JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES) ›› 2017, Vol. 55 ›› Issue (7): 55-60.doi: 10.6040/j.issn.1671-7554.0.2016.1098

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A dosimetric analysis of cervical metastases between radioactive 125I seeds implantation and external beam radiation therapy

CAO Qianqian1, JIANG Yuhua1, LI Yuliang2, YANG Ruijie3, LIU Lu3, ZHANG Xile3, WANG Junjie3   

  1. 1. Cancer Center, Second Hospital of Shandong University, Jinan 250033, China;
    2. Interventional Medical Center, Second Hospital of Shandong University, Jinan 250033;
    3. Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191, China
  • Received:2016-09-02 Online:2017-07-10 Published:2017-07-10

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Abstract: Objective To compare the gross tumor volume(GTV)and dose distributions for organs at risk(OAR)between external beam radiation therapy(EBRT)and low-dose rate(LDR)brachytherapy in the treatment of cervical vertebral metastases, in order to provide the basis for clinical treatment. Methods A total of 10 patients were randomly selected. Three-dimensional conformal radiotherapy(3D-CRT)planning was a single forth one with two oblique radiation fields. Intensity modulated radiotherapy(IMRT)planning included five equal radiation fields, and 2-arc volumetric-modulated arc radiotherapy(VMAT)was adopted. The images from Oncentra treatment planning system(TPS)were delivered to Prowess TPS to formulate LDR brachytherapy pre-operative simulation plan. Results For the same dose of spinal cord, the biologically effective dose(BED)of D90 and D95 of LDR were(184.15±25.84)Gy and(161.45±26.35)Gy. When the fraction scheme was 2 Gy/f, the D95 BED of VMAT, IMRT and 3D-CRT were(120.52±10.66)Gy,(119.19±10.91)Gy and(96.24±28.65)Gy. When the fraction scheme was 3 Gy/f, the 山 东 大 学 学 报 (医 学 版)55卷7期 -曹倩倩,等.放射性125I粒子植入与外放疗治疗颈椎转移瘤剂量学对比分析 \=-D95 BED 3 Gy/f of VMAT, IMRT and 3D-CRT were(122.19±7.54)Gy,(122.37±8.19)Gy and(95.94±24.70)Gy. All parameters complied with the normal distribution, P=0.00 after paired t test. There was no statistical difference in V5 of the mucosa among VMAT, IMRT and LDR(P=0.16, 0.34), and V5 of the mucosa of 3D-CRT was higher than that in LDR(P=0.00). The V30 and Dmean of LDR were less than those of 3D-CRT, VMAT and IMRT, statistically(P=0.00). Other parameters of the thyroid gland, parotid gland and mandible were significantly different between LDR and 3D-CRT, VMAT and IMRT(P=0.00). Conclusion When the fraction schemes were 2 Gy/f and 3 Gy/f, 3D-CRT, IMRT and VMAT had lower GTV doses than LDR, which could protect the OARs at the same time. Therefore, as to the cervical vertebral metastases after EBRT, LDR is a good choice for salvage treatment.

Key words: Cervical tumor, External Beam Radiation Therapy, Dosimetry, Brachytherapy, 125I seeds

CLC Number: 

  • R738.1
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