Helical Tomotherapy for Radiotherapy in Esophageal Cancer: A Preferred Plan With Better Conformal Target Coverage and More Homogeneous Dose Distribution

Chen, Yi Jen; Liu, An; Han, Chunhui; Tsai, Peter T.; Schultheiss, Timothy E.; Pezner, Richard D.; Vora, Nilesh; Lim, Dean; Shibata, Stephen; Kernstine, Kemp H.; Wong, Jeffrey Y.C.

doi:10.1016/j.meddos.2006.12.003

Cited by 62 publications

(38 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The decrease in cord dose could also be explained by the use of arcing as a planning technique even though no constraints have been placed on the numbers of monitor units delivered by each control point. The cord dose described in other studies is: 42 Gy [13]; 41 Gy [16]. The reduction in cord dose could be of significance, as new evidence suggests that cord dose should not exceed 40 Gy in cases of combined modality with oxaliplatin [38,39].…”

Section: Volumetric Modulated Arc Therapy For Oesophageal Malignanciesmentioning

confidence: 90%

“…The same magnitude of reduction in cardiac doses has not been illustrated by other studies, such as Chandra et al [13], who found no significant change when attempting to reduce heart dose, whereas Mayo et al [14] described V30 of .55% for hybrid IMRT and conventional plans but did not specifically attempt to reduce heart dose. Helical tomotherapy has also been described to reduce the volume of heart irradiated in this tumour site [16].…”

Section: Volumetric Modulated Arc Therapy For Oesophageal Malignanciesmentioning

confidence: 99%

“…A few studies have investigated the potential dosimetric advantage of IMRT in oesophageal cancer [13][14][15][16][17] and have demonstrated better dose conformity to the planning target volume (PTV) and lower V20 and V30 lung volumes. One study that included in the planning goals an absolute reduction of 10% in volumes of heart receiving 40 Gy and 50 Gy described no significant reduction in cardiac dose compared with the clinical plan [13], but also indicated that in certain cases with better dose-volume histogram (DVH) objectives the heart dose could be reduced with IMRT.…”

mentioning

confidence: 99%

“…One study that included in the planning goals an absolute reduction of 10% in volumes of heart receiving 40 Gy and 50 Gy described no significant reduction in cardiac dose compared with the clinical plan [13], but also indicated that in certain cases with better dose-volume histogram (DVH) objectives the heart dose could be reduced with IMRT. Sparing of the heart in terms of V30 or V45 is described with tomotherapy for oesophageal cancers [16]. Epidermal and/or vascular growth factor receptor blockade (e.g.…”

mentioning

confidence: 99%

“…The arc plans were compared with clinically optimised conformal four-field plans as a conformal four-field plan is the current standard practice both at this centre and elsewhere. IMRT techniques have been investigated previously [13][14][15][16][17], so are not considered here. The aim was to reduce heart and spinal cord dose, while maintaining lung receiving 20 Gy ,20% and PTV coverage by 95% prescription isodose.…”

mentioning

confidence: 99%

See 4 more Smart Citations

Volumetric modulated arc therapy planning for distal oesophageal malignancies

Hawkins

Bedford²,

Warrington³

et al. 2012

BJR

View full text Add to dashboard Cite

Objectives: Volumetric modulated arc therapy (VMAT) is a novel form of intensitymodulated radiation therapy that allows the radiation dose to be delivered in a single gantry rotation using conformal or modulated fields. The capability of VMAT to reduce heart and cord dose, while maintaining lung receiving 20 Gy ,20%, was evaluated for chemoradiation for oesophageal cancer. Methods: An optimised forward-planned four-field arrangement was compared with inverse-planned coplanar VMAT arcs with 35 control points for 10 patients with lower gastro-oesophageal tumours prescribed 54 Gy in 30 fractions. Conformal (cARC) and intensity-modulated (VMATi) arcs were considered. Plans were assessed and compared using the planning target volume (PTV) irradiated to 95% of the prescription dose (V95), volumes of lung irradiated to 20 Gy (V20), heart irradiated to 30 Gy (V30), spinal cord maximum dose and van't Riet conformation number (CN). The monitor units per fraction and delivery time were recorded for a single representative plan. Results: VMATi provided a significant reduction in the heart V30 (31% vs 55%; p50.02) with better CN (0.72 vs 0.65; p50.01) than the conformal plan. The treatment delivery was 1 min 28 s for VMAT compared with 3 min 15 s. Conclusion: For similar PTV coverage, VMATi delivers a lower dose to organs at risk than conformal plans in a shorter time, and this has warranted clinical implementation.

show abstract

Section: Volumetric Modulated Arc Therapy For Oesophageal Malignanciesmentioning

confidence: 90%

Section: Volumetric Modulated Arc Therapy For Oesophageal Malignanciesmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Volumetric modulated arc therapy planning for distal oesophageal malignancies

Hawkins

Bedford²,

Warrington³

et al. 2012

BJR

View full text Add to dashboard Cite

show abstract

Radiation modality use and cardiopulmonary mortality risk in elderly patients with esophageal cancer

Lin

Zhang

Godby

et al. 2015

Cancer

View full text Add to dashboard Cite

BACKGROUND It is currently unclear if the superior normal organ sparing effect of Intensity Modulated Radiation Therapy (IMRT) as compared to three-dimensional radiation therapy (3D) has clinical impact on survival and cardiopulmonary mortality in esophageal cancer (EC) patients. METHODS We identified 2,553 patients older than age 65 years from the SEER/Texas Cancer Registry-Medicare databases who had non-metastatic EC diagnosed between 2002 and 2009 and were treated with either 3D (n=2,240) or IMRT (n=313) within 6 months of diagnosis. The outcomes of the two cohorts were compared using Inverse Probability of Treatment Weighting (IPTW) adjustment. RESULTS Except for marital status, year of diagnosis, and SEER region, both radiation cohorts were well balanced for various patient, tumor, and treatment characteristics, including the use of IMRT vs. 3D in urban/metro or rural areas. IMRT use increased from 2.6% in 2002 to 30% in 2009, while 3D use decreased from 97.4% in 2002 to 70% in 2009. On propensity score IPTW-adjusted multivariate analysis, IMRT was not associated with EC-specific mortality (HR 0.93, 95%CI 0.80-1.10) or pulmonary mortality (HR 1.11, 95%CI 0.37-3.36) but was significantly associated with lower all-cause mortality (HR 0.83, 95%CI 0.72-0.95), cardiac mortality (HR 0.18, 95%CI 0.06-0.54) and other cause mortality (HR 0.54, 95%CI 0.35-0.84). Similar associations were seen after adjusting for the type of chemotherapy, physician experience, and sensitivity analysis removing hybrid radiation claims. CONCLUSIONS In this population-based analysis, IMRT use was significantly associated with lower all-cause mortality, cardiac mortality, and other-cause mortality in EC patients.

show abstract

Dosimetric comparison between helical tomotherapy and intensity‐modulated radiotherapy for esophageal carcinoma

Lai

Yang

et al. 2017

Precision Radiation Oncology

View full text Add to dashboard Cite

Objective: To compare the effectiveness of different radiotherapy techniques -tomotherapy (TOMO) and intensity-modulated radiation therapy (IMRT) -for patients with esophageal carcinoma on the basis of dosimetric analysis. Methods:The target areas and organs at risk in 10 patients with esophageal carcinoma were underlined and transmitted to the Raystation and TOMO planning systems. The homogeneity index (HI) and conformal index (CI) values, and dose distributions to organs at risk were compared on the basis of dose-volume histograms parameters. Results:The median of HI of gross planning target volume by TOMO (HI = 0.0575) showed superior homogeneity dose distribution compared with the IMRT technique (HI = 0.0735, P = 0.047).The median of CI of planning target volume by TOMO (CI = 0.785) showed improved conformity of dose distribution compared with IMRT (CI = 0.6825, P = 0.009). The median of the maximum dose to planning gross tumor volume (PGTV) and planning target volume by TOMO was significantly decreased compared with IMRT. The median of total lung doses, total heart doses, and maximum doses to the spinal cord were all significantly reduced by TOMO compared with IMRT. Conclusions:Compared with IMRT, TOMO could provide better conformal target coverage, more homogeneity dose distribution, and significantly decreased the radiation dose to the lungs, heart, and spinal cord.

show abstract

Helical Tomotherapy for Radiotherapy in Esophageal Cancer: A Preferred Plan With Better Conformal Target Coverage and More Homogeneous Dose Distribution

Cited by 62 publications

References 26 publications

Volumetric modulated arc therapy planning for distal oesophageal malignancies

Volumetric modulated arc therapy planning for distal oesophageal malignancies

Radiation modality use and cardiopulmonary mortality risk in elderly patients with esophageal cancer

Dosimetric comparison between helical tomotherapy and intensity‐modulated radiotherapy for esophageal carcinoma

Contact Info

Product

Resources

About