Assessment of carotid artery dose in the treatment of nasopharyngeal cancer with IMRT versus conventional radiotherapy

Vitolo, Viviana; Millender, L.E.; Quivey, Jeanne M.; Yom, Sue S.; Schechter, Naomi R.; Jereczek-Fossa, Barbara A.; Milani, F; Orecchia, Roberto; Xia, Peng

doi:10.1016/j.radonc.2008.08.014

Cited by 16 publications

(10 citation statements)

References 30 publications

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“…However, we believe that using V20Gy which was not reported in Lomax data is far better than using the mean lung doses from radiobiological point of view. By comparing 3 field plans of Vitolo et al [23] with 3F-CRT in our series, we found that the mean dose to the carotid vessels was 98% compared to 100% respectively and the maximum dose 112% and 109% respectively, which confirms our results that the dose to the carotid vessels is relatively high by using single anterior field to SC-CTV.…”

Section: Discussionsupporting

confidence: 89%

Risk of Radiation Induced Carotid Artery Stenosis in Supraclavicular Lymph Node Irradiation in Breast Cancer Patients

Abdulmoniem¹,

Bayoumi²,

Asiri³

et al. 2014

JCT

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Background: The risk of carotid vessel stenosis is high after radiotherapy (RT) to neck; however, carotid vessels are unavoidable during supraclavicular (SC-RT) in adjuvant treatment of breast cancer (BC). However, carotid vessels RT dose is less well-understood. We aimed to determine the carotid vessels doses received by different techniques for SC-RT. Materials and Methods: Thirty consecutive BC patients were planned to receive SC-RT and breast after breast conserving surgery (BCS) after taking 5 mm image slices on computed tomography (CT) simulation. Organs at risk (OAR) including carotid vessels, lungs, spinal cord alongwith clinical target volume (CTV) for primary tumor and lymph nodes were delineated. Comparative analysis was done between two treatment plans; three-field conformal radiation therapy (3F-CRT) and four-field conformal RT (4F-CRT) for CTV and carotid vessels doses. Results: The 4F-CRT was found better than 3F-3DCRT regarding coverage and homogeneity of the CTV volume. The 98% of the CTV was covered by 84% dose in 3F-CRT and 95% in 4F-CRT (p 0.001). The carotid vessels maximum dose in the in 3F-CRT was 54.5 ± 1.3 Gy compared to 51.6 ± 1.3 Gy in 4F-CRT (p 0.014), however the mean dose did not differ significantly (p value 0.8). The ipsilateral lung dose did not differ between the two techniques (p Value 0.9). Conclusion: The 4F-CRT plan was found better than 3F-CRT in CTV coverage with minimal dose to the carotid vessel and without significant higher dose to the ipsilateral lung. KeywordsBreast Cancer; Supraclavicular Radiotherapy; Carotid Vessel Dose R. Abdulmoniem et al. 239

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Section: Discussionsupporting

confidence: 89%

Risk of Radiation Induced Carotid Artery Stenosis in Supraclavicular Lymph Node Irradiation in Breast Cancer Patients

Abdulmoniem¹,

Bayoumi²,

Asiri³

et al. 2014

JCT

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“…The SIB concept has been rapidly adopted for the IMRT of head and neck cancer patients [39,40]. Dose escalation in the area of the primary macroscopic tumor is also applied in several other regions, probably most frequently for breast cancer -the clinical benefit on local control has been demonstrated [2,31].…”

Section: Discussionmentioning

confidence: 99%

Intensity-Modulated Radiotherapy for Prostate Cancer Implementing Molecular Imaging with 18F-Choline PET-CT to Define a Simultaneous Integrated Boost

et al. 2010

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Section: Nodal Metastasis In Nasopharyngeal Cancermentioning

confidence: 99%

“…In addition, a recent study pointed out the possibility that superior CTV coverage of IMRT results in an increase in the carotid artery dose compared with conventional three-field technique [19]. Vitolo et al [19] determined the radiation dose to the carotid artery in NPC patients treated with IMRT and compared it with the dose delivered by a conventional three-field technique. The median mean dose to the carotid arteries was 65.7 Gy with IMRT vs 58.4 Gy with conventional three-field technique (p,0.001), although with the application of dose constraints to the carotid arteries it was possible to reduce the mean carotid dose to 54 Gy in the IMRT replans.…”

Section: Nodal Metastasis In Nasopharyngeal Cancermentioning

confidence: 99%

Factors associated with nodal metastasis in nasopharyngeal cancer: an approach to reduce the radiation field in selected patients

Tomita

Fuwa²,

Ariji³

et al. 2011

BJR

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Objectives: The purpose of this study was to investigate factors associated with lymph node (LN) metastasis to identify which nasopharyngeal cancer (NPC) patients can undergo a reduction in the prophylactic radiation field. MRI of biopsy-proven NPC patients was evaluated to determine primary tumour extension and the existence of LN metastasis. Methods: Sex, age, pathological type, T stage, primary tumour size, existence beyond the midline of the nasopharynx at the primary site and parapharyngeal extension of the primary tumour were assessed regarding their impact on the laterality of LN metastasis using the x 2 test. Results: Of the 167 patients, 149 (89%) showed nodal involvement. The existence beyond the midline of the nasopharynx was significantly associated with the laterality of LN metastasis (p,0.0001). Most patients (82%) with primary tumour presence within the midline showed only ipsilateral LN metastasis or no LN metastasis. In addition, contralateral LN metastases were seen only at Level II and the retropharyngeal LN among most of other patients. Conclusion: These results suggest that LN areas other than Level II and the retropharyngeal LN on the contralateral side could be omitted in patients with primary tumour presence within the midline and without the contralateral Level II or the retropharyngeal LN. Whether disease control is compromised by reducing the radiation field for subclinical diseases is a problem that should be solved in the future by prospective study.

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Assessment of carotid artery dose in the treatment of nasopharyngeal cancer with IMRT versus conventional radiotherapy

Cited by 16 publications

References 30 publications

Risk of Radiation Induced Carotid Artery Stenosis in Supraclavicular Lymph Node Irradiation in Breast Cancer Patients

Risk of Radiation Induced Carotid Artery Stenosis in Supraclavicular Lymph Node Irradiation in Breast Cancer Patients

Intensity-Modulated Radiotherapy for Prostate Cancer Implementing Molecular Imaging with 18F-Choline PET-CT to Define a Simultaneous Integrated Boost

Factors associated with nodal metastasis in nasopharyngeal cancer: an approach to reduce the radiation field in selected patients

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