Evaluation of various dose homogeneity indices for treatment of patients with cervix cancer using intensity-modulated radiation therapy technique

Atiq, Atia; Atiq, Maria; Iqbal, Khalid; Shamsi, Quratul Ain; Buzdar, Saeed Ahmad

doi:10.1017/s1460396918000249

Cited by 10 publications

(3 citation statements)

References 26 publications

(56 reference statements)

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“…Various authors have discussed the HI for gynecological cancer (Kataria et al, 2012;Lebedenko et al, 2018;Atiq et al, 2019), which gives a clear picture about the dose uniformity within the tumour. Hot and cold spots that affect the radiation outcome can be easily identified using this index.…”

Section: Discussionmentioning

confidence: 99%

IMRT as an Alternative Technique for Intracavitary Brachytherapy in Patients with Carcinoma of the Cervix: A Feasibility Study Using Unified Dosimetric Index

Balan,

Ramasubramanian

2023

Asian Pac J Cancer Prev

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Objective: Intracavitary brachytherapy (ICBT) plays an important role in the management of carcinoma of the cervix. This study attempts to find the feasibility of intensity-modulated radiation therapy (IMRT) as a boost for patients who are not suitable for ICBT in order to improve their disease-free and overall survival. Methods: Twenty patients with carcinoma of the cervix were included in this study. Nine fields of IMRT and ICBT plans were generated for PTV Boost . Various dosimetric indices like coverage, conformity, homogeneity, and gradient index were calculated, and the corresponding unified dosimetric index (UDI) values were generated. Plans were classified based on combined UDI, and the UDI values were compared with those of ICBT. In addition, rectum and bladder doses were compared. Results: All the dosimetric indices were within acceptable limits except for the gradient index. The gradient index of the IMRT and ICBT plans were 8.77 ± 0.26 and 1.33 ± 0.06 respectively (p < 0.0001). The mean of combined UDI with standard deviation was 32.557 ± 8.940 and plan quality was calculated from these values. Rectum and bladder doses for ICBT were lesser than IMRT (p < 0.0001). Conclusion: ICBT is the gold standard for boost RT in carcinoma of the cervix patients. IMRT boost is feasible for patients who are unsuitable on medical grounds for brachytherapy.

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Section: Discussionmentioning

confidence: 99%

IMRT as an Alternative Technique for Intracavitary Brachytherapy in Patients with Carcinoma of the Cervix: A Feasibility Study Using Unified Dosimetric Index

Balan,

Ramasubramanian

2023

Asian Pac J Cancer Prev

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“…Homogeneity of treatment plans, calculated using this formula, have acceptable values between 1 and 1·5. [23] GI accounts for the measurement of shallowness or steepness of dose fall-off in tumor volume. [24] GI is defined as volume of PD to the 50% isodose volume of PD.…”

Section: Methodsmentioning

confidence: 99%

A comparative study of RapidArc and intensity-modulated radiotherapy plan quality for cervical cancer treatment

Atiq

Iqbal

et al. 2018

Indian J Cancer

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BACKGROUND: RapidArc therapy, a complex form of intensity-modulated radiotherapy (IMRT), is now widely used to treat cancer patients. AIMS: This study aimed to investigate and compare the plan quality of IMRT and RapidArc techniques using various dosimetric indices to find the better treatment modality for treating patients with cervix cancer. MATERIALS AND METHODS: Thirteen cervical cancer patients treated with IMRT were selected for analysis and original plans were subsequently re-optimized using the RapidArc technique. Plans were generated such that dose of 5000 cGy was delivered in 25 equal fractions. Inverse planning was done by Eclipse (Varian Medical Systems, Palo Alto, CA) treatment planning system for 15 MV photon beams from computed tomographic data. Double arcs were used for RapidArc plans. Quality of treatment plans was evaluated by calculating conformity index (CI), homogeneity index (HI), gradient index (GI), coverage, and unified dosimetry index (UDI) for each plan. RESULTS AND CONCLUSION: RapidArc resulted in better planning target volume (PTV) coverage as is evident from its superior conformation number, coverage, CI, HI, GI, and UDI. Regarding organs at risk (OARs), RapidArc plans exhibit superior organ sparing as is evident from integral dose comparison. Difference between both techniques was determined by statistical analysis. For all cases under study, modest differences between IMRT and RapidArc treatment were observed. RapidArc-based treatment planning is safer with similar planning goals compared to the standard fixed IMRT technique. This study clearly demonstrated that favorable dose distribution in PTV and OARs was achieved using RapidArc technique, and hence, the risk of damage to normal tissues is reduced.

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“…GI is defined as volume of PD to the 50% isodose volume of PD. 18,19 The lower ratio of GI represents the greater dose falloff and better plan conformity.…”

Section: ¼ Piv=tvmentioning

confidence: 99%

Dosimetric comparison of intensity-modulated radiotherapy (IMRT) and RapidArc in low grade mucoepidermoid carcinoma of the salivary gland: a single institutional experience

et al. 2020

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Purpose: To report a single-institution experience of intensity-modulated radiotherapy (IMRT) and RapidArc treatment plans for the patients treated with low grade mucoepidermoid carcinoma (MEC) of the salivary gland while sparing the organs at risk (OARs) within tolerance limits. Material and Methods: Twenty-five patients with MEC were selected to develop and analyse the treatment plans using both of the techniques. Dose distributions were calculated using Eclipse treatment planning system (Varian Medical Systems, Palo Alto, CA). Plans were generated to deliver the dose of 6000 cGy in 30 fractions. For IMRT, seven angle plans were used and for RapidArc, two half arcs were used with the same 6 MV photon beam. Quality of treatment plans was evaluated by using parameters such as, coverage, conformity index (CI), homogeneity index (HI), gradient index (GI), unified dosimetry index (UDI), dose volume histogram, delivery time and OARs sparing for IMRT and RapidArc plans. Results: The analysis revealed that IMRT and RapidArc coverages are 0·90 and 0·94, respectively; CIs are 1·15 and 1·10, respectively; HIs are 1·12 and 1·07, respectively; GIs are 0·94 and 0·98, respectively. Average UDI values for RapidArc and IMRT are 1·09 and 1·11, respectively. Integral dose comparison shows better OAR sparing for RapidArc. RapidArc plans have the shorter beam on time (45%) in comparison with IMRT plans. Conclusion: Planning constraints were achieved in both techniques. However, RapidArc showed better quality treatment plan, OARs sparing and shorter delivery time as compared to IMRT.

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Evaluation of various dose homogeneity indices for treatment of patients with cervix cancer using intensity-modulated radiation therapy technique

Cited by 10 publications

References 26 publications

IMRT as an Alternative Technique for Intracavitary Brachytherapy in Patients with Carcinoma of the Cervix: A Feasibility Study Using Unified Dosimetric Index

IMRT as an Alternative Technique for Intracavitary Brachytherapy in Patients with Carcinoma of the Cervix: A Feasibility Study Using Unified Dosimetric Index

A comparative study of RapidArc and intensity-modulated radiotherapy plan quality for cervical cancer treatment

Dosimetric comparison of intensity-modulated radiotherapy (IMRT) and RapidArc in low grade mucoepidermoid carcinoma of the salivary gland: a single institutional experience

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