Full Text:

 

영남의대학술지 Vol.24_No.2 Suppl. P.S538-543, Dec. 2007

Original Article

전립선암의 세기조절방사선치료와 입체조형방사선치료에서 선량분포 특성 비교

Dose distribution of Intensity Modulated Radiation Therapy and 3 Dimensional Conformal Radiation Therapy in Prostate Cancer

김성규, 김명세, 윤상모
영남대학교 의과대학 방사선종양학교실
책임저자:김성규, 대구광역시 남구 대명5동 317-1, 영남대학교 의과대학 방사선종양학교실
Tel: (053) 620-3373, Fax: (053) 624-3599
E-mail: skkim3@ynu.ac.kr

December 30, 2007

Abstract

Purpose:The aim of this study was to compare the dose distribution of intensity modulated radiation therapy (IMRT) with 3 dimensional conformal radiation therapy (3DCRT) in prostate cancer.
Materials and Methods:The IMRT plan and the 3DCRT plan used the 9 fields technique, respectively. In IMRT, tumor dose was a total dose of 50 Gy at 2.0 Gy per day, 5 days a week for 5 weeks. All cases were following the dose volume histogram (DVH) constraints. The maximum and minimum tumor dose constraints were 5,075 cGy and 4,925 cGy, respectively. The rectum dose constraints were <35% over 40 Gy. The bladder dose constraints were <35% over 30 Gy. The femur head dose constraints were <15% over 16 Gy. Tumor dose in the 3DCRT were 50 Gy.
Results:In IMRT, the maximum dose of PTV was 101.9% and minimum dose was 89.5% for given dose. In 3DCRT, the maximum dose of PTV was 103.5% and minimum dose was 86.5% for given dose. The rectum dose was 29.2% over 40 Gy in IMRT compared with 67.9% in 3DCRT. The bladder dose was 30.1% over 30 Gy in IMRT compared with 30.6% in 3DCRT.The right femur head dose was 5.3% over 16 Gy in IMRT compared with 8.3% in 3DCRT. The left femur head dose was 6.8% over 16 Gy in IMRT compared with 9.1% in 3 DCRT.
Conclusion:The dose of critical organs (rectum, bladder, and femur head) in IMRT showed to reduce than dose of 3DCRT. The rectum dose over 40 Gy in IMRT was reduced 38.7% than 3DCRT. The bladder dose over 30 Gy in IMRT was similar to 3DCRT. The femur head dose over 16 Gy in IMRT was reduced about 2.3~3% than 3DCRT.

Key Words: IMRT, 3DCRT, prostate, dose distribution, DVH

References

1. Perez CA, Brady LW. Priciples and Practice of Radiation Oncology: Carcinoma of the Prostate 4th. edit. Philadelphia. Lippincott Co. 2004. p1694.

2. 통계청. 대한민국 암 등록 현황 통계자료. 대전; 2006.

3. Pasteau O. Traitement du cancer de la prostate par le radium. Rev de Mal de la Nutriion 1911:363.

4. Caulk JR. Carcinoma of the prostate. J Urol 1937;37:832.

5. Flocks RH. Interstitial irradiation therapy with a solution of Au 198 as part of combination therapy for prostatic carcinoma. J Nucl Med 1964;5:691-705.

6. Wallner K, Roy J, Harrison L. Tumor control and morbidity following transperineal I-125 implantation for stage T1-T2 prostate carcinoma. J Clin Oncol 1996 Feb;14:449-53.

7. Park SW, Oh DH, Bae HS, Cho BC, Park JH, Han SH. Application of intensity modulated radiation therapy(IMRT) in prostate cancer. J Korean Soc for Thera Radiol & Oncol 2000 May;20(1):68-72.

8. Palta JR, Mackie TR, editors. Intensity- Modulated Radiation Therapy: The State of the Art: IMRT for prostate cancer. 1st ed. Wisconsin: Medical Physics Publishing;2003. p. 626.

9. Daemaley DP, Khoo VS, Norma AR, Comparison of radiation side-effects of conformal and conventional radiotherapy in prostate cancer : A randomised trial. Lancet 1999 Jan;353:267-72.

10. Nutting C, Deamaley DP, Webb S. Intensity modulated radiation therapy: A clinical review. British J Radiol 2000 May;869:459-69.

11. Price R, Hanks E, McNeeley SW, Horwitz EM, Pinover WH. Advantages of using noncoplanar vs axial beam arrangements when treating prostate cancer with intensity-modulated radiation therapy and the step-and shoot delivery method. Int J Radiat Oncol Biol Phys 2002 May;53:236-43.

12. Pollack A, Zagars GK, Starkschall G, Antolok JA, Lee JJ, Huang E, von Eschenbach AC, Kuban DA, Rosen I. Prostate cancer radiation dose response: Results of the MD Anderson phase III randomized trial. Int J Radiat Oncol Biol Phys 2002a Aug;53:1097-105.

13. Price R, Murphy S, McNeeley SW. A method for increased dose corformity and segment reduction for SMLC delivered IMRT treatment of the prostate. Int J Radiat Oncol Biol Phys 2003 Nov;57:843-52.