Dosimetric comparison of tomotherapy and volumetric-modulated arc therapy for children with neuroblastoma

• 作者: Dong Tingting Liu Xia Liu Zhikai Pang Tingtian Qiu Jie
• 来源期刊: 儿科学研究（英文）
• 关键词: Tomotherapy Volumetric-modulated arc therapy Neuroblastoma Dosimetric comparison Pediatric
• 年，卷（期）: 2020,（3）
• 所属期刊栏目: Original Article
• 页码范围: 186-191
• 页数: 6页
• 语种: 中文
• DOI: 10.1002/ped4.12215

摘要

Importance::Irradiation treatment for pediatric patients with neuroblastoma represents a major challenge due to the pediatric dose limits for critical structures and the necessity of sufficient dose coverage of the clinical target volume for local control.Objective::To investigate dosimetric differences between tomotherapy (TOMO) and volumetric-modulated arc therapy (VMAT) as retroperitoneal radiotherapy for children with neuroblastoma.Methods::Eight patients who received retroperitoneal radiotherapy for neuroblastoma were selected for comparison of TOMO and VMAT treatment plans. The D min, D max, D mean, D 95, D 2, and D 98 of planning target volume (PTV), conformity index (CI), heterogeneity index (HI), and organs at risk (OARs) parameters were compared. Delivery machine unit (MU) and image-guide radiotherapy solution results were also compared. Results::All patients received a cumulative dose of 19.5 Gy to the PTV. VMAT showed higher CI (0.93 ± 0.02), compared with TOMO (0.87 ± 0.03, P < 0.001). Notably, the average PTV HI was significantly better using TOMO (1.05 ± 0.01) than VMAT (1.08 ± 0.02, P = 0.003). Compared with VMAT, the D min, D 95, and D 98 all exhibited increases in TOMO; D max variation was less than 1% in TOMO. The D 0.1cc for the spinal cord and D 2cc for the small intestine were better in TOMO in terms of OARs. However, TOMO had more MUs and required a longer delivery time. Interpretation::Both planning techniques are capable of producing high-quality treatment plans. TOMO is superior for PTV coverage, but inferior for CI. TOMO requires extra treatment time; its cost is greater than the cost of VMAT.