Carotid sparing hypofractionated tomotherapy in early glottic cancers: Refining image guided IMRT to improve morbidity

Chatterjee, Sanjoy; Guha, S.; Prasath, Sriram; Mallick, Indranil; Achari, R.

doi:10.4103/0973-1482.119349

Cited by 11 publications

(12 citation statements)

References 12 publications

(13 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Target and OAR were contoured based on the guideline of University of Florida as summarized in Table 1 [ 5 ]. Clinical target volume (CTV) was contoured; superiorly, to include the most cranial extent of the arytenoid cartilage, inferiorly, to include from 1 to 1.5 cm below the level of the true vocal cords, posteriorly, to include the arytenoid cartilage and posterior commissure, and anteriorly and laterally, to include the anterior commissure while excluding the thyroid cartilage.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Carotid sparing intensity modulated radiotherapy on early glottic cancer: preliminary study

Choi

Jeong

et al. 2016

Radiat Oncol J

View full text Add to dashboard Cite

PurposeTo compare the dose distribution between carotid sparing intensity modulated radiotherapy (IMRT) and opposed lateral field technique (LAFT), and to determine the effects of carotid sparing IMRT in early glottic cancer patients who have risk factors for atherosclerosis.Materials and MethodsTen early glottic cancer patients were treated with carotid sparing IMRT. For each patient, the conventional LAFT plan was developed for comparison. IMRT and LAFT plans were compared in terms of planning target volume (PTV) coverage, conformity index, homogeneity index, and the doses to planning organ at risk volume (PRV) for carotid arteries, spinal cord and pharyngeal constrictor muscle.ResultsRecurrence was not observed in any patients during the follow-up period. V95% for PTV showed no significant difference between IMRT and LAFT plans, while V100% was significantly higher in the IMRT plan (95.5% vs. 94.6%, p = 0.005). The homogeneity index (11.6%) and conformity index (1.4) in the IMRT plan were significantly better than those in the LAFT plans (8.5% and 5.1, respectively) (p = 0.005). The median V5Gy (90.0%), V25Gy (13.5%), and V50Gy (0%) for carotid artery PRV in the IMRT plan were significantly lower than those in the LAFT plan (99.1%, 89.0%, and 77.3%, respectively) (p = 0.005).ConclusionOur study suggests that carotid sparing IMRT can significantly decrease the dose to carotid arteries compared to LAFT, and it would be considered for early glottic cancer patient with high risk of atherosclerosis.

show abstract

Section: Methodsmentioning

confidence: 99%

“…where treatment volume is defined as the volume irradiated more than 95% of the prescription dose [ 5 ].…”

Section: Methodsmentioning

confidence: 99%

Carotid sparing intensity modulated radiotherapy on early glottic cancer: preliminary study

Choi

Jeong

et al. 2016

Radiat Oncol J

View full text Add to dashboard Cite

show abstract

“… 7 In this context, the dosimetric and clinical research on the so-called intensity-modulated radiotherapy (IMRT) or tomotherapy based “carotid-sparing radiotherapy technique” has demonstrated that it was plausible to reduce the CAs doses to meaningfully lower levels with no negative impact on the target dose coverage in early-stage laryngeal carcinoma patients. 2 , 3 , 8 - 12 …”

Section: Introductionmentioning

confidence: 99%

Preliminary Simulation Study of Carotid Artery and Pharyngeal Constrictor Muscle Sparing-Radiotherapy in Glottic Carcinoma

Özdemir

Acibuci

Selek

et al. 2020

Technol Cancer Res Treat

View full text Add to dashboard Cite

Background: This preliminary simulation study aimed to compare the dosimetric outcomes of carotid arteries (CAs) and pharyngeal constrictor muscle (PCM) in patients with T1N0M0 glottic carcinoma undergoing helical tomotherapy-intensity modulated radiotherapy (HT-IMRT) and 3-dimensional conformal radiotherapy (3D-CRT) plans. Methods: In addition to the clinical target volume (CTV) which was defined as the entire larynx, the CAs and PCM of 11 glottic carcinoma patients were delineated. The CTV was uniformly expanded 5 mm to create a planning target volume (PTV) relative to the PCM and at a distance of 2 mm from the CA. The dosimetric characteristics in HT-IMRT and lateral opposed fields-based 3D-CRT plans were analyzed. Results: Median D95%and V100% of PTV were significantly higher in HT-IMRT (p < 0.001) compared to 3D-CRT. The right/left CA dosimetric outcomes, including the mean doses (20.7/21.5 Gy versus 48.7/50.5 Gy), Dmax (53.6/52.0 Gy versus 67.4/67.7 Gy), V30 (25.0/27.1% versus 77.6/80.3%), V40 (8.0/7.9% versus 74.6/71.9%), and V50 (2.0/1.2% versus 70.0/71.6%) were also significantly lower in HT-IMRT (p < 0.05), similar to the mean PCM doses (49.6 Gy versus 62.6 Gy for 3D-CRT;p < 0.001), respectively. Conclusions: Our present results demonstrated the feasibility of simultaneous sparing of the CAs and PCM in HT-IMRT- compared to 3D-CRT plans in glottic carcinoma patients undergoing definitive radiotherapy.

show abstract

“…For these reasons, various treatment techniques have been introduced to decrease the dose administered to CA during RT for EGC [ 6 - 9 ]. Intensity-modulated radiation therapy (IMRT) can maintain good coverage while significantly reducing the dose administered to the CA, as compared with traditional LOF and 3-dimensional conformal RT (3DCRT) [ 6 - 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…Intensity-modulated radiation therapy (IMRT) can maintain good coverage while significantly reducing the dose administered to the CA, as compared with traditional LOF and 3-dimensional conformal RT (3DCRT) [ 6 - 8 ]. Further, Chatterjee et al [ 9 ] have reported that helical tomotherapy-based IMRT offers significant improvements to CA sparing. Inverse planning–based IMRT is highly effective in reducing the dose to adjacent organ at risks (OAR) and improves target dose conformity by controlling the beam intensity.…”

Section: Introductionmentioning

confidence: 99%

Carotid-Sparing TomoHelical 3-Dimensional Conformal Radiotherapy for Early Glottic Cancer

Hong

et al. 2016

Cancer Res Treat

View full text Add to dashboard Cite

PurposeThe purpose of this study was to investigate the dosimetric benefits and treatment efficiency of carotid-sparing TomoHelical 3-dimensional conformal radiotherapy (TH-3DCRT) for early glottic cancer. Materials and MethodsTen early-stage (T1N0M0) glottic squamous cell carcinoma patients were simulated, based on computed tomography scans. Two-field 3DCRT (2F-3DCRT), 3-field intensity-modulated radiation therapy (3F-IMRT), TomoHelical-IMRT (TH-IMRT), and TH-3DCRT plans were generated with a 67.5-Gy total prescription dose to the planning target volume (PTV) for each patient. In order to evaluate the plan quality, dosimetric characteristics were compared in terms of conformity index (CI) and homogeneity index (HI) for PTV, dose to the carotid arteries, and maximum dose to the spinal cord. Treatment planning and delivery times were compared to evaluate treatment efficiency. ResultsThe median CI was substantially better for the 3F-IMRT (0.65), TH-IMRT (0.64), and TH-3DCRT (0.63) plans, compared to the 2F-3DCRT plan (0.32). PTV HI was slightly better for TH-3DCRT and TH-IMRT (1.05) compared to 2F-3DCRT (1.06) and 3F-IMRT (1.09). TH-3DCRT, 3F-IMRT, and TH-IMRT showed an excellent carotid sparing capability compared to 2F-3DCRT (p < 0.05). For all plans, the maximum dose to the spinal cord was < 45 Gy. The median treatment planning times for 2F-3DCRT (5.85 minutes) and TH-3DCRT (7.10 minutes) were much lower than those for 3F-IMRT (45.48 minutes) and TH-IMRT (35.30 minutes). The delivery times for 2F-3DCRT (2.06 minutes) and 3F-IMRT (2.48 minutes) were slightly lower than those for TH-IMRT (2.90 minutes) and TH-3DCRT (2.86 minutes). ConclusionTH-3DCRT showed excellent carotid-sparing capability, while offering high efficiency and maintaining good PTV coverage.

show abstract

Carotid sparing hypofractionated tomotherapy in early glottic cancers: Refining image guided IMRT to improve morbidity

Abstract: Carotid sparing was possible using cstomo plans with significantly better conformity. Applying AS5 could enable us to reduce the PTV (3 mm) margin in X, Y axes for the remaining 15 fractions.

Cited by 11 publications

References 12 publications

Carotid sparing intensity modulated radiotherapy on early glottic cancer: preliminary study

Carotid sparing intensity modulated radiotherapy on early glottic cancer: preliminary study

Preliminary Simulation Study of Carotid Artery and Pharyngeal Constrictor Muscle Sparing-Radiotherapy in Glottic Carcinoma

Carotid-Sparing TomoHelical 3-Dimensional Conformal Radiotherapy for Early Glottic Cancer

Contact Info

Product

Resources

About