Tülay ÖZBEK, Candan DEMİRÖZ ABAKAY, Meral KURT, Sibel KAHRAMAN ÇETİNTAŞ, Ali ALTAY, Abdullah YEŞİL, Arda KAHRAMAN, Öznur SARIBAŞ

Volümetrik Ark Tedavi (VMAT) Tekniği Kullanarak Tüm Vücut Işınlaması ve Tüm Kemik İliği Işınlamasının Dozimetrik Karşılaştırılması

Bu araştırmada tüm vücut ışınlaması (TVI) ve tüm kemik iliği ışınlaması (TKI) için, Volümetrik Ark Tedavi (VMAT) tekniği kullanılarak, hedef hacim ve kritik organ dozlarının karşılaştırılması amaçlanmıştır. Çalışmada, insan doku ve organ yoğunluklarına sahip, rando fantom kullanıldı. VMAT planları günlük fraksiyon dozu 6 Gy olmak üzere toplam doz 12 Gy olacak şekilde, oluşturuldu. Hedef hacimler ve risk altındaki organların (RAO) aldığı doz değerleri karşılaştırıldı. VMAT-TVI için ortalama akciğer dozu, 7.6 Gy ve lens dozu 4.4 Gy iken, VMAT-TKI için, RAO’nun dozları 2.7 ila 7.15 Gy aralığındadır. Ayrıca her iki plan için tedavi öncesi kalite kontrolü Octavius 4D fantom kullanılarak, planlanan ve verilen dozlar arasında doz doğruluğu, her 3 düzlemde 3mm ve %3 kriterleri ile gama indeks analizi, her iki tedavi planı için ≤1 olduğu saptanmıştır. Planlanan ve uygulanan tedavi arasında oldukça hassas doz dağılımı olduğu gözlemlendi. Her iki tedavi tekniğinde de hedef volüm istenilen dozu aldığı, fakat VMAT-TVI tekniğinde, doz homojenliği ve tedavi uygulama tekniklerinin iyileştirilmesi gerektiği sonucuna varıldı. TKI ile akciğer dışındaki diğer RAO'ların da daha iyi korunabildiği saptandı. Çalışmamızın sonucunda, VMAT'ın gelecekte geleneksel tekniklere göre hem TVI hem de TKI uygulaması için uygun bir teknik olabileceği görüşüne varıldı.

Anahtar Kelimeler:

Tüm vücut ışınlaması (TVI), toplam kemik iliği ışınlaması (TKI), volümerik ark tedavisi (VMAT), kalite güvencesi (KG)

Dosimetric Comparison of Total Body Irradiation and Total Marrow Irradiation Using Volumetric Arc Therapy (VMAT)

It is aimed to compare target volume and critical organ doses using Volumeric arc therapy (VMAT) technique for Whole body irradiation (TVI) and Whole bone marrow irradiation (TKI). In the study, a random phantom with human tissue and organ densities was used.. VMAT plans were created with a daily fraction dose of 6 Gy and a total dose of 12 Gy. Target volumes and dose values received by critical organs were compared. Treatment plans The mean lung dose for VMAT-TVI is 7.6 Gy and the lens dose is 4.4 Gy, while organs at risk (OAR) doses for VMAT-TKI range from 2.7 to 7.15 Gy. In addition, pre-treatment quality control for both plans, dose accuracy between planned and administered doses using the Octavius 4D phantom, gamma index analysis with 3mm and 3% criteria in all 3 planes, we found that ≤1 for both treatment plans. We observed a very precise dose distribution between the planned and administered treatment. It was concluded that in both treatment techniques, the target volume received the desired dose, but in the VMAT-TBI technique, dose homogeneity and treatment application techniques should be improved. It was determined that other RAOs other than the lung were also better protected with TMI. As a result of our study, it was concluded that VMAT may be a suitable technique for both TBI and TMI application compared to traditional techniques in the future.

Keywords:

Total body irradiation (TBI), Total marrow irradiation (TMI), Volumetric arc therapy (VMAT), Quality assurance (QA),

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