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:: جلد 22، شماره 1 - ( زمستان 1398: 1-201 1398 ) ::
جلد 22 شماره 1 صفحات 99-106 برگشت به فهرست نسخه ها
ارزیابی دوزیمتریک غدد بزاقی در درمان سرطان زبان با روش‌های پرتودرمانی با شدت تعدیل‌شده و تطبیقی سه بعدی
ایرج عابدی ، پگاه سعادتمند ، هادی اکبری زاده ، علیرضا عموحیدری ، احمد شانئی
چکیده:   (253 مشاهده)
هدف: هدف این مطالعه مقایسه دزیمتریک و رادیوبیولوژیک غدد بزاقی در بیماران سرطان زبان درمان شده با  تکنیک‌های مختلف پرتودرمانی با شدت تعدیل‌شده(IMRT)  و تطبیقی سه بعدی(3D-CRT)  می‌باشد.
مواد و روشها: این مطالعه بر روی طرح درمان 25 بیمار مبتلا به سرطان زبان در مرحله T2-T3/N0 صورت گرفته است. طراحی درمان بر روی تصاویر CT بیماران برای تکنیک‌های 3D-CRT و IMRT (با میدان‌های 5، 7 و9) برای همه بیماران انجام گرفت. سپس همگنی (HI) و تطابق دز (CI) در حجم هدف، بیشینه و میانگین دوز غدد بزاقی و احتمال بروز عوارض پاروتید محاسبه و مقایسه شدند.
یافتهها: نتایج این مطالعه حاکی از افزایش HI  وCI  (به ترتیب تا 54/61% و 78/28%) در IMRT نسبت به 3D-CRT می‌باشد. هم‌چنین افزایش تعداد میدان تابش در تکنیک IMRT می‌تواند منجر به کاهش میانگین دز رسیده به غدد زیر زبانی (تا 52/9) و کاهش بیشینه دز دریافتی غدد تحت فکی (تا 93/6%) شود. استفاده از تکنیک IMRT با 5 و 7 میدان می‌تواند منجر به افزایش معنادار در احتمال خشکی دهان ناشی از پرتوگیری غدد پاروتید (تا 61/8%) نسبت به تکنیک 3D-CRT شود.
نتیجهگیری: نتیجه‌گیری می‌شود که استفاده از تکنیک IMRT با 9 میدان در مقایسه با تکنیک 3D-CRT در بیماران سرطان زبان، منجر به همگنی و تطابق بیش‌تر در هدف و دز دریافتی کم‌تر غدد تحت فکی و زیر زبانی می‌شود.
 
واژه‌های کلیدی: سرطان‌های دهان، سرطان‌های زبان، پرتودرمانی تطبیقی، پرتو درمانی با شدت تعدیل شده، غدد بزاقی، غدد پاروتید
متن کامل [PDF 1028 kb]   (95 دریافت)    
نوع مطالعه: پژوهشي | موضوع مقاله: عمومى
دریافت: ۱۳۹۸/۳/۲ | پذیرش: ۱۳۹۸/۵/۱۵ | انتشار: ۱۳۹۸/۱۰/۱۴
فهرست منابع
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31. [1] Jemal A, Bray F, Center MM, Ferlay J, Ward E FD. Global cancer statistics. Cancer J Clin 2011; 61: 69-90. [DOI:10.3322/caac.20107] [PMID]
32. [2] Miller KD, Siegel RL, Lin CC, Mariotto AB, Kramer JL, Rowland JH, et al. Cancer treatment and survivorship statistics, 2016. CA Cancer J Clin 2016; 66: 271-289. [DOI:10.3322/caac.21349] [PMID]
33. [3] Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin 2019; 69: 7-34. [DOI:10.3322/caac.21551] [PMID]
34. [4] Collan J, Lundberg M, Vaalavirta L, Bäck L, Kajanti M, Mäkitie A, et al. Patterns of relapse following surgery and postoperative intensity modulated radiotherapy for oral and oropharyngeal cancer. Acta Oncol (Madr) 2011; 50: 1119-1125. [DOI:10.3109/0284186X.2010.549839] [PMID]
35. [5] De Felice F, Musio D, Terenzi V, Valentini V, Cassoni A, Tombolini M, et al. Treatment improvement and better patient care: which is the most important one in oral cavity cancer? Radiat Oncol 2014; 9: 263. [DOI:10.1186/s13014-014-0263-x] [PMID] [PMCID]
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37. [7] Huang TY, Hsu LP, Wen YH, Huang TT, Chou YF, Lee CF, et al. Predictors of locoregional recurrence in early stage oral cavity cancer with free surgical margins. Oral Oncol 2010; 46: 49-55. [DOI:10.1016/j.oraloncology.2009.10.011] [PMID]
38. [8] Chen WC, Hwang TZ, Wang WH, Lu CH, Chen CC, Chen CM, et al. Comparison between conventional and intensity-modulated post-operative radiotherapy for stage III and IV oral cavity cancer in terms of treatment results and toxicity. Oral Oncol 2009; 45: 505-510. [DOI:10.1016/j.oraloncology.2008.07.002] [PMID]
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48. [18] Lambrecht M, Nevens D, Nuyts S. Intensity-modulated radiotherapy vs. parotid-sparing 3D conformal radiotherapy. Strahlentherapie und Onkol 2013; 189: 223-229. [DOI:10.1007/s00066-012-0289-7] [PMID]
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50. [20] Eisbruch A, Chao KC, Garden A. Phase I/II study of conformal and intensity modulated irradiation for oropharyngeal cancer (RTOG 0022). Radiat Ther Oncol Gr Am Coll Radiol 2004.
51. [21] Chen BB, Huang SM, Xiao WW, Sun WZ, Liu MZ, Lu TX, et al. Prospective matched study on comparison of volumetric-modulated arc therapy and intensity-modulated radiotherapy for nasopharyngeal carcinoma: dosimetry, delivery efficiency and outcomes. J Cancer 2018; 9: 978-986. [DOI:10.7150/jca.22843] [PMID] [PMCID]
52. [22] Fujiwara M, Kamikonya N, Odawara S, Suzuki H, Niwa Y, Takada Y, et al. The threshold of hypothyroidism after radiation therapy for head and neck cancer: a retrospective analysis of 116 cases. J Radiat Res 2015; 56: 577-582. [DOI:10.1093/jrr/rrv006] [PMID] [PMCID]
53. [23] Zhai R, Kong F, Du C, Hu C, Ying H. Radiation-induced hypothyroidism after IMRT for nasopharyngeal carcinoma: clinical and dosimetric predictors in a prospective cohort study. Oral Oncol 2017; 68: 44-49. [DOI:10.1016/j.oraloncology.2017.03.005] [PMID]
54. [24] Measurements IC on RU and. ICRU Report 83 Prescribing, Recording, and Reporting Photon-beam Intensity-modulated Radiation Therapy (IMRT)-Journal of the ICRU-Vol 10 No 1 2010. 2010. [DOI:10.1093/jicru/ndq002]
55. [25] Lee TF, Ting HM, Chao PJ, Fang FM. Dual arc volumetric-modulated arc radiotherapy (VMAT) of nasopharyngeal carcinomas: a simultaneous integrated boost treatment plan comparison with intensity-modulated radiotherapies and single arc VMAT. Clin Oncol 2012; 24: 196-207. [DOI:10.1016/j.clon.2011.06.006] [PMID]
56. [26] Gay HA, Niemierko A. A free program for calculating EUD-based NTCP and TCP in external beam radiotherapy. Phys Medica 2007; 23: 115-125. [DOI:10.1016/j.ejmp.2007.07.001] [PMID]
57. [27] Emami B. Tolerance of normal tissue to therapeutic radiation. Reports Radiother Oncol 2013; 1.
58. [28] Deasy JO, Moiseenko V, Marks L, Chao KSC, Nam J, Eisbruch A. Radiotherapy dose-volume effects on salivary gland function. Int J Radiat Oncol Biol Phys 2010; 76: S58-63. [DOI:10.1016/j.ijrobp.2009.06.090] [PMID] [PMCID]
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60. [30] McQuaid D, Dunlop A, Nill S, Franzese C, Nutting CM, Harrington KJ, et al. Evaluation of radiotherapy techniques for radical treatment of lateralised oropharyngeal cancers. Strahlentherapie und Onkol 2016; 192: 516-525 [DOI:10.1007/s00066-016-0980-1] [PMID]
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Abedi I, Saadatmand P, Akbari-Zadeh H, Amouheidari A, Shanei A. Dosimetry evaluation of salivary glands in 3D conformal radiotherapy and intensity modulated radiotherapy in oral tongue cancer. koomesh. 2020; 22 (1) :99-106
URL: http://koomeshjournal.semums.ac.ir/article-1-5684-fa.html

عابدی ایرج، سعادتمند پگاه، اکبری زاده هادی، عموحیدری علیرضا، شانئی احمد. ارزیابی دوزیمتریک غدد بزاقی در درمان سرطان زبان با روش‌های پرتودرمانی با شدت تعدیل‌شده و تطبیقی سه بعدی. كومش. 1398; 22 (1) :99-106

URL: http://koomeshjournal.semums.ac.ir/article-1-5684-fa.html



جلد 22، شماره 1 - ( زمستان 1398: 1-201 1398 ) برگشت به فهرست نسخه ها
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