III 기 폐암 치료에서

체적변조아크 기반의 새로운 복합방사선치료기법의 유용성 검증 이 논문을 박사 학위 논문으로 제출했습니다. 지상욱 박사학위논문 확정.

박사논문을 준비하는 과정은 저의 부족한 점을 알아가는 과정이었습니다. 논문이 완성되기까지 부족한 점이 많았지만 변함없는 관심과 애정으로 지도해주시고 부족한 부분은 항상 채워주신 안승도 교수님께 깊은 감사를 드립니다. 바쁘신 와중에도 기꺼이 논문 심사를 해주신 송시열, 김수산, 박진홍, 정원규 씨께 머리 숙여 감사드립니다.

This study aimed to demonstrate the utility of the new hVMAT technique in stage III lung. Scatter plots of the V5 and V20 of the lung according to the PTV/lung ratio of the SI.

INTRODUCTION

MATERIALS and METHODS

3DCRT plans were made using five static beams in 29 patients, and the plans for. The CI ranges from 0 (no spatial correspondence between the two volumes and no protection of healthy tissue at the given isodose) to 1 (perfect protection of healthy tissue). But this CI alone is not enough to evaluate PTV coverage. intended to compensate for the deficiencies of CI.

A value close to 0 means either a complete absence of conformation, i.e. the target volume is not irradiated or a very large amount of irradiation compared to the target. HI was calculated as follows13:. where D2% and D98% are the minimum dose to 2% and 98% of the target volume, respectively, and DP is. The absolute volume of the PTV does not sufficiently represent the relative size of the PTV to.

Thus, we used the “PTV/lung ratio” to quantify the relative size of the PTV. total measured length of normal lung and PTV in the superior-inferior direction.

Figure 1. Schematic diagrams represent that measurement method of the planning target

RESULTS

Therefore, we divided the patients into two groups based on the. and dosimetric parameters between two groups according to the PTV/lung ratio of SI axis. MLD; mean lung dose, hVMAT; hybrid volumetric modulated arc therapy, VMAT; volumetric modulated arc therapy, 3DCRT; 3-dimensional conformal radiation therapy, PTV; planning target volume, P-coefficient;. The difference in the values for V5 and V20 of the lung for the two techniques is.

The PTV/lung ratio of the SI axis, lung V20 was further reduced by the hVMAT schedule. However, the correlation between the V5 difference and the ratio of the SI axis was not. Scatter plot of V5 and V20 difference between hVMAT and CRT or hVMAT. and VMAT plane according to the PTV/lung ratio for the SI axis.

CRT; conformal radiation. therapy, VMAT; volumetric modulated arc therapy, hVMAT; hybrid volumetrically modulated. arc therapy, PTV; plan target volume, SI; superior-inferior). Correlation analysis between lung dosimetric parameters and PTV/lung ratio of the SI axis. PTV/LUNG ratio of the SI axis. 3DCRT; 3-dimensional conformal radiation therapy, hVMAT; hybrid volumetric modulated arc therapy, VMAT; volumetric modulated arc therapy, PTV; plan target volume, SI; superior-inferior.

The isodose line from the hVMAT plot shows the best dose distribution. in terms of irradiated lung volume. The average spinal cord Dmax of hVMAT plans was higher than VMAT, however. 3DCRT; 3-dimensional conformal radiotherapy, VMAT; volumetric modulated arc therapy, hVMAT; hybrid VMAT, CI; conformity index, CN; conformation number, HI; homogeneity index (empty p-values represent p < 0.001).

We also compared the dose parameters of group A (relatively small) and group B (relatively large) separately according to the PTV/lung ratio of the SI axis (Table 5). Group A; PTV/lung ratio of SI axis < 0.55, group B; PTV/lung ratio of SI axis ³0.55, 3DCRT; 3-dimensional conformal radiotherapy, VMAT; volumetric modulated arc therapy, hVMAT; hybrid VMAT, CI; conformity index, CN;. Based on clinical stage, the mean overall survival time of stage IIIA and. stage IIIB was 21.0 and 26.4 months, and the 1-year overall survival rate of stage IIIA and .

DISCUSSION

VMAT or 3DCRT, and V5 and V10 of the lung were smaller in hVMAT and 3DCRT plan. The hVMAT plan combined static beams (60% . dose) and arcs (40% dose), dosimetric comparison showed similar findings to those. Through this new technique, all dosimetric parameters of the lung (V5, . V10, V20, MLD) were improved while maintaining a proper spinal cord dose, esophageal.

Table 6. Comparison of hybrid planning studies for lung cancer.

CONCLUSION

Chan OS, Lee MC, Hung AW, et al: Superiority of hybrid-volumetric arc therapy. Mayo CS, Urie MM, Fitzgerald TJ, et al: Hybrid IMRT for the treatment of breast cancer. Donnelly PM, Yang TS, Peat JK, et al: What factors explain racial differences in the lung.

목적: 폐암 3기 환자에서 기존의 3차원 입체조형방사선치료(3DCRT), 세기조절방사선치료(IMRT) 또는 용적변조방사선치료(VMAT) 기술로는 충분한 방사선량을 조사하기 어려운 경우. 이를 해결하기 위해 새로운 하이브리드 VMAT(hVMAT) 기술이 등장했다. 이 연구의 목적은 3기 폐암 치료를 위한 새로운 hVMAT 기술을 개발하는 것입니다.

방법: hVMAT로 치료받은 III기 폐암 환자 32명을 분석했습니다. 세 가지 치료 계획(3DCRT 대 VMAT 대 hVMAT)을 비교하는 데 사용되었습니다.