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Strahlentherapie und Onkologie

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01.03.2012 | Original article

RapidArc combined with the active breathing coordinator provides an effective and accurate approach for the radiotherapy of hepatocellular carcinoma

verfasst von: G.Z. Gong, Y. Yin, L.G. Xing, Y.J. Guo, T. Liu, J. Chen, J. Lu, C. Ma, T. Sun, T. Bai, G. Zhang, R. Wang

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 3/2012

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Abstract

Purpose

The goal of this research was to investigate the feasibility of volumetric modulated arc therapy, RapidArc (RA), in association with the active breathing coordinator (ABC) for the treatment of hepatocellular carcinoma (HCC) with radiotherapy.

Patients and materials

A total of 12 patients with HCC, after receiving transcatheter arterial chemoembolization (TACE) treatment, underwent three-dimensional computer tomography (3D-CT) scanning associated with ABC using end inspiration hold (EIH), end expiration hold (EEH), and free breathing (FB) techniques. The three-dimensional conformal radiotherapy (3D-CRT), intensity-modulated radiotherapy (IMRT), and RA plans (three 135° arcs) were designed on different CT images, respectively. The liver volume, gross tumor volume (GTV), and planning target volume (PTV) of the three breath status and the dosimetric differences of the different plans were compared.

Results

There were no significant differences in the volumes of live and GTV between the three breathing techniques (p > 0.05); the PTV in FB was greater than in the EEH and EIH (p < 0.05). The overall conformality index (CI) and homogeneity index (HI) for RA (CI 0.92, HI 0.90) were better than IMRT (CI 0.90, HI 0.89) and 3D-CRT (CI 0.70, HI 0.84) for the three breathing techniques (p< 0.05). The RA and IMRT significantly reduced the mean dose, V₂₀, V₃₀, and V₄₀ of normal liver compared to 3D-CRT, while the V₅ and V₁₀ in RA were higher than in IMRT. The mean values in mean dose, V₁₀, V₂₀, V₃₀, and V₄₀ of the normal liver were reduced from 13.12 Gy, 46%, 24%, 13%, and 8% in RA_FB to 10.23 Gy, 35%, 16%, 8%, and 5% in RA_EEH and 9.23 Gy, 32%, 16%, 8%, and 5% in RA_EIH, respectively. In addition, the treatment time of RA was equal to 3D-CRT, which was significantly shorter than IMRT.

Conclusion

RA in conjunction with ABC for the treatment of HCC with radiotherapy can achieve better dose delivery and ensure the accuracy of the target volume, which spares more organs at risk, uses fewer monitor units, and shortens treatment time.

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Titel: RapidArc combined with the active breathing coordinator provides an effective and accurate approach for the radiotherapy of hepatocellular carcinoma
verfasst von: G.Z. Gong
Y. Yin
L.G. Xing
Y.J. Guo
T. Liu
J. Chen
J. Lu
C. Ma
T. Sun
T. Bai
G. Zhang
R. Wang
Publikationsdatum: 01.03.2012
Verlag: Springer-Verlag
Erschienen in: Strahlentherapie und Onkologie / Ausgabe 3/2012
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-011-0044-5

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