Conventional 2D (2DRT) and 3D conformal radiotherapy (3DCRT) versus intensity-modulated radiotherapy (IMRT) for nasopharyngeal cancer treatment

Moretto, Francesco; Rampino, Monica; Muñoz, Fernándo; Redda, Maria Grazia Ruo; Reali, Alessia; Balcet, Vittoria; Badellino, Serena; Piva, Cristina; Schena, Marina; Airoldi, Mario; Ostellino, O.; Pecorari, Giancarlo; Ragona, Riccardo; Ricardi, Umberto

doi:10.1007/s11547-013-0359-7

Cited by 27 publications

(23 citation statements)

References 36 publications

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“…Notably, about 70% of patients in this study were diagnosed with NPC of early stage, which matched the relative higher survival outcomes in comparison with prior reports [4–6, 8, 9] on the whole. When stratified by tumor stage, however, the outcomes of early stage patients treated with IMRT and 2DCRT were highly similar to the results of the studies by Su et al [14] and Zhang et al [6], respectively.…”

Section: Discussionsupporting

confidence: 87%

“…By head to head comparison, Fang et al [8] and Moretto et al [9] both found that IMRT was comparable to 2DCRT in locoregional control, DMFS and OS, despite in smaller cohorts of patients. In a phase III randomized trial [10] aiming at the efficiency of adjuvant chemotherapy in locoregionally advanced NPC, radiation technique (IMRT vs 2DCRT/3DCRT) was also not associated with any type of survival.…”

Section: Discussionmentioning

confidence: 99%

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Effect of intensity-modulated radiotherapy versus two-dimensional conventional radiotherapy alone in nasopharyngeal carcinoma

et al. 2016

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BackgroundAlbeit intensity-modulated radiotherapy (IMRT) is currently the recommended radiation technique in treating nasopharyngeal carcinoma, the effect of IMRT versus two-dimensional conventional radiotherapy (2DCRT) alone is still contradictory.ResultsIn the original unmatched cohort of 1198 patients, IMRT obtained comparable 5-year overall survival (OS) (91.3% vs 87.1%, P = 0.120), locoregional relapse-free survival (LRFS) (92.3% vs 90.4%, P = 0.221) and distant metastasis-free survival (DMFS) (92.9% vs 92.1%, P = 0.901) to 2DCRT. In the propensity-matched cohort of 604 patients, no significant survival differences were observed between the two arms (5-year OS 90.9% vs 90.5%, P = 0.655; LRFS 92.5% vs 92.4%, P = 0.866; DMFS 92.5% vs 92.9%, P = 0.384). In multivariate analysis, IMRT did not significantly lower the risk of death, locoregional relapse or distant metastasis, irrespective of tumor stage.MethodsOverall, 1198 patients who underwent IMRT (316 patients) or 2DCRT (882 patients) without any chemotherapy was retrospectively analyzed. Patients in both arms were matched at equal ratio using propensity-score matching method. OS, LRFS and DMFS were assessed with Kaplan-Meier method, log-rank test and Cox regression.ConclusionsIn this propensity-matched study, IMRT showed no survival advantage over 2DCRT alone in nasopharyngeal carcinoma.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Effect of intensity-modulated radiotherapy versus two-dimensional conventional radiotherapy alone in nasopharyngeal carcinoma

et al. 2016

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“…Of the 79 full articles retrieved, 38 were further excluded for no matched comparison, 19 for reviews, 12 for insufficient data, and 2 for repeated patients. Finally, 8 articles [6,[12][13][14][26][27][28][29] met the inclusion criteria and the flowchart of the retrieved studies are presented in Fig. 1.…”

Section: Search Results and Characteristics Of Studiesmentioning

confidence: 99%

Intensity-modulated radiation therapy versus 2D-RT or 3D-CRT for the treatment of nasopharyngeal carcinoma: A systematic review and meta-analysis

et al. 2015

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“…The first part of our study (3DCRT versus IMRT) indicated that there was no significant reduction in the dose to bilateral PMCs and CSTs between the 3DCRT and IMRT plans. The critical structures adjacent to the target volume marked as OARs can be better spared during the IMRT planning process due to a steep dose gradient and a high conformity [17,18]. The second part of our study (IMRT versus IMRT_ PMC&CST), has shown that a significant reduction in the dose to bilateral PMCs and CSTs regions can be achieved without compromising the coverage of planning target volume and the limiting dose to these conventional OARs.…”

Section: Discussionmentioning

confidence: 99%

Integration of BOLD-fMRI and DTI into radiation treatment planning for high-grade gliomas located near the primary motor cortexes and corticospinal tracts

Wang

et al. 2015

Radiat Oncol

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BackgroundThe main objective of this study was to evaluate the efficacy of integrating the blood oxygen level dependent functional magnetic resonance imaging (BOLD-fMRI) and diffusion tensor imaging (DTI) data into radiation treatment planning for high-grade gliomas located near the primary motor cortexes (PMCs) and corticospinal tracts (CSTs).MethodsA total of 20 patients with high-grade gliomas adjacent to PMCs and CSTs between 2012 and 2014 were recruited. The bilateral PMCs and CSTs were located in the normal regions without any overlapping with target volume of the lesions. BOLD-fMRI, DTI and conventional MRI were performed on patients (Karnofsky performance score ≥ 70) before radical radiotherapy treatment. Four different imaging studies were conducted in each patient: a planning computed tomography (CT), an anatomical MRI, a DTI and a BOLD-fMRI. For each case, three treatment plans (3DCRT, IMRT and IMRT_PMC&CST) were developed by 3 different physicists using the Pinnacle planning system.ResultsOur study has shown that there was no significant difference between the 3DCRT and IMRT plans in terms of dose homogeneity, but IMRT displayed better planning target volume (PTV) dose conformity. In addition, we have found that the Dmax and Dmean to the ipsilateral and contralateral PMC and CST regions were considerably decreased in IMRT_PMC&CST group (p < 0.001).ConclusionsIn conclusion, integration of BOLD-fMRI and DTI into radiation treatment planning is feasible and beneficial. With the assistance of the above-described techniques, the bilateral PMCs and CSTs adjacent to the target volume could be clearly marked as OARs and spared during treatment.

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Conventional 2D (2DRT) and 3D conformal radiotherapy (3DCRT) versus intensity-modulated radiotherapy (IMRT) for nasopharyngeal cancer treatment

Cited by 27 publications

References 36 publications

Effect of intensity-modulated radiotherapy versus two-dimensional conventional radiotherapy alone in nasopharyngeal carcinoma

Effect of intensity-modulated radiotherapy versus two-dimensional conventional radiotherapy alone in nasopharyngeal carcinoma

Intensity-modulated radiation therapy versus 2D-RT or 3D-CRT for the treatment of nasopharyngeal carcinoma: A systematic review and meta-analysis

Integration of BOLD-fMRI and DTI into radiation treatment planning for high-grade gliomas located near the primary motor cortexes and corticospinal tracts

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