The Journal of Korean Society for Radiation Therapy (대한방사선치료학회지)

Korean Society for Radiation Therapy (대한방사선치료학회)
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Feasibility study of using Halcyon LINAC for Double-target spine stereotactic body radiation therapy

이중 표적 척추 전이암의 체부정위방사선치료 시 Halcyon LINAC의 치료 유용성 평가

  • Jeong Hee Ju (Department of Radiation Oncology, Samsung Medical Center) ;
  • An Ye Chan (Department of Radiation Oncology, Samsung Medical Center) ;
  • Park Byung Suk (Department of Radiation Oncology, Samsung Medical Center) ;
  • Park Myung Hwan (Department of Radiation Oncology, Samsung Medical Center) ;
  • Park Yong Chul (Department of Radiation Oncology, Samsung Medical Center)
  • 정희주 (삼성서울병원 방사선종양학과) ;
  • 안예찬 (삼성서울병원 방사선종양학과) ;
  • 박병석 (삼성서울병원 방사선종양학과) ;
  • 박명환 (삼성서울병원 방사선종양학과) ;
  • 박용철 (삼성서울병원 방사선종양학과)
  • Published : 2022.12.31
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Abstract

Objectives: The purpose is to evaluate dosimetric performance and delivery efficiency of VMAT with Halcyon LINAC for double target spine SBRT Materials and Methods: 12 patients with spine oligometastases were retrospectively studied. Single-isocenter spine SBRT plans was established using Halcyon® with Dual Layer MLC and Truebeam® with High Definition MLC. All patients' plans were created in Eclipse TPS through the identical conditions and optimization. C.I, H.I, G.I (Gradient Index), maximal and volumetric doses to spinal cord and low dose area were evaluated for comparison of both plans. Also, total MU and BOT(Beam On Time) were evaluated. Results: Halcyon plans was no Statistical differences in C.I and H.I. However, the average of G.I was 4.64 for Halcyon, which decreased to 5.5% compared to Truebeam (P<0.001). Halcyon plans demonstrated statistically significant reduced G.I. The average of 50% and 25% isodose volume was 487.56 cc (-3.82%, P<0.001), 1859.45 cc (-4.75%, P<0.001) in Halcyon, respectively. Significantly reduced low dose spill were observed in Halcyon plans. In the evaluation of the spinal cord, the average of Dmean and V10 of Halcyon plans in the sample group with an overlap volume of less than 1 cc was 6.802 Gy (-3.504%, P=0.067), 5.766±1.683 cc (-8.199%, P=0.002), respectively. Halcyon plans demonstrated statistically significant reduced Dmean and V10. For delivery efficiency, MU and BOT(maximum dose rate for each machine), on average, increased in Halcyon plans. However, the average of BOT(800MU/min for each machine) was 648.33 sec for Halcyon (-1.74%, P<0.001). Conclusion: Halcyon plan for double-target spine SBRT demonstrated advantages in the low dose area with a steep dose gradient, while having dosimetrically equivalent target dose distribution and spinal cord protective effect. As a result, Halcyon LINAC produced a dosimetrically improved plan for double-target spine SBRT.

목 적: 이중 표적 척추 전이암의 체부정위방사선치료 시 Halcyon 선형가속기의 용적변조회전치료 계획의 질 및 전달 효율을 평가하고자 한다. 대상 및 방법: 본원의 이중 표적 척추 전이암 환자 12명을 선정하여 Dual Layer MLC를 장착한 Halcyon®과 High Definition MLC를 장착한 Truebeam® 을 이용하여 단일치료중심 척추 SBRT 계획을 수립하였다. 모든 치료 계획은 Eclipse를 이용하여 동일한 조건 및 최적화 과정을 통해 생성하였으며, 치료계획 비교를 위해 C.I, H.I, G.I(Gradient Index), 척수 선량 및 저선량 영역을 평가하고, 전체 MU를 비교하였다. 또한 BOT(Beam On Time)를 측정하여 치료 시간을 비교하였다. 결 과: C.I 와 H.I에서는 통계적으로 유의한 차이는 보이지 않았다. 다만, G.I의 평균은 Halcyon이 4.64으로 Truebeam에 비해 5.5%로 감소하였으며(P<0.001), Halcyon의 50% 및 25% isodose volume 평균은 각각 487.56 cc (-3.82%, P<0.001), 1859.45 cc (-4.75%, P<0.001) 으로 Truebeam보다 축소된 용적을 보였다. 또한 척수 선량 평가에서는 Overlap volume이 1 cc이하인 표본집단에서 Halcyon의 평균 선량 및 V10의 평균은 6.802 Gy (-3.504%, P=0.067), 5.766±1.683 cc (-8.199%, P=0.002)으로 Truebeam보다 낮았다. MU와 각 장비의 최대선량률을 사용한 BOT는 Halcyon에서 증가했으나, 동일한 선량률로 조사 시 Halcyon의 평균은 648.33 sec (-1.74%, P<0.001)으로 단축되었다. 결 론: 이중 표적 척추 전이암의 SBRT 시 Halcyon의 치료 계획은 Truebeam의 치료 계획과 유사한 타겟 내선량 분포 및 척수 보호효과를 가지면서, 가파른 선량 기울기로 저선량 영역에서 이점을 보였다. 이를 통해 이중 표적 척추 전이암 SBRT 시 Halcyon의 적용은 선량학적으로 향상된 치료계획을 제공함을 알 수 있다.

Keywords

References

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