为有限 osteosclerotic 骨髓瘤的容量的调制的弧放射疗法

• 作者: Antonin Levy Aurélie Robles Coralie Moncharmont Cyrus Chargari Guy de Laroche Isabelle Guichard Jean-Baptiste Guy Jean-Noёl Talabard Lamine Farid Lysian Cartier Nadia Malkoun Nicolas Magné
• 来源期刊: 世界放射学杂志：英文版（电子版）
• 学科: 医学
• 关键词: Volumetric INTENSITY-MODULATED arc RADIOTHERAPY Conformal RADIOTHERAPY Critical organs Osteosclerotic MYELOMA POLYNEUROPATHY organomegaly ENDOCRINOPATHY monoclonal GAMMOPATHY and skin change syndrome
• 年，卷（期）: 2013,（4）
• 页码范围: 173-177
• 页数: 5页
• 分类号: R733.3

摘要

AIM:To assess the feasibility of volumetric intensity-modulated arc radiotherapy (VMAT) in patients with limited polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes syndrome. METHODS:A 70-year-old male with histologically confirmed osteosclerotic myeloma was treated in our department in July 2010 with VMAT. Fourty-six Gray in 23 fractions were given on three bone lesions. Doses delivered to target volume and critical organs were compared with a tridimensional conformal radiotherapy (3D-RT) plan. Treatment was well tolerated without any side effects.RESULTS:VMAT improved dose homogeneity within the target volume, as compared to 3D-RT (standard deviations:2.9 Gy and 1.6 Gy for 3D and VMAT, respectively). VMAT resulted in a better sparing of critical organs. Dose delivered to 20% of organ volume (D20) was reduced from 22 Gy (3D-RT) to 15 Gy (VMAT) for small bowel, from 24 Gy (3D-RT) to 17 Gy (VMAT) for bladder and from 47 Gy (3D-RT) to 3 Gy (VMAT) for spinal cord. Volumes of critical organs that received at least 20 Gy (V20) were decreased by the use of VMAT, as compared to 3D-RT (V20 bladder:10% vs 99%; V20 small bowel:6% vs 21%). One year after treatment completion, no tumor progression has been reported. CONCLUSION:VMAT improved dose distribution as compared to 3D-RT for limited osteosclerotic myeloma, with better saving of critical organs.