容积旋转调强放射治疗技术在头颈部肿瘤的应用_West China Medical Journal

Authors：

 申芹 ^1,2 ,  陈念永 ¹ , 李光俊 ¹

1. ;
2. ;

Corresponding author：

陈念永, Email: n_ychen@hotmail.com

Keywords：

容积旋转调强放射治疗; 头颈部肿瘤; 放射物理学

DOI：

10.7507/1002-0179.201600442

Video：

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容积旋转调强放射治疗（VMAT）技术作为一种新型的放射治疗（放疗）技术，通过照射过程中机架连续旋转，连续改变剂量率、机架位置和多叶准直器叶片位置等，实现不同射野方向上的射束强度调整。其最大优势在于能达到与传统调强放疗技术相似或更好剂量分布的同时，大大提高了治疗效率。但作为新兴技术，完整的VMAT执行方案还有待开发，现有的临床数据相当有限。头颈部肿瘤因其复杂的解剖结构，对放疗计划质量要求甚高，该文旨在对VMAT在头颈部肿瘤的应用作一综述，以期为VMAT在头颈部肿瘤的临床实施提供循证依据。

Citation： 申芹, 陈念永, 李光俊. 容积旋转调强放射治疗技术在头颈部肿瘤的应用. West China Medical Journal, 2016, 31(9): 1614-1617. doi: 10.7507/1002-0179.201600442 Copy

1.	Shah JP, Lydiatt W. Treatment of cancer of the head and neck[J]. CA Cancer J Clin, 1995, 45:352-368.
2.	刘平, 胡春宏. 头颈部恶性肿瘤的同步放化疗研究进展[J]. 肿瘤研究与临床, 2000, 4(4):284-286.
3.	于金明, 邢力刚. 头颈部肿瘤放射治疗研究进展[J]. 耳鼻咽喉-头颈外科, 2003, 10(2):118-123.
4.	Tham IW, Hee SW, Yeo RM, et al. Treatment of nasopharyngeal carcinoma using intensity-modulated radiotherapy-the National cancer centre Singapore experience[J]. Int J Radiat Oncol Biol Phys, 2009, 75(5):1481-1486.
5.	Kam MK, Teo PM, Chau RM, et al. Treatment of nasopharyngeal carcinoma with intensity-modulated radiotherapy:the Hong Kong experience[J]. Int J Radiat Oncol Biol Phys, 2004, 60(5):1440-1450.
6.	Ezzell GA, Galvin JM, Low D, et al. Guidance document on delivery, treatment planning, and clinical implementation of IMRT:report of the IMRT Subcommittee of the AAPM Radiation Therapy Committee[J]. Med Phys, 2003, 30(8):2089-2115.
7.	Hoogeman MS, Nuyttens JJ, Levendag PC, et al. Time dependence of intrafraction patient motion assessed by repeat stereoscopic imaging[J]. Int J Radiat Oncol Biol Phys, 2008, 70(2):609-618.
8.	Hall EJ. Intensity-modulated radiation therapy, protons, and the risk of second cancers[J]. Int J Radiat Oncol Biol Phys, 2006, 65(1):1-7.
9.	郭蕊, 孙颖, 黄劭敏, 等. 鼻咽癌容积旋转调强放疗与常规静态调强放疗的剂量学对比研究[J]. 中山大学学报:医学科学版, 2012, 33(6):835-840, 855.
10.	Bzdusek K, Friberger H, Eriksson K, et al. Development and evaluation of an efficient approach to volumetric arc therapy planning[J]. Med Phys, 2009, 36(6):2328-2339.
11.	Takahashi S. Conformation radiotherapy. Rotation techniques as applied to radiography and raditherapy of cancer[J]. Acta Radiol Diagn (Stockh), 1965(Suppl 242):1.
12.	Yu CX, Li XA, Ma L, et al. Clinical implementation of intensity-modulated arc therapy[J]. Int J Radiat Oncol Biol Phys, 2002, 53(2):453-463.
13.	Yu CX, Tang G. Intensity-modulated arc therapy:principles, technologies and clinical implemention[J]. Phys Med Biol, 2011, 56(5):31-54.
14.	Otto K. Volumetric modulated arc therapy:IMRT in a single gantry arc[J]. Med Phys, 2008, 35(1):310-317.
15.	Teoh M, Clark CH, Wood K, et al. Volumetric modulated arc therapy:a review of current literature and clinical use in practice[J]. Br J Radiol, 2011, 84(17):967-996.
16.	Amendola BE, Amendola M, Perez N, et al. Volumetric-modulated arc therapy with RapidArc(^®):An evaluation of treatment delivery efficiency[J]. Rep Pract Oncol Radiother, 2013, 18(6):383-386.
17.	Lee TF, Ting HM, Chao PJ, et al. 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[J]. Clin Oncol (R Coll Radiol), 2012, 24(3):196-207.
18.	Verbakel WF, Cuijpers JP, Hoffmans D, et al. Volumetric intensity-modulated arc therapy vs. conventional IMRT in head-and-neck cancer:a comparative planning and dosimetric study[J]. Int J Radiat Oncol Biol Phys, 2009, 74(1):252-259.
19.	Vanetti E, Clivio A, Nicolini G, et al. Volumetric modulated arc radiotherapy for carcinomas of the oro-pharynx, hypo-pharynx and larynx:a treatment planning comparison with fixed field IMRT[J]. Radiother Oncol, 2009, 92(1):111-117.
20.	Johnston M, Clifford S, Bromley R, et al. Volumetric-modulated arc therapy in head and neck radiotherapy:a planning comparison using simultaneous integrated boost for nasopharynx and oropharynx carcinoma[J]. Clin Oncol (R Coll Radiol), 2011, 23(8):503-511.
21.	Holt A, Van Gestel D, Arends MP, et al. Multi-institutional comparison of volumetric modulated arc therapy vs. intensity-modulated radiation therapy for head-and-neck cancer:a planning study[J]. Radiat Oncol, 2013, 8:26.
22.	Orlandi E, Giandini T, Iannacone E, et al. Radiotherapy for unresectable sinonasal cancers:dosimetric comparison of intensity modulated radiation therapy with coplanar and non-coplanar volumetric modulated arc therapy[J]. Radiother Oncol, 2014, 113(2):260-266.
23.	Alvarez-Moret J, Pohl F, Koelbl O, et al. Evaluation of volumetric modulated arc therapy (VMAT) with Oncentra MasterPlan^® for the treatment of head and neck cancer[J]. Radiat Oncol, 2010, 5:110.
24.	Rao M, Yang W, Chen F, et al. Comparison of elekta VMAT with helical tomotherapy and fixed field IMRT:plan quality, delivery efficiency and accuracy[J]. Med Phys, 2010, 37(3):1350-1359.
25.	唐正中, 吴爱东, 钱立庭, 等. 鼻咽癌静态IMRT与VMAT同步加量放疗剂量学比较[J]. 安徽医科大学学报, 2014, 49(8):1164-1167.
26.	吴昊, 韩树奎, 孙艳, 等. 局部进展期鼻咽癌快速旋转调强与固定野动态调强放疗的剂量学比较[J]. 中华放射肿瘤学杂志, 2010, 19(5):410-413.
27.	徐寿平, 王连元, 戴相昆, 等. 螺旋断层放疗系统原理及其应用[J]. 医疗卫生装备, 2008, 29(12):100-102.
28.	Lu SH, Cheng JC, Kuo SH, et al. Volumetric modulated arc therapy for nasopharyngeal carcinoma:a dosimetric comparison with TomoTherapy and step-and-shoot IMRT[J]. Radiother Oncol, 2012, 104(3):324-330.
29.	Clemente S, Wu B, Sanguineti G, et al. SmartArc-based volumetric modulated arc therapy for oropharyngeal cancer:a dosimetric comparison with both intensity-modulated radiation therapy and helical tomotherapy[J]. Int J Radiat Oncol Biol Phys, 2011, 80(4):1248-1255.
30.	Broggi S, Perna L, Bonsignore F, et al. Static and rotational intensity modulated techniques for head-neck cancer radiotherapy:a planning comparison[J]. Phys Med, 2014, 30(8):973-979.
31.	Bertelsen A, Hansen CR, Johansen J, et al. Single arc volumetric modulated arc therapy of head and neck cancer[J]. Radiother Oncol, 2010, 95(2):142-148.
32.	Guckenberger M, Richter A, Krieger T, et al. Is a single arc sufficient in volumetric-modulated arc therapy (VMAT) for complex-shaped target volumes?[J]. Radiother Oncol, 2009, 93(2):259-265.
33.	Ning ZH, Mu JM, Jin JX, et al. Single arc volumetric-modulated arc therapy is sufficient for nasopharyngeal carcinoma:a dosimetric comparison with dual arc VMAT and dynamic MLC and step-and-shoot intensity-modulated radiotherapy[J]. Radiat Oncol, 2013, 8:237.
34.	Qiu JJ, Chang Z, Wu QJ, et al. Impact of volumetric modulated arc therapy technique on treatment with partial breast irradiation[J]. Int J Radiat Oncol Biol Phys, 2010, 78(1):288-296.
35.	Ezzell GA, Burmeister JW, Dogan N, et al. IMRT commissioning:multiple institution planning and dosimetry comparisons, a report from AAPM Task Group 119[J]. Med Phys, 2009, 36(11):5359-5373.
36.	Webb S, Mcquaid D. Some considerations concerning volume-modulated arc therapy:a stepping stone towards a general theory[J]. Phys Med Biol, 2009, 54(14):4345-4360.

1. Shah JP, Lydiatt W. Treatment of cancer of the head and neck[J]. CA Cancer J Clin, 1995, 45:352-368.
2. 刘平, 胡春宏. 头颈部恶性肿瘤的同步放化疗研究进展[J]. 肿瘤研究与临床, 2000, 4(4):284-286.
3. 于金明, 邢力刚. 头颈部肿瘤放射治疗研究进展[J]. 耳鼻咽喉-头颈外科, 2003, 10(2):118-123.
4. Tham IW, Hee SW, Yeo RM, et al. Treatment of nasopharyngeal carcinoma using intensity-modulated radiotherapy-the National cancer centre Singapore experience[J]. Int J Radiat Oncol Biol Phys, 2009, 75(5):1481-1486.
5. Kam MK, Teo PM, Chau RM, et al. Treatment of nasopharyngeal carcinoma with intensity-modulated radiotherapy:the Hong Kong experience[J]. Int J Radiat Oncol Biol Phys, 2004, 60(5):1440-1450.
6. Ezzell GA, Galvin JM, Low D, et al. Guidance document on delivery, treatment planning, and clinical implementation of IMRT:report of the IMRT Subcommittee of the AAPM Radiation Therapy Committee[J]. Med Phys, 2003, 30(8):2089-2115.
7. Hoogeman MS, Nuyttens JJ, Levendag PC, et al. Time dependence of intrafraction patient motion assessed by repeat stereoscopic imaging[J]. Int J Radiat Oncol Biol Phys, 2008, 70(2):609-618.
8. Hall EJ. Intensity-modulated radiation therapy, protons, and the risk of second cancers[J]. Int J Radiat Oncol Biol Phys, 2006, 65(1):1-7.
9. 郭蕊, 孙颖, 黄劭敏, 等. 鼻咽癌容积旋转调强放疗与常规静态调强放疗的剂量学对比研究[J]. 中山大学学报:医学科学版, 2012, 33(6):835-840, 855.
10. Bzdusek K, Friberger H, Eriksson K, et al. Development and evaluation of an efficient approach to volumetric arc therapy planning[J]. Med Phys, 2009, 36(6):2328-2339.
11. Takahashi S. Conformation radiotherapy. Rotation techniques as applied to radiography and raditherapy of cancer[J]. Acta Radiol Diagn (Stockh), 1965(Suppl 242):1.
12. Yu CX, Li XA, Ma L, et al. Clinical implementation of intensity-modulated arc therapy[J]. Int J Radiat Oncol Biol Phys, 2002, 53(2):453-463.
13. Yu CX, Tang G. Intensity-modulated arc therapy:principles, technologies and clinical implemention[J]. Phys Med Biol, 2011, 56(5):31-54.
14. Otto K. Volumetric modulated arc therapy:IMRT in a single gantry arc[J]. Med Phys, 2008, 35(1):310-317.
15. Teoh M, Clark CH, Wood K, et al. Volumetric modulated arc therapy:a review of current literature and clinical use in practice[J]. Br J Radiol, 2011, 84(17):967-996.
16. Amendola BE, Amendola M, Perez N, et al. Volumetric-modulated arc therapy with RapidArc(^®):An evaluation of treatment delivery efficiency[J]. Rep Pract Oncol Radiother, 2013, 18(6):383-386.
17. Lee TF, Ting HM, Chao PJ, et al. 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[J]. Clin Oncol (R Coll Radiol), 2012, 24(3):196-207.
18. Verbakel WF, Cuijpers JP, Hoffmans D, et al. Volumetric intensity-modulated arc therapy vs. conventional IMRT in head-and-neck cancer:a comparative planning and dosimetric study[J]. Int J Radiat Oncol Biol Phys, 2009, 74(1):252-259.
19. Vanetti E, Clivio A, Nicolini G, et al. Volumetric modulated arc radiotherapy for carcinomas of the oro-pharynx, hypo-pharynx and larynx:a treatment planning comparison with fixed field IMRT[J]. Radiother Oncol, 2009, 92(1):111-117.
20. Johnston M, Clifford S, Bromley R, et al. Volumetric-modulated arc therapy in head and neck radiotherapy:a planning comparison using simultaneous integrated boost for nasopharynx and oropharynx carcinoma[J]. Clin Oncol (R Coll Radiol), 2011, 23(8):503-511.
21. Holt A, Van Gestel D, Arends MP, et al. Multi-institutional comparison of volumetric modulated arc therapy vs. intensity-modulated radiation therapy for head-and-neck cancer:a planning study[J]. Radiat Oncol, 2013, 8:26.
22. Orlandi E, Giandini T, Iannacone E, et al. Radiotherapy for unresectable sinonasal cancers:dosimetric comparison of intensity modulated radiation therapy with coplanar and non-coplanar volumetric modulated arc therapy[J]. Radiother Oncol, 2014, 113(2):260-266.
23. Alvarez-Moret J, Pohl F, Koelbl O, et al. Evaluation of volumetric modulated arc therapy (VMAT) with Oncentra MasterPlan^® for the treatment of head and neck cancer[J]. Radiat Oncol, 2010, 5:110.
24. Rao M, Yang W, Chen F, et al. Comparison of elekta VMAT with helical tomotherapy and fixed field IMRT:plan quality, delivery efficiency and accuracy[J]. Med Phys, 2010, 37(3):1350-1359.
25. 唐正中, 吴爱东, 钱立庭, 等. 鼻咽癌静态IMRT与VMAT同步加量放疗剂量学比较[J]. 安徽医科大学学报, 2014, 49(8):1164-1167.
26. 吴昊, 韩树奎, 孙艳, 等. 局部进展期鼻咽癌快速旋转调强与固定野动态调强放疗的剂量学比较[J]. 中华放射肿瘤学杂志, 2010, 19(5):410-413.
27. 徐寿平, 王连元, 戴相昆, 等. 螺旋断层放疗系统原理及其应用[J]. 医疗卫生装备, 2008, 29(12):100-102.
28. Lu SH, Cheng JC, Kuo SH, et al. Volumetric modulated arc therapy for nasopharyngeal carcinoma:a dosimetric comparison with TomoTherapy and step-and-shoot IMRT[J]. Radiother Oncol, 2012, 104(3):324-330.
29. Clemente S, Wu B, Sanguineti G, et al. SmartArc-based volumetric modulated arc therapy for oropharyngeal cancer:a dosimetric comparison with both intensity-modulated radiation therapy and helical tomotherapy[J]. Int J Radiat Oncol Biol Phys, 2011, 80(4):1248-1255.
30. Broggi S, Perna L, Bonsignore F, et al. Static and rotational intensity modulated techniques for head-neck cancer radiotherapy:a planning comparison[J]. Phys Med, 2014, 30(8):973-979.
31. Bertelsen A, Hansen CR, Johansen J, et al. Single arc volumetric modulated arc therapy of head and neck cancer[J]. Radiother Oncol, 2010, 95(2):142-148.
32. Guckenberger M, Richter A, Krieger T, et al. Is a single arc sufficient in volumetric-modulated arc therapy (VMAT) for complex-shaped target volumes?[J]. Radiother Oncol, 2009, 93(2):259-265.
33. Ning ZH, Mu JM, Jin JX, et al. Single arc volumetric-modulated arc therapy is sufficient for nasopharyngeal carcinoma:a dosimetric comparison with dual arc VMAT and dynamic MLC and step-and-shoot intensity-modulated radiotherapy[J]. Radiat Oncol, 2013, 8:237.
34. Qiu JJ, Chang Z, Wu QJ, et al. Impact of volumetric modulated arc therapy technique on treatment with partial breast irradiation[J]. Int J Radiat Oncol Biol Phys, 2010, 78(1):288-296.
35. Ezzell GA, Burmeister JW, Dogan N, et al. IMRT commissioning:multiple institution planning and dosimetry comparisons, a report from AAPM Task Group 119[J]. Med Phys, 2009, 36(11):5359-5373.
36. Webb S, Mcquaid D. Some considerations concerning volume-modulated arc therapy:a stepping stone towards a general theory[J]. Phys Med Biol, 2009, 54(14):4345-4360.

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容积旋转调强放射治疗技术在头颈部肿瘤的应用

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