Cyberknife radyocerrahi sisteminde beyin metastazlarının tedavi planlamasında IRIS, sabit kolimatör ve çok yapraklı kolimatörler ile elde edilen planların dozimetrik olarak karşılaştırılması
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Date
2022-01-18
Authors
Tosun, Mehmet
Journal Title
Journal ISSN
Volume Title
Publisher
Bursa Uludağ Üniversitesi
Abstract
Bu çalışmada, CyberKnife radyocerrahi sisteminde meme kanseri tanılı 10 beyin metastazlı olgunun planlama sistemi kullanılarak sanal tedavi planları üç farklı kolimatör (Sabit Kolimatör, IRIS ve MLC) için dozimetrik karşılaştırma ve değerlendirme yapıldı. Çalışmanın amacı meme kanseri tanılı beyin metastazlı olguların tedavi planlama sisteminde farklı yöntemlerle yapılan sanal tedavi planlarını dozimetrik olarak değerlendirilmesidir. Bu amaçla Bursa Uludağ Üniversitesi Tıp Fakültesi Radyasyon Onkolojisi Anabilim Dalı’nda tedaviye alınmış meme kanseri tanılı beyin metastazlı 10 olguya ait arşiv bilgileri retrospektif olarak elde edildi ve planlama sisteminde sanal tedavi planları yapıldı. Yapılan planlarda reçete edilen doz 3 fraksiyonda 18 Gy ve izodoz eğrisi % 80’de tanımlandı. Çalışmanın tamamlanmasıyla elde edilen tedavi planların hedef hacim dozları, kritik organ dozları, homojenite, konformalite, gradiyent indeksi, monitör unit (MU), NOD ve tedavi süre verileri karşılaştırıldı. Elde edilen planlar için izodozun hedef hacimin %95’ini sarmasına ve kritik organların korunmasına dikkat edildi. Oluşturulan planlardaki dose volüme histogram (DVH)’lar ile doz dağılımları elde edildi. Çalışmada elde edilen verilerle statistical package for the social sciences (SPSS) programında üçlü karşılaştırmada Repeated Mesure Anova ve Friedman testleri kullanılarak istatistiksel analiz yapıldı. PTV (Dmax, Dmin, D2), Beyin-PTV (V8, V10, V12), sol göz, sol-sağ hipokampüs, beyin sapı, optik kiazma, hipofiz bezi, sol lakrimal, sol ve sağ kohlea, HI ve GI değerleri birbirlerine yakın değerler elde edilmiş ve anlamlı fark saptanmamıştır. Sol-sağ lens, sağ göz, sol optik sinir ve CI için IRIS kolimatör, sağ optik sinir, sağ lakrimal ve nCI için FIXED kolimatör, MU, NOD ve tedavi süresi için ise MLC’de iyi olduğu görülmüş ve anlamlı fark saptanmıştır.
In this study, dosimetric comparison and evaluation of virtual treatment plans for three different collimators (FIXED Collimator, IRIS and MLC) were performed using the planning system of 10 brain metastasized cases diagnosed with breast cancer in the CyberKnife radiosurgery system. The aim of this study is to evaluate dosimetrically the virtual treatment plans made by different methods in the treatment planning system of brain metastasis patients diagnosed with breast cancer. For this purpose, archival information about 10 cases with brain metastases diagnosed with breast cancer that were treated at the Department of Radiation Oncology of the Faculty of Medicine of Bursa Uludag University was obtained retrospectively and virtual treatment plans were made in the planning system. In the plans made, the prescribed dose was 18 Gy in 3 fractions and the isodose curve was defined at 80%. The target volume doses, critical organ doses, homogeneity, conformality, gradient index, monitor unit (MU), NOD and treatment duration data of the treatment plans obtained after the completion of the study were compared. For the obtained plans, attention was paid to the fact that isodose envelops 95% of the target volume and protects critical organs. Dose volume histogram (DVH) was used to obtain dose distributions in the created plans. In this study, the data obtained in the statistical package for the social sciences (SPSS) program were analyzed using Repeated Mesure Anova and Friedman tests in a three-way comparison using statistical package for the social sciences (SPSS). PTV (Dmax, Dmin, D2), Brain-PTV (V8, V10, V12), left eye, left-right hippocampus, brain stem, optic chiasma, pituitary gland, left lacrimal, left and right cohlea, HI and GI values were obtained close to each other and no significant difference was found. The IRIS collimator for the left-right lens, right eye, left optic nerve and CI, the FIXED collimator for the right optic nerve, right lacrimal and NCI, and the MU, NOD and MLC for the duration of treatment were found to be good and a significant difference was found.
In this study, dosimetric comparison and evaluation of virtual treatment plans for three different collimators (FIXED Collimator, IRIS and MLC) were performed using the planning system of 10 brain metastasized cases diagnosed with breast cancer in the CyberKnife radiosurgery system. The aim of this study is to evaluate dosimetrically the virtual treatment plans made by different methods in the treatment planning system of brain metastasis patients diagnosed with breast cancer. For this purpose, archival information about 10 cases with brain metastases diagnosed with breast cancer that were treated at the Department of Radiation Oncology of the Faculty of Medicine of Bursa Uludag University was obtained retrospectively and virtual treatment plans were made in the planning system. In the plans made, the prescribed dose was 18 Gy in 3 fractions and the isodose curve was defined at 80%. The target volume doses, critical organ doses, homogeneity, conformality, gradient index, monitor unit (MU), NOD and treatment duration data of the treatment plans obtained after the completion of the study were compared. For the obtained plans, attention was paid to the fact that isodose envelops 95% of the target volume and protects critical organs. Dose volume histogram (DVH) was used to obtain dose distributions in the created plans. In this study, the data obtained in the statistical package for the social sciences (SPSS) program were analyzed using Repeated Mesure Anova and Friedman tests in a three-way comparison using statistical package for the social sciences (SPSS). PTV (Dmax, Dmin, D2), Brain-PTV (V8, V10, V12), left eye, left-right hippocampus, brain stem, optic chiasma, pituitary gland, left lacrimal, left and right cohlea, HI and GI values were obtained close to each other and no significant difference was found. The IRIS collimator for the left-right lens, right eye, left optic nerve and CI, the FIXED collimator for the right optic nerve, right lacrimal and NCI, and the MU, NOD and MLC for the duration of treatment were found to be good and a significant difference was found.
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Keywords
Beyin metastazı, Stereotaktik radyocerrahi, CyberKnife, Riskli organlar, Meme kanseri, Brain metastasis, Stereotactic radiosurgery, Organs at risk, Breast cancer, Dose volume
Citation
Tosun, M. (2022). Cyberknife radyocerrahi sisteminde beyin metastazlarının tedavi planlamasında IRIS, sabit kolimatör ve çok yapraklı kolimatörler ile elde edilen planların dozimetrik olarak karşılaştırılması. Yayınlanmamış yüksek lisans tezi. Bursa Uludağ Üniversitesi Sağlık Bilimleri Enstitüsü.