Plan Dose Evaluation of Three Dimensional Conformal Radiotherapy Planning (3D-CRT) of Nasopharyngeal Carcinoma (NPC): Experience of a Tertiary Care University Hospital in Pakistan

Abbası, Ahmed Nadeem; Hafiz, Asim; Nasir, Aejaz; Khan, Khurshid Ahmed

doi:10.7314/apjcp.2013.14.10.5989

Cited by 9 publications

(7 citation statements)

References 19 publications

(24 reference statements)

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“…In our practice, the distribution of nodal involvement varies from Level 1 to Level 5 in such an unpredictable manner that we intend to include all nodal regions in our Phase 2 volumes. 2 This fact is being observed in various other studies. 3 We would like to request the authors to share with the readers of British Journal of Radiology their study data pertaining to patterns of nodal failures with further stratification mentioning any possibility of a confounding variable playing any role in this pattern.…”

Section: (The Editors Do Not Hold Themselves Responsible For Opinionssupporting

confidence: 61%

Nasopharyngeal carcinoma (NPC)—issues in the inclusion of cervical nodal region in radiation treatment volume

Qureshi¹,

Abbası²,

Nasir³

et al. 2017

BJR

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Section: (The Editors Do Not Hold Themselves Responsible For Opinionssupporting

confidence: 61%

Nasopharyngeal carcinoma (NPC)—issues in the inclusion of cervical nodal region in radiation treatment volume

Qureshi¹,

Abbası²,

Nasir³

et al. 2017

BJR

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“…Abbasi et al [ 11 ] identified the main factors affecting the tumor V95 % including advanced T classification, intracranial tumor invasion and a tumor volume greater than 200 cm 3 . The data in Fig.…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of the distance between the primary tumor and brainstem in the patients with locally advanced nasopharyngeal carcinoma

Wang

Shen

et al. 2016

BMC Cancer

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BackgroundBrainstem dose limitations influence radiation dose reaching to tumor in the patients with locally-advanced nasopharyngeal cancer (NPC).MethodsA retrospective analysis of the prognostic value of the distance between the primary tumor and brainstem (Dbs) in 358 patients with locally-advanced NPC after intensity-modulated radiation therapy (IMRT). Receiver operating characteristic (ROC) curves were used to identify the cut-off value to analyze the impact of Dbs on tumor dose coverage and prognosis.ResultsThe three-year overall survival (OS), local relapse-free survival (LRFS), distant metastasis-free survival (DMFS), and disease-free survival (DFS) were 88.8 vs. 78.4 % (P = 0.007), 96.5 vs. 91.1 % (P = 0.018), 87.8 vs. 79.3 % (P = 0.067), and 84.1 vs. 69.6 % (P = 0.002) for the patients with the Dbs > 4.7 vs. ≤ 4.7 mm, respectively. ROC curves revealed Dbs (4.7 mm) combined with American Joint Committee on Cancer (AJCC) T classification had a significantly better prognostic value for OS (P < 0.05).ConclusionsDbs (≤4.7 mm) is an independent negative prognostic factor for OS/LRFS/DFS and enhances the prognostic value of T classification in the patients with locally-advanced NPC.

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“…The following parameters were used to evaluate the protection of OARs: Dmax (maximum point dose), D0.1cc (maximum dose encompassing 0.1cc of the structure), and D1cc (maximum dose encompassing 1cc of the structure) for the spinal cord and brain stem [ 7 , 14 , 26 , 27 ]; Dmax and D2 for the optic chiasm and optic nerve [ 11 , 13 ]; Dmax and V60Gy (the relative volume of the structure receiving over 60Gy) for the temporal lobe [ 6 , 28 ]; Dmax, D2, and Dmean for the lens [ 11 , 25 ]; and Dmean, Dmedian, and V30Gy (the relative volume of the structure receiving over 30Gy) for the parotid [ 13 ]; Dmax for the pituitary [ 6 ]; V15/20/30/40Gy for the whole body (the relative volume of the whole body in scanning scope receiving over V15/20/30/40Gy) [ 14 ].…”

Section: Methodsmentioning

confidence: 99%

“…However, very few publications have focused on such comparisons in NPC. Importantly, because the primary tumor of NPC is surrounded by critical structures such as the brain stem and optic structures, T-stage is a very important factor in the planning of radiotherapy [ 25 ]. For this reason, in this study, we compared the dosimetric differences between VMAT and HT in early T-stage NPC patients.…”

Section: Introductionmentioning

confidence: 99%

Dosimetric Comparisons of Volumetric Modulated Arc Therapy and Tomotherapy for Early T-Stage Nasopharyngeal Carcinoma

Zhou

Shen

et al. 2018

BioMed Research International

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Purpose To compare the dosimetric differences between volumetric modulated arc therapy (VMAT) and helical tomotherapy (HT) in treating early T-stage nasopharyngeal carcinoma (NPC). Method Ten patients with early T-stage NPC who received tomotherapy using simultaneously integrated boost (SIB) strategies were replanned with VMAT (RapidArc of Varian, dual-arc). Dosimetric comparisons between the RapidArc plan and the HT plan included the following: (1) D98, homogeneity, and conformity of PTVs; (2) sparing of organs at risk (OARs); (3) delivery time and monitor units (MUs). Results (1) Compared with RapidArc, HT achieved better dose conformity (CI of PGTVnx + nd: 0.861 versus 0.818, P = 0.004). (2) In terms of OAR protection, RapidArc exhibited significant superiority in sparing ipsilateral optic nerve (Dmax: 27.5Gy versus 49.1Gy, P < 0.001; D2: 23.5Gy versus 48.2Gy, P < 0.001), contralateral optic nerve (Dmax: 30.4Gy versus 49.2Gy, P < 0.001; D2: 26.2Gy versus 48.1Gy, P < 0.001), and optic chiasm (Dmax: 32.8Gy versus 48.3Gy, P < 0.001; D2: 30Gy versus 47.6Gy, P < 0.001). HT demonstrated a superior ability to protect the brain stem (D1cc: 43.0Gy versus 45.2Gy, P = 0.012), ipsilateral temporal lobe (Dmax 64.5Gy versus 66.4 Gy, P = 0.015), contralateral temporal lobe (Dmax: 62.8Gy versus 65.1Gy, P = 0.001), ipsilateral lens (Dmax: 4.27Gy versus 5.24Gy, P = 0.009; D2: 4.00Gy versus 5.05Gy, P = 0.002; Dmean: 2.99Gy versus 4.31Gy, P < 0.001), contralateral lens (Dmax: 4.25Gy versus 5.09Gy, P = 0.047; D2: 3.91Gy versus 4.92Gy, P = 0.005; Dmean: 2.91Gy versus 4.18Gy, P < 0.001), ipsilateral parotid (Dmean: 36.4Gy versus 41.1Gy, P = 0.002; V30Gy: 54.8% versus 70.4%, P = 0.009), and contralateral parotid (Dmean: 33.4Gy versus 39.1Gy, P < 0.001; V30Gy: 48.2% versus 67.3%, P = 0.005). There were no statistically significant differences in spinal cord or pituitary protection between the RapidArc plan and the HT plan. (3) RapidArc achieved a much shorter delivery time (3.8 min versus 7.5 min, P < 0.001) and a lower MU (618MUs versus 5646MUs, P < 0.001). Conclusion Our results show that RapidArc and HT are comparable in D98, dose homogeneity, and protection of the spinal cord and pituitary gland. RapidArc performs better in shortening delivery time, lowering MUs, and sparing the optic nerve and optic chiasm. HT is superior in dose conformity and protection of the brain stem, temporal lobe, lens, and parotid.

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Plan Dose Evaluation of Three Dimensional Conformal Radiotherapy Planning (3D-CRT) of Nasopharyngeal Carcinoma (NPC): Experience of a Tertiary Care University Hospital in Pakistan

Cited by 9 publications

References 19 publications

Nasopharyngeal carcinoma (NPC)—issues in the inclusion of cervical nodal region in radiation treatment volume

Nasopharyngeal carcinoma (NPC)—issues in the inclusion of cervical nodal region in radiation treatment volume

Prognostic value of the distance between the primary tumor and brainstem in the patients with locally advanced nasopharyngeal carcinoma

Dosimetric Comparisons of Volumetric Modulated Arc Therapy and Tomotherapy for Early T-Stage Nasopharyngeal Carcinoma

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