مقایسه‌ی دوز حلزون گوش در بیماران مبتلا به سرطان سر و گردن تحت درمان با رادیوتراپی سه بعدی انطباقی و توموتراپی حلزونی

نوع مقاله : مقاله های پژوهشی

نویسندگان

1 دانشجوی کارشناسی ارشد، گروه فیزیک پزشکی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

2 دانشیار، گروه رادیوانکولوژی، دانشکده‌ی پزشکی، بیمارستان سیدالشهدا، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

3 کارشناسی ارشد فیزیک پزشکی، بیمارستان سیدالشهدا، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

4 دکتری فیزیک پزشکی، گروه فیزیک پزشکی، دانشکده‌ی پزشکی، اصفهان، ایران

5 استاد، گروه فیزیک پزشکی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

چکیده

مقاله پژوهشی




مقدمه: سرطان سر و گردن (Head and neck cancer) جزء ده سرطان شایع در سراسر جهان است. به دلیل پیچیدگی آناتومی سر و گردن، در هنگام پرتودرمانی اندام‌های زیادی دوز دریافت می‌کنند. هدف این مطالعه، مقایسه‌ی دوز رسیده به حلزون گوش در دو روش (Three-Dimensional Conformal Radiotherapy) 3D-CRT و (Helical Tomotherapy) HT بود.
روش‌ها: مطالعه‌ی حاضر کاربردی و مقطعی است. 28 بیمار که دارای سرطان نازوفارنکس بوده و به بیمارستان سیدالشهدا (امید) برای درمان بین سال‌های 1399-1401 مراجعه کرده و کاندید درمان با یکی از دستگاه‌های 3D-CRT و یا HT می‌باشند؛ در این مطالعه قرار گرفتند. طرح درمانی برای هر بیمار در دو دستگاه، شبیه‌سازی ‌شده و سپس متغیرهای مطالعه مانند حداکثر و میانگین دوز و شاخص‌های همگنی و انطباق مورد بررسی قرار گرفتند.
یافته‌ها: با مقایسه‌ی طرح‌های درمانی HT و 3D-CRT، میانگین دوز قابل دریافت حلزون گوش و سایر اندام‌‌های در معرض خطر در روش HT نسبت به روش 3D-CRT کاهش یافته و تفاوت قابل‌توجهی داشته‌اند، که نشان می‌دهد اختلاف معنی‌داری بین دو روش وجود دارد.
نتیجه‌گیری: طبق داده‌های مطالعه‌ی ما روی بیماران مبتلا به سرطان نازوفارنکس، نتایج نشان داد که HT از همگنی و انطباق هدف بهتری برخوردار است و دوز تحویلی به (Organ At Risk) OARها را در مقایسه با 3D-CRT معمولی کاهش می‌دهد.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Comparison of the Cochlea Dose in Head and Neck Cancer Patients Treated with 3-Dimensional Conformal Radiotherapy and Helical Tomotherapy

نویسندگان [English]

  • Hossein Rast 1
  • Simin Hemmati 2
  • Nahid Shami 3
  • Mohsen Saeb 4
  • Mohammad Bagher Tavakoli 5
1 MSc Student, Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Associate Professor, Department of Radio Oncology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
3 MSc in Medical Physics, Omid Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
4 PhD in Medical Physics, Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
5 Professor, Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
چکیده [English]

Background: Head and neck cancer (HNC) is among the ten most common cancers worldwide. Due to the complex anatomy of the head and neck, many organs receive radiation during treatment. The aim of this study is to compare the dose received by the cochlea in two different treatment methods, 3D-CRT (Three-Dimensional Conformal Radiotherapy) and HT (Helical Tomotherapy). 
Methods: The current study is applied and cross-sectional. 28 patients who had nasopharyngeal cancer and were referred to Seyed al-Shohada Hospital (Omid) for treatment between 2020-2022 and were candidates for treatment with one of the 3D-CRT or HT devices; were included in this study. The treatment plan for each patient was simulated in two devices and then study variables such as maximum and average dose and homogeneity and conformity index were investigated.
Findings: Comparison of the treatment plans using Helical Tomotherapy (HT) and Three-Dimensional Conformal Radiation Therapy (3D-CRT), Showed that the average dose received by organs at risk, such as the cochlea, was significantly lower in the HT method compared to the 3D-CRT method. This indicating a significant difference between the two treatment methods.
Conclusion: Our study on patients with nasopharyngeal cancer revealed that Helical Tomotherapy (HT) treatment led to better target homogeneity and compliance compared to conventional Three-Dimensional Conformal Radiation Therapy (3D-CRT). Additionally, HT was found to reduce the dose delivered to organs at risk (OARs) compared to 3D-CRT.

کلیدواژه‌ها [English]

  • Head and neck cancer
  • Nasopharynx
  • Conformal radiotherapy
  • Tomotherapy
  • Cochlea

مراجع

  1. Mirzaei M, Hosseini SA, Ghoncheh M, Soheilipour F, Soltani S, Soheilipour F, et al. Epidemiology and trend of head and neck cancers in Iran. Glob J Health Sci 2016; 8(1): 189-93.
  2. Lee TF, Yeh SA, Chao PJ, Chang L, Chiu CL, Ting HM, et al. Normal tissue complication probability modeling for cochlea constraints to avoid causing tinnitus after head-and-neck intensity-modulated radiation therapy. Radiat Oncol 2015; 10(1): 194.
  3. Liao LJ, Hou PY, Lo WC, Hsu WL, You SL. Subjective problems swallowing in head and neck cancer survivors. Int J Head Neck Sci 2020; 4(4): 156-63.
  4. Reid PA, Wilson P, Li Y, Marcu LG, Bezak E. Current understanding of cancer stem cells: Review of their radiobiology and role in head and neck cancers. Head Neck 2017; 39(9): 1920-32.
  5. Schultz C, Goffi-Gomez MVS, Liberman PHP, de Assis Pellizzon AC, Carvalho AL. Hearing loss and complaint in patients with head and neck cancer treated with radiotherapy. Arch Otolaryngol Head Neck Surg 2010; 136(11): 1065-9.
  6. Cruz OS, Tsoutsou P, Castella C, Khanfir K, Anchisi S, Bouayed S, et al. Locoregional control and toxicity in head and neck carcinoma patients following helical tomotherapy-delivered intensity-modulated radiation therapy compared with 3D-CRT Data. Oncology 2018; 95(2): 61-8.
  7. Mosleh-Shirazi MA, Amraee A, Mohaghegh F. Dose-response relationship and normal-tissue complication probability of conductive hearing loss in patients undergoing head-and-neck or cranial radiotherapy: a prospective study including 70 ears. Phys Med 2019; 61: 64-9.
  8. Zhang C, Liu LX, Li WZ, Liang W, Chen ZH, Huang XH, et al. Cochlea sparing with a stratified scheme of dose limitation employed in intensity-modulated radiotherapy for nasopharyngeal carcinoma: A dosimetry study. Med Dosim 2019; 44(3): 226-32.
  9. Hua C, Bass JK, Khan R, Kun LE, Merchant TE. Hearing loss after radiotherapy for pediatric brain tumors: effect of cochlear dose. Int J Radiat Oncol Biol Phys 2008; 72(3): 892-9.
  10. Carrier F, Liao Y, Mendenhall N, Guerrieri P, Todor D, Ahmad A, et al. Three Discipline Collaborative Radiation Therapy (3DCRT) Special Debate: I would treat prostate cancer with proton therapy. J Appl Clin Med Phys 2019; 20(7): 7.
  11. Kucha N, Soni TP, Jakhotia N, Patni N, Singh DK, Gupta AK, et al. A prospective, comparative analysis of acute toxicity profile between three-dimensional conformal radiotherapy (3DCRT) and intensity-modulated radiotherapy (IMRT) in locally advanced head and neck cancer patients. Cancer Treat Res Commun 2020; 25: 100223.
  12. Begnozzi L, Benassi M, Bertanelli M, Bonini A, Cionini L, Conte L, et al. Quality assurance of 3D-CRT: Indications and difficulties in their applications. Crit Rev Oncol Hematol 2009; 70(1): 24-38.
  13. Cui Z, Liu J, Sun Q, Wang C, Fang M, He Z, et al. Short-term efficacy comparison between helical tomotherapy and intensity-modulated radiotherapy in patients with locally advanced nasopharyngeal carcinoma. [Online]. [cited 09 Apr 2020]; Available from: URL: https://assets.researchsquare.com/files/rs-21288/v1/970dd0f8-e1b9-4898-9d91-2519c3eab49b.pdf?c=1631832954

 

  1. Saw CB, Katz L, Gillette C, Koutcher L. 3D treatment planning on helical tomotherapy delivery system. Med Dosim 2018; 43(2): 159-67.
  2. Balog J, Mackie TR, Pearson D, Hui S, Paliwal B, Jeraj R. Benchmarking beam alignment for a clinical helical tomotherapy device. Med Phys 2003; 30(6): 1118-27.
  3. Fiorino C, Dell'Oca I, Pierelli A, Broggi S, De Martin E, Di Muzio N, et al. Significant improvement in normal tissue sparing and target coverage for head and neck cancer by means of helical tomotherapy. Radiother Oncol 2006; 78(3): 276-82.
  4. Duma MN, Heinrich C, Schönknecht C, Chizzali B, Mayinger M, Devecka M, et al. Helical TomoTherapy for locally advanced or recurrent breast cancer. Radiat Oncol 2017; 12(1): 31.
  5. Lin JC, Tsai JT, Chen LJ, Li MH, Liu WH. Compared planning dosimetry of TOMO, VMAT and IMRT in rectal cancer with different simulated positions. Oncotarget 2017; 8(26): 42020-9.
  6. Xu Y, Deng W, Yang S, Li P, Kong Y, Tian Y, et al. Dosimetric comparison of the helical tomotherapy, volumetric-modulated arc therapy and fixed-field intensity-modulated radiotherapy for stage IIB-IIIB non-small cell lung cancer. Sci Rep 2017; 7(1): 14863.
  7. Lu S, Fan H, Hu X, Li X, Kuang Y, Yu D, et al. Dosimetric comparison of helical tomotherapy, volume-modulated arc therapy, and fixed-field intensity-modulated radiation therapy in locally advanced nasopharyngeal carcinoma. Front Oncol 2021; 11: 764946.
  8. Li S, Zhou Q, Shen LF, Li H, Li ZZ, Yang Z, et al. Dosimetric comparisons of volumetric modulated arc therapy and tomotherapy for early T-stage nasopharyngeal carcinoma. Biomed Res Int 2018; 2018: 2653497.
  9. Buzea CG, Mirestean C, Butuc I, Zara A, Iancu D. Radiation-induced biological changes of neural structures in the base of the skull tumours.
    J Radiother Pract 2017; 16(2): 183-98.
  10. Nguyen NP, Smith-Raymond L, Vinh-Hung V, Sloan D, Davis R, Vos P, et al. Feasibility of tomotherapy to spare the cochlea from excessive radiation in head and neck cancer. Oral Oncol 2011; 47(5): 414-9.
مجله دانشکده پزشکی اصفهان
دوره 41، شماره 710
هفته 2 اردیبهشت
فروردین و اردیبهشت 1402
صفحه 124-130

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