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Boyun ve mediasten tutulumlu hodgkin lenfoma olgularında Butterfly VMAT tekniği avantajlı mıdır?

Amaç: Bu çalışmada, erken evre Hodgkin lenfoma (HL) tanılı bilateral boyun ve mediasten yerleşimli genç kadın ve erkek olgularda, üç boyutlu konformal radyoterapi (3DCRT) ile volumetric modulated arc therapy (VMAT) ve butterfly VMAT tekniklerinin dozimetrik olarak karşılaştırılması amaçlanmıştır. Gereç ve Yöntemler: Erken evre HL'lı 20 hastaya radyoterapi uygulandı. Tüm plan verileri, hedef hacim ve kritik organ doz hacim histogramları karşılaştırıldı. Her üç teknik için konformite indeksi, homojenite indeksi ve % V107 farklılıkları değerlendirildi. Bulgular: Sağ meme maksimum, V25, V30 ve sol meme maksimum, V20, 25, 30 değerleri ise 3DCRT planlamada diğer VMAT planlarında elde edilen değerlerden daha yüksek idi. Bu da istatistiksel olarak anlamlı bulundu. Akciğer V5 değerleri 3DCRT planlamasında, VMAT planlarından daha düşüktü ve V20, 25,30 değerleri ise VMAT planlarından istatistiksel olarak daha yüksekti. Sağ ve sol parotis ortalamaları, V5,20 25, 30 değerleri butterfly VMAT planlamasında diğer planlara göre anlamlı olarak daha düşüktü. Sağ parotis V20, V25 değerinin butterfly VMAT planlamasında, ikili karşılaştırmalarda VMAT planından daha düşük olduğu bulunmuştur. Sonuçlar: Memede 20 Gy ve üzerinde VMAT, butterfly VMAT, 20 Gy ve altında ise 3DCRT tekniğinin daha avantajlı olduğu görülmektedir. Parotis dozları açısından ise butterfly VMAT’ın daha avantajlı olduğu görülmektedir.

Anahtar Kelimeler:

Hodgkin lenfoma, radioterapi, butterfly

Is Butterfly VMAT technique advantageous in hodgkin lymphoma patients with neck and mediastinal involvement?

Aim: In this paper, comparative planning for Three dimensional conformal (3DCRT), volumetric modulated arc therapy (VMAT) ve butterfly VMAT in a young female and male cohort with bilateral neck and mediastinal involvement diagnosed with early-stage Hodgkin’s lymphoma (HL) and we report whether the butterfly technique is advantageous. Material and Methods: 20 patients with early-stage HL were treated radiotherapy. All plan solutions were compared by target volume and critical organ dose-volume histograms. The conformity index, homogeneity index, and V107% differences were evaluated for all three techniques. Results: Right breast max, V25, V30 and left breast max V20,25,30 values in 3DCRT planning. It was found to be higher than the values obtained in the plans, which was found to be statistically significant. Lung V5 values were lower in 3DCRT planning than VMAT plans, and V20, 25,30 values were statistically higher than VMAT plans. Right, and left parotid means, V5,20 25, 30 values were significantly lower in butterfly VMAT planning compared to other plans. The right parotid V20, V25 value was found to be lower in butterfly-VMAT planning than in the VMAT plan in bilateral comparisons. Conclusion: VMAT, butterfly VMAT over 20 Gy in the breast, and 3DCRT techniques under 20 Gy are more advantageous in the examination of dose volumes of the organs at risk. İn terms of parotid doses, butterfly VMAT seems to be more advantageous.

Keywords:

Hodgkin’s lymphoma, radiotherapy, butterfly,

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