RESUMEN
Objective To identify clinical and dosimetric parameters from dose-volume histogram(DVH) relating with incidence of severe acute radiation-induced esophagitis(RE)in patients with non-small cell lung can-cer(NSCLC)underwent tomotherapy with concurrent or sequential chemotherapy. Methods Records about clini-cal information and treatment plan parameters from DVH of 62 NSCLC patients treated with tomotherapy were pro-spectively collected to assess the correlation to severe acute RE from January 2012 to December 2016. Results There were 24.2％patients developed grade 3 RE,grade 4 or 5 in 0％patients. Multivariate analysis indicated that concurrent chemotherapy,esophagus median dose and esophagus V25 and V55 were the influencing factors of RE. The incidence of low frequencies RE was correlated with sequential chemotherapy ,esophagus median dose < 49 Gy,esophagus V25 < 64％ ,V55 < 33％ and V60 < 15％. Conclusions For NSCLC patients treated with tomo-therapy and chemotherapy,the occurrence of acute RE was similar to that of other techniques. It is recommended to balance such parameters for optimizing treatment planning.
RESUMEN
Objective To identify clinical and dosimetric parameters from dose-volume histogram(DVH) relating with incidence of severe acute radiation-induced esophagitis(RE)in patients with non-small cell lung can-cer(NSCLC)underwent tomotherapy with concurrent or sequential chemotherapy. Methods Records about clini-cal information and treatment plan parameters from DVH of 62 NSCLC patients treated with tomotherapy were pro-spectively collected to assess the correlation to severe acute RE from January 2012 to December 2016. Results There were 24.2％patients developed grade 3 RE,grade 4 or 5 in 0％patients. Multivariate analysis indicated that concurrent chemotherapy,esophagus median dose and esophagus V25 and V55 were the influencing factors of RE. The incidence of low frequencies RE was correlated with sequential chemotherapy ,esophagus median dose < 49 Gy,esophagus V25 < 64％ ,V55 < 33％ and V60 < 15％. Conclusions For NSCLC patients treated with tomo-therapy and chemotherapy,the occurrence of acute RE was similar to that of other techniques. It is recommended to balance such parameters for optimizing treatment planning.
RESUMEN
Objective To compare the setup errors between single-site and two-site image guidance in treating multiple metastases using Tomotherapy.Methods A total of 1 220 sets of megavoltage CT (MVCT) images from 50 multiple metastases patients were collected.The setup errors of two anatomic sites were determined by registration of MVCT images with planning images.Bland-Altman plot analysis was used to assess the coincidence of these two methods.Pearson correlation analysis was performed to evaluate the correlation of the setup errors determined by two sets of data and to analyze the deviation values of setup errors.Results The deviation values of setup errors more than 3 mm between two sites were 34％,46％ and 28％ in lateral (x),longitudinal (y),vertical (z) directions,respectively.The deviation values of setup errors more than 5 mm were 10％,16％ and 8％,respectively.The BlandAltman plot analysis showed that the 95％ agreement limits of agreement were (9.3,-10.6),(10.5,-11.7),(7.3,-6.9) mm in x,y,z directions,respectively,which were all out of 5 mm tolerance.The Pearson coefficient of correlation along all three directions was less than 0.05,and R2 was 0.074,0.475,and 0.178 in x,y,z directions,respectively.Conclusions To determine the setup errors for patients with multiple metastases,single-site image guidance method is not consistent,and the two site image guidance method would be recommended.