.05). Conclusions:The optimization of IDL for SRT-VMAT plan can be achieved with the method of contracting PTV to form new target for planning. 4 or 5 mm is needed to be contracted to achieve the optimal IDL range, and to get lower GI and protect the normal brain tissue.