Influence of Couch and Collimator on Dose Distribution of RapidArc Treatment Planning for Prostate Cancer in Radiation Therapy

치료테이블과 콜리메이터가 전립선암 래피드아크 치료계획의 선량분포에 미치는 영향

  • Kim, Hyung-Dong (Department of Physics, College of Science, Yeungnam University) ;
  • Kim, Byung-Young (Department of Physics, College of Science, Yeungnam University) ;
  • Kim, Sung-Jin (Department of Physics, College of Science, Yeungnam University) ;
  • Yun, Sang-Mo (Department of Radiation Oncology, Daegu Fatima Hospital) ;
  • Kim, Sung-Kyu (Department of Therapeutic Radiology & Oncology, College of Medicine, Yeungnam University)
  • 김형동 (영남대학교 물리학과) ;
  • 김병용 (영남대학교 물리학과) ;
  • 김성진 (영남대학교 물리학과) ;
  • 윤상모 (대구파티마병원 방사선종양학과) ;
  • 김성규 (영남대학교 의과대학 방사선종양학교실)
  • Received : 20110000
  • Accepted : 20110000
  • Published : 2012.06.30

Abstract

We investigated the influence of photon energy, couch and collimator angle differences between arcs on dose distribution of RapidArc treatment planning for prostate cancer. RapidArc plans were created for 6 MV and 10 MV photons using 2 arcs coplanar and noncoplanar fields. The collimator angle differences between two arcs were $0^{\circ}$, $15^{\circ}$, $30^{\circ}$, $45^{\circ}$, $60^{\circ}$, $75^{\circ}$ and $90^{\circ}$. The plans were optimized using same dose constrains for target and OAR (organ at risk). To evaluate the dose distribution, plans were analyzed using CI (conformity index), HI (homogeneity index), QOC (quality of coverage), etc. Photon energy, couch and collimator angle differences between arcs had a little influence on the target and OAR. The difference of dosimetric indices was less than 3.6% in the target and OAR. However, there was significant increase in the region exposed to low dose. The increase of V15% in the femur was 6.4% (left) and 5.5% (right) for the 6 MV treatment plan and 23.4% (left), 24.1% (right) for the noncoplanar plan. The increase of V10% in the Far Region distant from target was 54.2 cc for the 6 MV photon energy, 343.4 cc for the noncoplanar and 457.8 cc for the no collimator rotation between arcs.

치료 테이블 회전, 아크 간 콜리메이터 회전 각도가 광자에너지별 전립선암 래피드아크 치료계획의 선량분포에 미치는 영향에 대해 조사하였다. 6 MV와 10 MV 광자 에너지에 대해 2 아크(two arcs)를 사용하여 아크 간 콜리메이터 각도 차이가 $0^{\circ}$, $15^{\circ}$, $30^{\circ}$, $45^{\circ}$, $60^{\circ}$, $75^{\circ}$, $90^{\circ}$인 경우와 치료 테이블 회전 유무에 따라 치료계획을 시행하였다. 선량 최적화를 위한 표적 및 중요 장기의 선량 제한치(dose constraints)를 동일하게 적용하여 계산하였고 선량 분포를 평가하기 위해 CI (Conformity index), HI (Homogeneity index), QOC (Quality of Coverage) 등의 정량화된 선량 지표를 구하여 각 치료계획의 최적화 결과를 비교하였다. 그 결과 치료계획표적용적과 중요장기의 선량 지표 차이는 3.6% 이하로 광자에너지, 치료테이블, 아크 간 콜리메이터 각도의 영향은 크지 않았다. 그러나 표적에서 먼 정상조직의 경우 저 선량 영역 차이가 크게 나타났다. 좌우 대퇴골두의 V15%는 6 MV 일 때 각각 6.4%, 5.5% 높았고, 치료테이블 회전 시에는 23.4%, 24.1% 높게 나타났다. 표적에서 먼 영역(Far Region)의 V10%는 6 MV 일 때 54.2 cc, 치료테이블 회전이 없을 때 343.4 cc, 아크 간 콜리메이터 각도가 $0^{\circ}$일 때 457.8 cc 크게 나타났다.

Keywords

References

  1. Intensity Modulated Radiation Therapy Collaborative Working Group: Intensity modulated radiotherapy: Current status and issues of interest. Int J Radiation Oncology Biol Phys 51:880-917 (2001) https://doi.org/10.1016/S0360-3016(01)01749-7
  2. Ling CC, Burman C, Chui CS, et al: Conformal radiation treatment of prostate cancer using inversely-planned intensity-modulated photon beams produced with dynamic multileaf collimation. Int J Radiation Oncology Biol Phys 35:721-730 (1996) https://doi.org/10.1016/0360-3016(96)00174-5
  3. De Meerleer GO, Vakaet LMM, De Gersem W, et al: Radiotherapy of prostate cancer with or without intensity modulated beams: A planning comparison. Int J Radiation Oncology Biol Phys 47:639-648 (2000) https://doi.org/10.1016/S0360-3016(00)00419-3
  4. Yu CX, Li XA, Ma L, et al: Clinical implementation of intensity- modulated arch therapy. Int J Radiation Oncology Biol Phys 53:453-463 (2002) https://doi.org/10.1016/S0360-3016(02)02777-3
  5. Otto K: Volumetric modulated arc therapy: IMRT in a single gantry arc. Med Phys 35:310-317 (2008) https://doi.org/10.1118/1.2818738
  6. Laughlin JS, Mohan R, Kutcher GJ: Choice of optimum megavoltage for accelerators for photon beam treatment. Int J Radiation Oncology Biol Phys 12:1551-1557 (1986) https://doi.org/10.1016/0360-3016(86)90277-4
  7. Sternick ES, Bleier AR, Carol MP, et al: Intensity modulated radiation therapy: What photon energy is best? International Conference on the Use of Computers in Radiation Therapy (ICCR), XIIth Annual Meeting. Salt Lake, (1997) pp. 418-419
  8. Soderstrom S, Eklof A, Brahme A: Aspects on the optimal photon beam energy for radiation therapy. Acta Oncologica 38:179-187 (1999) https://doi.org/10.1080/028418699431591
  9. Rao M, Yang W, Chen F, et al: Comparison of Elekta VMAT with helical tomotherapy and fixed field IMRT: plan quality delivery efficiency and accuracy. Med Phys 37:1350-1359 (2010) https://doi.org/10.1118/1.3326965
  10. Price RA, Hanks GE, Mcneeley SW, et al: Advantages of using noncoplanar vs. axial beam arrangements when treating prostate cancer with intensity-modulated radiation therapy and the step-and-shoot delivery method Int. J. Radiation Oncology Biol Phys 53:236-243 (2002) https://doi.org/10.1016/S0360-3016(02)02736-0
  11. Lee WR, Daniel L: Radiation Therapy Oncology Group RTOG 0415: A phase III randomized study of hypofractionated 3D-CRT/IMRT versus conventionally fractionated 3D-CRT/IMRT in patients with favorable-risk prostate cancer. Mahul, BA, (2009)
  12. Pirzkall A, Carol MP, Pickett B, et al: The effect of beam energy and number of fields on photon based imrt for deep seated targets. Int J Radiation Oncology Biol Phys 53:434-442 (2002) https://doi.org/10.1016/S0360-3016(02)02750-5
  13. Feuvret L, Noel G, Mazeron JJ, et al: Conformity index: A review. Int J Radiation Oncology Biol Phys 64:333-342 (2006) https://doi.org/10.1016/j.ijrobp.2005.09.028
  14. Ost P, Speleers B, De Merleer G, et al: Volumetric modulated arc therapy and intensity modulated radiotherapy for primary prostate radiotherapy with simultaneous integrated boost to intraprostatic lesion with 6 and 18 MV: a planning comparison study. Int J Radiation Oncology Biol Phys 79:920-926 (2011) https://doi.org/10.1016/j.ijrobp.2010.04.025
  15. Pirzkall A, Carol M, Pickett B, et al: The effect of beam energy and number of fields on photon-based IMRT for deep-seated targets. Int J Radiation Oncology Biol Phys 53:434- 442 (2002) https://doi.org/10.1016/S0360-3016(02)02750-5
  16. Smith V, Verhey L, Serago CF: Comparison of radiosurgery treatment modalities based on complication and control probabilities. Int J Radiation Oncology Biol Phys 40:507-513 (1998) https://doi.org/10.1016/S0360-3016(97)00721-9
  17. Hall EJ, Wuu CS: Radiation-induced second cancers: the impact of 3D-CRT and IMRT. Int J Radiation Oncology Biol Phys 56:83-88 (2003) https://doi.org/10.1016/S0360-3016(03)00073-7