立体定向放射治疗低危前列腺癌时近端精囊包入靶体积的剂量学评价

Ela Delikgöz Soykut, Hatice Tataroglu
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摘要

目的:超低分割立体定向放射治疗(SBRT)被认为是一种可行的治疗选择。超低分割放射治疗的靶体积确定为前列腺和/或近端精囊;然而,对于何时将近端精囊添加到目标体积并没有明确的指导方针。我们的目的是通过剂量学评估,当SBRT用于低风险PCa患者时,在计划靶体积(PTV)中纳入近端精囊对危险器官(OAR)剂量分布的影响。方法:回顾性筛选应用射波刀行SBRT的低危PCa患者,随机入选20例。由同一放射肿瘤学家按照国际等高线图集的建议检查桨叶和靶体积的等高线。通过确定两种不同的PTV(方案1为前列腺单独治疗,方案2为前列腺伴近端精囊),由同一位专业物理学家制定了两种治疗方案。5×7.25选择Gy作为两个计划的剂量表。结果:两种方案在覆盖率、同质性指数、新整合指数(nCI)方面差异无统计学意义(p=0.397, p=0.452, p=0.225)。方案2具有更高的PTV - Dmax (p
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Dosimetric evaluation of inclusion of proximal seminal vesicle in target volume in low-risk prostate cancer treated with stereotactic body radiotherapy
Aims: Ultra hypofractionation using stereotactic body radiotherapy (SBRT) for low-risk PCa is considered a viable treatment option. The target volume for ultra hypofractionated RT was determined as prostate and/or proximal seminal vesicles; however, there are no clear guidelines on when to add a proximal seminal vesicle to the target volume. We aimed to dosimetrically assess the effect of inclusion of the proximal seminal vesicle in the planning target volume (PTV) on the dose distribution of organ at risk (OAR) when SBRT is administered to patients with low-risk PCa. Methods: Low-risk PCa cases who underwent SBRT with CyberKnife were retrospectively screened, and 20 random cases were included. The contours of OARs and target volumes were checked as recommended in international contouring atlases by the same radiation oncologist. Two treatment plans by determining two different PTV (prostate alone in plan 1 and prostate with proximal seminal vesicles in plan 2) were made by the same specialist physicist. 5×7.25 Gy was chosen as the dose schedule defined for both plans. Results: Regarding coverage, homogeneity index, and new conformity index (nCI), there was no significant difference between the two plans (p=0.397, p=0.452, p=0.225). The plan 2 had a greater PTV Dmax (p
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