碩士 / 高雄醫學大學 / 醫學影像暨放射科學系碩士在職專班 / 105 / With the progress of modern treatment technology, the goal of cancer therapy is not only to cure the disease, but also focus on quality of life to reduce side effects of treatment. Radiation therapy is a most effective therapy for brain metastases. The literature indicates the hippocampus in the brain plays the major functional role of memory and spatial orientation. Hippocampal-sparing technique can reduce the dose of hippocampus in whole brain radiation therapy. The quality of life can be much improved without loss of brain and cognitive functions after irradiation.
In this study, we enrolled nine patients with brain metastasis conformed in regional hospital in Southern Taiwan from 2016 to 2017. All patients the indication to receive hippocampus-sparing whole brain radiation therapy. We conducted to compared two different treatment planning study using the technique of volume modulated arc therapy. All patients were fixed with head mask and set up a head flexion angle of 300 , and then received computed tomography simulation. We analyzed the coplanar and non-coplanar treatment plan using therapy planning system (Philip Pinnacle Planning System Version 9.2). Dose constraints were set equally to compare the target target volume (PTV) and the organs at risk (OAR), including the hippocampus, eyes,lens, and optic nerve.
The results show no significant difference in the uniformity and conformal index between two treatment plans in the brain PTV (p>0.05). However, the mean PTV dose of hippocampus shows more homogenous in non-coplanar plan (p<0.05) , and the maximal dose in both hippocampus in the non-coplanar plan was significantly lower than coplanar plan (p<0.05). Other OAR in both two plan was similar (p> 0.05). However, treatment time of the coplanar plan can significantly shorter than the non-coplanar counterpart (p <0.05).
In our study, we concluded the non-coplanar plan is better than the coplanar plan in patients who undergo hippocampus-sparing whole brain radiation therapy. Non-coplanar plan can be employed to indicated patients to reduce the hippocampus dose. However, longer therapy time is needed in non-coplanar plan. Whether the longer therapy may lead to patient’s discomfort, consequent internal shift, or set up error or not? Ongoing study need to be further explored.
| Identifer | oai:union.ndltd.org:TW/105KMC05770010 |
| Date | January 2017 |
| Creators | Chia-Ling Hung, 洪佳伶 |
| Contributors | Shiang-Bin Jong, 鍾相彬 |
| Source Sets | National Digital Library of Theses and Dissertations in Taiwan |
| Language | zh-TW |
| Detected Language | English |
| Type | 學位論文 ; thesis |
| Format | 69 |
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