Does IMRT increase the peripheral radiation dose? A comparison of treatment plans 2000 and 2010

Salz, Henning; Eichner, R.; Wiezorek, Tilo

doi:10.1016/j.zemedi.2011.03.004

Cited by 7 publications

(5 citation statements)

References 22 publications

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“…Some researchers have pointed out that a higher peripheral dose may occur with the IMRT technique [24,25]; others have reported a similar peripheral dose for IMRT and 3-dimensional CRT, at least in selected cases [26]; still others have reported a lower peripheral dose for IMRT in some cases [27]. These discrepancies may result from the fact that VMAT is a novel radiation therapy technique.…”

Section: Discussionmentioning

confidence: 99%

Peripheral dose measurements in cervical cancer radiotherapy: a comparison of volumetric modulated arc therapy and step-and-shoot IMRT techniques

et al. 2014

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PurposeThe aim of this study was to investigate the peripheral doses resulting from volumetric modulated arc therapy (VMAT) and intensity modulated radiotherapy (IMRT) techniques in cervical cancer radiotherapy.MethodsNine patients with cervical cancer had treatment planned with both VMAT and IMRT. A specially designed phantom was used for this study, with ion chambers placed at interest points approximating the position of the breast, thyroid, and lens. The peripheral doses at the phantom interest points were measured and compared between the VMAT and IMRT techniques.ResultsVMAT provides a potential dosimetric advantage compared with IMRT. The mean (± standard deviation) peripheral dose to the breast point for 1 fraction (2 Gy) during VMAT measured 5.13 ± 0.96 mGy, compared with 9.04 ± 1.50 mGy for IMRT. At the thyroid and lens interest points, the mean (± standard deviation) peripheral dose during VMAT was 2.19 ± 0.33 and 2.16 ± 0.28 mGy, compared with 7.07 ± 0.76 and 6.97 ± 0.91 mGy for IMRT, respectively. VMAT reduced the monitor units used by 28% and shortened the treatment delivery time by 54% compared with IMRT.ConclusionWhile the dosimetric results are similar for both techniques, VMAT results in a lower peripheral dose to the patient and reduces the monitor-unit usage and treatment delivery time compared with IMRT.

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Section: Discussionmentioning

confidence: 99%

Peripheral dose measurements in cervical cancer radiotherapy: a comparison of volumetric modulated arc therapy and step-and-shoot IMRT techniques

et al. 2014

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“…This prospective study, therefore, showed that (primary or additive) conventional fractionated radiotherapy for localised prostate cancer delivered by 3D, or by one of two different IMRT techniques (IMRT or TOMO), did not lead to any clinically relevant changes to the partial blood count over the course of treatments. This finding is important because IMRT is associated with a higher transversal integral dose in the normal tissue compared to 3D conformal RT in the irradiation of the pelvis (19). Tomotherapy causes increased low-dose exposure and a relatively moderate medium-dose exposure of the surrounding normal tissue (12).…”

Section: Discussionmentioning

confidence: 99%

Lack of Relevant Haemogram Changes During Percutaneous Radiotherapy of Localised Prostate Cancer

Zwicker

Swartman

Huber

et al. 2020

In Vivo

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Background/Aim: In percutaneous radiotherapy dose-distribution and volumetric-load of normal tissue varies in different radiation-techniques. Haematotoxicity may lead to deficiencies of the immune and blood system or to secondary malignancies. Therefore, regular blood-counts are carried out during fractionated radiotherapy. The aim was to investigate patient haemogram courses during radiotherapy of localised prostate-cancer treated with different radiationtechniques (n=3). Patients and Methods: In this prospective study, blood count changes were examined during fractionated radiotherapy (3D-conformal-RT/step-and-shoot-IMRT/helical-IMRT) on the prostate-region in localised prostate-cancer cases (n=50). Results: The whole patient group displayed a small but significant reduction in leukocytes. This reduction was higher in the two IMRT groups compared to the 3D-group but without any case of leukopenia. Haemoglobin-or thrombocyte-levels did not significantly change. Conclusion: Regardless of the delivery mode used, localised fractionated irradiation of prostate region did not cause any clinically relevant haemogram changes in this study. These findings question the necessity of regular blood counts during fractionated radiotherapy of the prostate region for patients without any risk factors.

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“…Although the IMRT technique is the method that is usually used for treating NPC patients, it possibly increases the risk of radiation‐induced secondary cancers in normal tissues and OARs surrounding the tumour compared to conventional or conformal radiotherapy . There are two reasons for that: (i) IMRT plans typically involve the irradiation of larger volumes of normal tissue to low doses because of the configuration of the used treatment fields, (ii) IMRT can increase the peripheral dose attributable to the greater number of Monitor Units (MUs) that are used for each patient undergoing IMRT and head leakage from the treatment machine …”

Section: Discussionmentioning

confidence: 99%

“…26 There are two reasons for that: (i) IMRT plans typically involve the irradiation of larger volumes of normal tissue to low doses because of the configuration of the used treatment fields, (ii) IMRT can increase the peripheral dose attributable to the greater number of Monitor Units (MUs) that are used for each patient undergoing IMRT and head leakage from the treatment machine. 3,27,28 Hall and Wuu 5 reported that IMRT may double the incidence of secondary malignancies compared with conformal radiotherapy (3D-CRT) from about 1% to 1.75% for patients surviving 10 years. Also, they added that the numbers may be larger for younger patients.…”

Section: Discussionmentioning

confidence: 99%

The risk of secondary cancer in nasopharyngeal carcinoma paediatric patients due to intensity modulated radiotherapy and mega‐voltage cone beam computed tomography

et al. 2016

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Does IMRT increase the peripheral radiation dose? A comparison of treatment plans 2000 and 2010

Cited by 7 publications

References 22 publications

Peripheral dose measurements in cervical cancer radiotherapy: a comparison of volumetric modulated arc therapy and step-and-shoot IMRT techniques

Peripheral dose measurements in cervical cancer radiotherapy: a comparison of volumetric modulated arc therapy and step-and-shoot IMRT techniques

Lack of Relevant Haemogram Changes During Percutaneous Radiotherapy of Localised Prostate Cancer

The risk of secondary cancer in nasopharyngeal carcinoma paediatric patients due to intensity modulated radiotherapy and mega‐voltage cone beam computed tomography

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