Comparison of the ovarian sparing between VMAT and IMRT after ovarian transposition surgery for cervical cancer patients
10.3760/cma.j.issn.0254-5098.2021.05.003
- VernacularTitle:宫颈癌卵巢移位术后VMAT与IMRT卵巢放疗剂量的比较
- Author:
Chang GUO
1
;
Yifan WU
;
Zhenyu ZHAI
;
Hanzi XU
Author Information
1. 江苏省肿瘤医院 江苏省肿瘤防治研究所 南京医科大学附属肿瘤医院放疗科 210009
- Keywords:
Cervical cancer;
Ovarian transposition;
Intensity modulated radiotherapy;
Ovarian;
Dose
- From:
Chinese Journal of Radiological Medicine and Protection
2021;41(5):334-339
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the dosimetric difference between IMRT and VMAT plans for ovarian protection after cervical cancer ovarian transposition surgery.Methods:Thirty-one patients who had received both cervical cancer resection and ovarian transposition were selected for adjuvant radiotherapy. The 9-field evenly divided IMRT and the dual-arc VMAT technology were performed for the treatment planning. The difference of the ovarian mean dose between the two techniques was explored. The relationship between the position of the ovarian-target interval and the ovarian dose was also analyzed.Results:A total of 54 ovaries in 31 patients were effectively transposed and moved out of the target area. Among them, 9 ovaries were located above the upper boundary of the PTV. For these cases, the ovarian mean dose of IMRT and VMAT were (177.8±90.7) and (166.7±70.6) cGy, respectively, which was not statistically different( P>0.05).45 ovaries were located in the same level with PTV. For these cases, the ovarian mean dose of IMRT and VMAT were (459.1±239.9) and (428.3±238.2) cGy, respectively ( z=3.11, P=0.002). The ovarian mean dose has the highest correlation and negative correlation with the closest lateral distance from the ovarian volume center to the PTV surface (IMRT, r=-0.922, P=0.001; VMAT, r=-0.865, P=0.001). To reduce the ovarian mean dose to 500 cGy, the lateral closest distance between the ovarian volume center and the PTV surface should be 3.6 cm and 3.3 cm for IMRT and VMAT respectively. Conclusions:There is no difference between the two planned ovarian doses when the ovaries were located above the upper boundary of the PTV. When the ovaries were located in the same level with PTV, the VMAT plan is better than IMRT in both ovarian dose and treatment efficiency. The ovarian dose could be predicted by the lateral closest distance from the ovarian volume center to the PTV.
