AIM To analyse clinical and dosimetric results of helical tomotherapy(HT)and volumetric modulated arc therapy(VMAT)in complex adjuvant breast and nodes irradiation.METHODS Seventy-three patients were included(31 HT an...AIM To analyse clinical and dosimetric results of helical tomotherapy(HT)and volumetric modulated arc therapy(VMAT)in complex adjuvant breast and nodes irradiation.METHODS Seventy-three patients were included(31 HT and 42 VMAT).Dose were 63.8 Gy(HT)and 63.2 Gy(VMAT)in the tumour bed,52.2 Gy in the breast,50.4 Gy in supraclavicular nodes(SCN)and internal mammary chain(IMC)with HT and 52.2 Gy and 49.3 Gy in IMC and SCN with VMAT in 29 fractions.Margins to particle tracking velocimetry were greater in the VMAT cohort(7 mm vs 5 mm).RESULTS For the HT cohort,the coverage of clinical target volumes was as follows:Tumour bed:99.4%±2.4%;breast:98.4%±4.3%;SCN:99.5%±1.2%;IMC:96.5%±13.9%.For the VMAT cohort,the coverage was as follows:Tumour bed:99.7%±0.5%,breast:99.3%±0.7%;SCN:99.6%±1.4%;IMC:99.3%±3%.For ipsilateral lung,Dmean and V20 were 13.6±1.2 Gy,21.1%±5%(HT)and 13.6±1.4 Gy,20.1%±3.2%(VMAT).Dmean and V30 of the heart were 7.4±1.4 Gy,1%±1%(HT)and 10.3±4.2 Gy,2.5%±3.9%(VMAT).For controlateral breast Dmean was 3.6±0.2 Gy(HT)and 4.6±0.9 Gy(VMAT).Acute skin toxicity grade 3 was 5%in the two cohorts.CONCLUSION HT and VMAT in complex adjuvant breast irradiation allow a good coverage of target volumes with an acceptable acute tolerance.A longer follow-up is needed to assess the impact of low doses to healthy tissues.展开更多
Radiotherapy for locally advanced pancreatic cancer is technically difficult and frequently associated with high-grade digestive toxicity.Helical tomotherapy(HT)is a new irradiation modality that combines megavoltage ...Radiotherapy for locally advanced pancreatic cancer is technically difficult and frequently associated with high-grade digestive toxicity.Helical tomotherapy(HT)is a new irradiation modality that combines megavoltage computed tomography imaging for patient positioning with intensity-modulated fan-beam radiotherapy.Its recent availability opens new fields of exploration for pancreatic radiotherapy as a result of its ability to tailor very well-defined dose distributions around the target volumes.Here,we report the use of HT in two patients with locally advanced pancreatic cancer. Doses to the bowel,kidneys and liver were reduced significantly,which allowed for excellent treatment tolerance without any high-grade adverse effects in either patient.展开更多
文摘AIM To analyse clinical and dosimetric results of helical tomotherapy(HT)and volumetric modulated arc therapy(VMAT)in complex adjuvant breast and nodes irradiation.METHODS Seventy-three patients were included(31 HT and 42 VMAT).Dose were 63.8 Gy(HT)and 63.2 Gy(VMAT)in the tumour bed,52.2 Gy in the breast,50.4 Gy in supraclavicular nodes(SCN)and internal mammary chain(IMC)with HT and 52.2 Gy and 49.3 Gy in IMC and SCN with VMAT in 29 fractions.Margins to particle tracking velocimetry were greater in the VMAT cohort(7 mm vs 5 mm).RESULTS For the HT cohort,the coverage of clinical target volumes was as follows:Tumour bed:99.4%±2.4%;breast:98.4%±4.3%;SCN:99.5%±1.2%;IMC:96.5%±13.9%.For the VMAT cohort,the coverage was as follows:Tumour bed:99.7%±0.5%,breast:99.3%±0.7%;SCN:99.6%±1.4%;IMC:99.3%±3%.For ipsilateral lung,Dmean and V20 were 13.6±1.2 Gy,21.1%±5%(HT)and 13.6±1.4 Gy,20.1%±3.2%(VMAT).Dmean and V30 of the heart were 7.4±1.4 Gy,1%±1%(HT)and 10.3±4.2 Gy,2.5%±3.9%(VMAT).For controlateral breast Dmean was 3.6±0.2 Gy(HT)and 4.6±0.9 Gy(VMAT).Acute skin toxicity grade 3 was 5%in the two cohorts.CONCLUSION HT and VMAT in complex adjuvant breast irradiation allow a good coverage of target volumes with an acceptable acute tolerance.A longer follow-up is needed to assess the impact of low doses to healthy tissues.
文摘Radiotherapy for locally advanced pancreatic cancer is technically difficult and frequently associated with high-grade digestive toxicity.Helical tomotherapy(HT)is a new irradiation modality that combines megavoltage computed tomography imaging for patient positioning with intensity-modulated fan-beam radiotherapy.Its recent availability opens new fields of exploration for pancreatic radiotherapy as a result of its ability to tailor very well-defined dose distributions around the target volumes.Here,we report the use of HT in two patients with locally advanced pancreatic cancer. Doses to the bowel,kidneys and liver were reduced significantly,which allowed for excellent treatment tolerance without any high-grade adverse effects in either patient.
