Journal of the Korean Society of Radiology (한국방사선학회논문지)

The Korean Society of Radiology (한국방사선학회)
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Usefulness Evaluation on the Treatment Plan of Tomotherapy and VMAT in Radiotherapy for Prostate Cancer

전립선암의 방사선치료에서 토모테라피와 VMAT의 치료계획에 따른 유용성 평가

  • 허광명 (동신대학교 방사선학과) ;
  • 한재복 (동신대학교 방사선학과) ;
  • 최남길 (동신대학교 방사선학과)
  • Received : 2015.09.23
  • Accepted : 2015.12.25
  • Published : 2015.12.31
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Abstract

In this study, to evaluate the usefulness of the treatment plan of tomotherapy and volumetric modulated arc therapy (VMAT) in the radiotherapy for prostate cancer, the absorbed dose, dose volume histogram (DVH), treatment efficiency, and the results of dose verification accuracy using MapCHECK2 were compared and analyzed. Of the prostate cancer patients who underwent tomotherapy treatment in the Radiologic Oncology of H University Hospital between July 2014 and December 2014, 12 patients were randomly selected. As a result of analyzing the absorbed dose and DVH, both radiologic treatment plans showed slight differences in the treatment of the cancer tissues and the bladder, but the difference was in the error range of -5% to +3%, and did not exceed the side effect guideline or the tolerance dose limit. VMAT showed higher treatment efficiency than tomotherapy with a 2.5 times shorter treatment time and a 10.3 times less monitor unit (MU). Both showed 95% or higher dose accuracy satisfying the standard. VMAT showed 2.3% higher efficiency than tomotherapy. In both tomotherapy and VMAT, appropriate doses were absorbed for cancer tissues, and did not exceed the tolerance dose for normal tissues showing no significant difference in dose distribution. However, considering the shorter treatment time, lower total MU, and better treatment efficiency and dose verification accuracy, VMAT may be more useful than tomotherapy in cancer treatments.

전립선암의 방사선치료에서 토모테라피와 용적변조회전치료(volumetric modulated arc therapy, VMAT)의 치료계획에 따른 유용성 평가를 위해 흡수선량, 선량체적곡선(dose volume histogram, DVH), 치료효율성, MapCHECK2를 이용한 선량 검증 정확도 결과를 각각 비교 분석하였다. 대상으로는 2014년 7월부터 12월까지 H 대학병원 방사선종양학과에서 토모테라피 치료를 받은 전립선암 환자 중 12명을 무작위로 선택하였다. 흡수선량과 DVH를 분석한 결과 종양조직과 방광에서 두 방사선 치료계획이 근소한 차이를 나타냈지만 처방선량의 오차범위인 -5%에서+3%안에 포함됐고 정상조직 부작용 확률 권고치인 견딤선량 범위를 넘지 않았다. 치료시간은 2.5배 짧고 MU(monitor unit)도 10.3배 작아 VMAT가 치료효율성이 높았다. 선량정확도는 모두 95% 이상의 통과기준에 포함 되었으며 VMAT가 2.3% 더 높게 나타났다. 토모테라피와 VMAT 모두 종양조직에 적합한 선량이 흡수되었으며 정상조직의 견딤선량 범위를 넘지 않아 선량분포특성에서 큰 차이는 없었다. 하지만 치료시간이 짧고, total MU가 낮아 치료효율성이 좋고 선량 검증의 정확도 또한 우수한 VMAT를 선택하는 것이 치료에 더 유용할 것으로 사료된다.

Keywords

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