Erken evre meme kanserli olgularda kısmi meme ışınlamasının CyberKnife-VMAT planlarının dozimetrik olarak karşılaştırılması
Date
2021-12-21
Authors
Kılıç, Hidayetül Mediha
Journal Title
Journal ISSN
Volume Title
Publisher
Bursa Uludağ Üniversitesi
Abstract
Bu çalışmada radyoterapi tedavisi görmüş erken evre meme kanseri tanılı 10 hasta için SBRT tekniği ile Volümetrik Modülasyonlu Ark Tedavi (VMAT) ve CyberKnife (CK) tedavi planlama sistemleri ile sanal tedavi planları yapılarak dozimetrik karşılaştırma yapılmıştır. Uludağ Üniversitesi Tıp Fakültesi Radyasyon Onkolojisi Anabilim Dalı’nda tedaviye alınmış erken evre meme kanserli 10 hastaya ait arşiv materyali retrospektif olarak elde edilmiş ve sanal tedavi planları yapılmıştır. Yapılan planlarda 30 Gy doz 5 fraksiyonda verilecek şekilde belirlenmiştir. Sanal planlar için GTV, aynı taraf meme, karşı meme, aynı taraf akciğer, karşı akciğer, kalp, tiroid, humerus, özafagus, karaciğer, sol ön inen koroner arter, meme başı, cilt ve göğüs duvarının konturlamaları radyasyon onkoloğu tarafından yapıldı. Planlarda izodozun hedef hacmin %95’ini sarmasına ve kritik organların belirlenen limitlerde doz almasına dikkat edildi. Oluşturulan planlardaki DVH’ lar ile doz dağılımları elde edildi. SPSS programıyla Mann Whitney U Testi ve Independent Simples-T Testi kullanılarak istatistiksel analiz yapıldı. Bunun sonucunda cilt, kalp, göğüs duvarı, özafagus, aynı taraf meme, aynı taraf akciğer, GTV, MU, HI ve CI dozimetrik karşılaştırmalarında anlamlı bir fark bulunurken, humerus, sol ön inen koroner arter, karşı meme, karaciğer, meme başı ve karşı akciğer için anlamlı bir fark bulunmamıştır. HI, CI, MU ve süre için en düşük değerler VMAT planlama sisteminden elde edilmiştir. Meme başı ve sol ön koroner arter dozları CyberKnife tekniğinde daha az bulunsada iki farklı tedavi tekniği arasında istatistiksel olarak anlamlılık saptanmamıştır.
In this study, dosimetric comparisons were made by making virtual treatment plans with the SBRT technique, Volumetric Modulated Arc Therapy (VMAT) and CyberKnife (CK) treatment planning systems for 10 patients diagnosed with early stage breast cancer who received radiotherapy treatment. Archival material of 10 patients with early stage breast cancer who were treated in Uludağ University Faculty of Medicine, Department of Radiation Oncology was obtained retrospectively and virtual treatment plans were made. In the plans made, a dose of 30 Gy was determined to be given in 5 fractions. For virtual plans, contours of GTV, ipsilateral breast, contralateral breast, ipsilateral lung, contralateral lung, heart, thyroid, humerus, esophagus, liver, left anterior descending coronary artery, nipple, skin and chest wall were performed by a radiation oncologist. In the plans, attention was paid to ensure that the isodose covers 95% of the target volume and that the critical organs receive doses within the determined limits. Dose distributions were obtained with the DVHs in the created plans. Statistical analysis was performed using the Mann Whitney U Test and the Independent Simples-T Test with the SPSS program. As a result, there was a significant difference in dosimetric comparisons of skin, heart, chest wall, esophagus, ipsilateral breast, ipsilateral lung, GTV, MU, HI and CI, while humerus, left anterior descending coronary artery, contralateral breast, liver, nipple and contralateral lung were found. No significant difference was found for The lowest values for HI, CI, MU and duration were obtained from the VMAT planning system. Although the doses of the nipple and left anterior coronary artery were lower in the CyberKnife technique, no statistical significance was found between the two different treatment techniques.
In this study, dosimetric comparisons were made by making virtual treatment plans with the SBRT technique, Volumetric Modulated Arc Therapy (VMAT) and CyberKnife (CK) treatment planning systems for 10 patients diagnosed with early stage breast cancer who received radiotherapy treatment. Archival material of 10 patients with early stage breast cancer who were treated in Uludağ University Faculty of Medicine, Department of Radiation Oncology was obtained retrospectively and virtual treatment plans were made. In the plans made, a dose of 30 Gy was determined to be given in 5 fractions. For virtual plans, contours of GTV, ipsilateral breast, contralateral breast, ipsilateral lung, contralateral lung, heart, thyroid, humerus, esophagus, liver, left anterior descending coronary artery, nipple, skin and chest wall were performed by a radiation oncologist. In the plans, attention was paid to ensure that the isodose covers 95% of the target volume and that the critical organs receive doses within the determined limits. Dose distributions were obtained with the DVHs in the created plans. Statistical analysis was performed using the Mann Whitney U Test and the Independent Simples-T Test with the SPSS program. As a result, there was a significant difference in dosimetric comparisons of skin, heart, chest wall, esophagus, ipsilateral breast, ipsilateral lung, GTV, MU, HI and CI, while humerus, left anterior descending coronary artery, contralateral breast, liver, nipple and contralateral lung were found. No significant difference was found for The lowest values for HI, CI, MU and duration were obtained from the VMAT planning system. Although the doses of the nipple and left anterior coronary artery were lower in the CyberKnife technique, no statistical significance was found between the two different treatment techniques.
Description
Keywords
Erken evre meme kanseri, Stereotaktik beden radyoterapisi, VMAT, CyberKnife, APBI, Early stage breast cancer, Stereotactic body radiotherapy
Citation
Kılıç, H. M. (2021). Erken evre meme kanserli olgularda kısmi meme ışınlamasının CyberKnife-VMAT planlarının dozimetrik olarak karşılaştırılması. Yayınlanmamış yüksek lisans tezi. Bursa Uludağ Üniversitesi Sağlık Bilimleri Enstitüsü.