Serviks kanserinde brakiterapi ve SBRT planlarının dozimetrik parametrelerinin retrospektif olarak karşılaştırılması
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Date
2021-11-10
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Bursa Uludağ Üniversitesi
Abstract
Bursa Uludağ Üniversitesi Tıp Fakültesi Radyasyon Onkolojisi Anabilim Dalı’nda tedavi almış serviks kanseri tanılı 15 hastaya ait arşiv materyali elde edildi. Brakiterapi ve SBRT planları oluşturularak karşılaştırıldı. Veriler Accuray Precision TPS’ye aktarılmış, retrospektif planların oluşturulması için planlanan hedef hacim (PTV) ve kritik organlar (mesane, rektum, sigmoid kolon, kemik iliği) konturlandı. Tüm hastalar için reçete edilen toplam doz 21 Gy, 3 fraksiyonda verildi. Oluşturulan sanal planlardaki DVH’ler ile doz dağılımları elde edildi. Kritik organ (mesane, rectum, sigmoid kolon ve kemik iliği) dozları ve EQD2 ve BED değerlerinin karsılaştırılması amaçlandı. Tedavi teknikleri arasında mesanenin D0,10cc değerleri için SBRT tekniği lehine anlamlı fark bulundu. Kemik iliğinin D50,00cc, D75,00cc ve D100,00cc değerleri için SBRT tekniği lehine anlamlı fark bulundu. Mesanenin EQD 2 ve BED değerleri (α/β=3) ve (α/β=10) açısından D0,10cc için SBRT lehine olumlu yönde anlamlı farklılık bulundu. Kemik iliğinin EQD 2 ve BED değerleri (α/β=3) ve (α/β=10) açısından D50,00cc, D75,00cc ve D100,00cc için SBRT lehine anlamlı farklılık bulundu. Sonuç olarak; SBRT, EBRT sonrası standart tedavi olarak görülen BRT’nin uygulanabilir olmadığı durumlarda iyi bir alternatif olarak kullanılabilir.
Archival material belonging to 15 patients diagnosed with cervical cancer who were treated at Bursa Uludağ University Faculty of Medicine, Department of Radiation Oncology were obtained. Brachytherapy and SBRT plans were created and compared. The data were transferred to Accuray Precision TPS, the planned target volume (PTV) and critical organs (bladder, rectum, sigmoid colon, bone marrow) were contoured to create retrospective plans. The total dose prescribed for all patients was 21 Gy, given in 3 fractions. Dose distributions were obtained with the DVHs in the created virtual plans. It was aimed to compare critical organ (bladder, rectum, sigmoid colon and bone marrow) doses and EQD2 and BED values. There was a significant difference between the treatment techniques in favor of the SBRT technique for bladder D0.10cc values. A significant difference was found in favor of the SBRT technique for the D 50.00cc, D75.00cc and D100.00cc values of the bone mar- row. A positive significant difference was found in favor of SBRT for D0.10cc in terms of EQD2 and BED values (α/β=3) and (α/β=10) of the bladder. A significant difference was found in favor of SBRT in terms of EQD2 and BED values of bone marrow (α/β=3) and (α/β=10) for D50.00cc, D75.00cc and D100.00cc. As a result; SBRT can be used as a good alternative in cases where BRT, which is seen as the standard treatment after EBRT, is not feasible.
Archival material belonging to 15 patients diagnosed with cervical cancer who were treated at Bursa Uludağ University Faculty of Medicine, Department of Radiation Oncology were obtained. Brachytherapy and SBRT plans were created and compared. The data were transferred to Accuray Precision TPS, the planned target volume (PTV) and critical organs (bladder, rectum, sigmoid colon, bone marrow) were contoured to create retrospective plans. The total dose prescribed for all patients was 21 Gy, given in 3 fractions. Dose distributions were obtained with the DVHs in the created virtual plans. It was aimed to compare critical organ (bladder, rectum, sigmoid colon and bone marrow) doses and EQD2 and BED values. There was a significant difference between the treatment techniques in favor of the SBRT technique for bladder D0.10cc values. A significant difference was found in favor of the SBRT technique for the D 50.00cc, D75.00cc and D100.00cc values of the bone mar- row. A positive significant difference was found in favor of SBRT for D0.10cc in terms of EQD2 and BED values (α/β=3) and (α/β=10) of the bladder. A significant difference was found in favor of SBRT in terms of EQD2 and BED values of bone marrow (α/β=3) and (α/β=10) for D50.00cc, D75.00cc and D100.00cc. As a result; SBRT can be used as a good alternative in cases where BRT, which is seen as the standard treatment after EBRT, is not feasible.
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Keywords
Serviks kanseri, SBRT, Brakiterapi, CyberKnife, Cervical cancer, Brachytherapy
Citation
Zorlutuna, M. vd. (2021). "Serviks kanserinde brakiterapi ve SBRT planlarının dozimetrik parametrelerinin retrospektif olarak karşılaştırılması". Uludağ Üniversitesi Tıp Fakültesi Dergisi, 47(3), 381-387.