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 cli...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.展开更多
基金Funding source Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences(No.2019XK320014)。
文摘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.
