두경부 IMRT 및 VMAT 시 체적 감소가 전산화치료계획에 미치는 영향
The Effect of Volume Reduction on Computed Treatment Planning during Head and Neck IMRT and VMAT
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초록
In this study, we assessed the effect of reduction of tumor volume in the head and neck cancer by using RANDO phantom in Static Intensity-Modulated Radiation Therapy (S-IMRT) and Volumetric-Modulated Arc Therapy (VMAT) planning. RANDO phantom’s body and protruding volumes were delineated by using Contour menu of Eclipse™ (Varian Medical System, Inc., Version 15.6, USA) treatment planning system. Inner margins of 2 mm to 10 mm from protruding volumes of the reference were applied to generate the parameters of reduced volume. In addition, target volume and Organ at Risk (OAR) volumes were delineated. S-IMRT plan and VMAT plan were designed in reference. These plans were assigned in the reduced volumes and dose was calculated in reduced volumes using preset Monitor unit (MU). Dose Volume Histogram (DVH) was generated to evaluate treatment planning. Conformity Index (CI) and R2 in reference S-IMRT were 0.983 and 0.015, respectively. There was no significant relationship between CI and the reduced volume. Homogeneity Index (HI) and R2 were 0.092 and 0.960, respectively. The HI increased when volume reduced. In reference VMAT, CI and R2 were 0.992 and 0.259, respectively. There was no relationship between the volume reduction and CI. On the other hand, HI and R2 were 0.078 and 0.895, respectively. The value of HI increased when the volume reduced. There was significant difference (p<0.05) between parameters (Dmean and Dmax) of normal organs of S-IMRT and VMAT except brain stem. Volume reduction affected the CI, HI and OAR dose. In the future, additional studies are necessary to incorporate the reduction of the volume in the clinical setting.
Abstract
In this study, we assessed the effect of reduction of tumor volume in the head and neck cancer by using RANDO phantom in Static Intensity-Modulated Radiation Therapy (S-IMRT) and Volumetric-Modulated Arc Therapy (VMAT) planning. RANDO phantom’s body and protruding volumes were delineated by using Contour menu of Eclipse™ (Varian Medical System, Inc., Version 15.6, USA) treatment planning system. Inner margins of 2 mm to 10 mm from protruding volumes of the reference were applied to generate the parameters of reduced volume. In addition, target volume and Organ at Risk (OAR) volumes were delineated. S-IMRT plan and VMAT plan were designed in reference. These plans were assigned in the reduced volumes and dose was calculated in reduced volumes using preset Monitor unit (MU). Dose Volume Histogram (DVH) was generated to evaluate treatment planning. Conformity Index (CI) and R2 in reference S-IMRT were 0.983 and 0.015, respectively. There was no significant relationship between CI and the reduced volume. Homogeneity Index (HI) and R2 were 0.092 and 0.960, respectively. The HI increased when volume reduced. In reference VMAT, CI and R2 were 0.992 and 0.259, respectively. There was no relationship between the volume reduction and CI. On the other hand, HI and R2 were 0.078 and 0.895, respectively. The value of HI increased when the volume reduced. There was significant difference (p<0.05) between parameters (Dmean and Dmax) of normal organs of S-IMRT and VMAT except brain stem. Volume reduction affected the CI, HI and OAR dose. In the future, additional studies are necessary to incorporate the reduction of the volume in the clinical setting.
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