Three-dimensional conformal radiotherapy for locally advanced (Stage II and worse) head-and-neck cancer: Dosimetric and clinical evaluation

Portaluri, Maurizio; Fucilli, Fulvio Italo Maria; Castagna, Roberta; Bambace, Santa; Pili, Giorgio; Tramacere, Francesco; Russo, Donatella; Francavilla, Maria Carmen

doi:10.1016/j.ijrobp.2006.03.014

Cited by 16 publications

(19 citation statements)

References 21 publications

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“…Eight studies reported data on salivary gland hypofunction (seven salivary flow rates and one scintigraphy), and 11 studies assessed xerostomia. The studies demonstrated consensus that reduced radiotherapy dosages by 3D conformal radiotherapy to contralateral parotid glands resulted in less loss of salivary gland function postradiotherapy up to 2 years after completion of radiotherapy [95][96][97][98][99][100][101][102] and 3D conformal radiotherapy to have a Table 3 potential to decrease the prevalence and severity of xerostomia [95,99,100,[103][104][105][106][107]. As was shown for conventional radiotherapy, xerostomia was also shown to be significantly worse following bilateral 3D conformal radiotherapy compared to unilateral treatment [108].…”

Section: D Conformal Radiotherapymentioning

confidence: 82%

A systematic review of salivary gland hypofunction and xerostomia induced by cancer therapies: prevalence, severity and impact on quality of life

Jensen

Pedersen

Vissink

et al. 2010

Support Care Cancer

365

297

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Salivary gland hypofunction and xerostomia are induced by radiotherapy in the head and neck region depending on the cumulative radiation dose to the gland tissue. Treatment focus should be on optimized/new approaches to further reduce the dose to the parotids, and particularly submandibular and minor salivary glands, as these glands are major contributors to moistening of oral tissues. Other cancer treatments also induce salivary gland hypofunction, although to a lesser severity, and in the case of chemotherapy and immunotherapy, the adverse effect is temporary. Fields of sparse literature included pediatric cancer populations, cancer chemotherapy, radioactive iodine treatment, total body irradiation/hematopoietic stem cell transplantation, and immunotherapy.

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Section: D Conformal Radiotherapymentioning

confidence: 82%

A systematic review of salivary gland hypofunction and xerostomia induced by cancer therapies: prevalence, severity and impact on quality of life

Jensen

Pedersen

Vissink

et al. 2010

Support Care Cancer

365

297

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“…Xerostomia risk is reduced with sparing of at least one parotid gland or even one submandibular gland (12). In one study, patients receiving <30 Gy to the contralateral parotid reported no or mild subjective xerostomia (13). …”

Section: Review Of Dose–volume Datamentioning

confidence: 99%

Radiotherapy Dose–Volume Effects on Salivary Gland Function

Deasy

Moiseenko

Marks

et al. 2010

International Journal of Radiation Oncology*Biology*Physics

476

406

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Publications relating parotid dose-volume characteristics to radiotherapy-induced salivary toxicity were reviewed. Late salivary dysfunction has been correlated to the mean parotid gland dose, with recovery occurring with time. Severe xerostomia (defined as long-term salivary function of <25% of baseline) is usually avoided if at least one parotid gland is spared to a mean dose of less than ≈20 Gy or if both glands are spared to less than ≈25 Gy (mean dose). For complex, partial-volume RT patterns (e.g., intensity-modulated radiotherapy), each parotid mean dose should be kept as low as possible, consistent with the desired clinical target volume coverage. A lower parotid mean dose usually results in better function. Submandibular gland sparing also significantly decreases the risk of xerostomia. The currently available predictive models are imprecise, and additional study is required to identify more accurate models of xerostomia risk.

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“…Four different treatment plans were obtained for each individual patient using the following planning techniques: The Bellinzona technique,[1] FPMS,[2] the 3-D ConPas,[3] and the FIF technique,[4] which are described as follows. All the four techniques use one isocenter point.…”

Section: Methodsmentioning

confidence: 99%

“…This technique, described in detail by Portaluri et al .,[4] uses mainly 11 fields, from 6 gantry angles, (0°, 280°, 80°, 180°, 135°, and 220°) with a mean of two fields per angle. [4] The unique isocenter point is placed behind the first cervical vertebral body.…”

Section: Methodsmentioning

confidence: 99%

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Comparative study of four advanced 3d-conformal radiation therapy treatment planning techniques for head and neck cancer

Herrassi

Bentayeb

Malisan

2013

Journal of Medical Physics

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For the head-and-neck cancer bilateral irradiation, intensity-modulated radiation therapy (IMRT) is the most reported technique as it enables both target dose coverage and organ-at-risk (OAR) sparing. However, during the last 20 years, three-dimensional conformal radiotherapy (3DCRT) techniques have been introduced, which are tailored to improve the classic shrinking field technique, as regards both planning target volume (PTV) dose conformality and sparing of OAR’s, such as parotid glands and spinal cord. In this study, we tested experimentally in a sample of 13 patients, four of these advanced 3DCRT techniques, all using photon beams only and a unique isocentre, namely Bellinzona, Forward-Planned Multisegments (FPMS), ConPas, and field-in-field (FIF) techniques. Statistical analysis of the main dosimetric parameters of PTV and OAR’s DVH’s as well as of homogeneity and conformity indexes was carried out in order to compare the performance of each technique. The results show that the PTV dose coverage is adequate for all the techniques, with the FPMS techniques providing the highest value for D95%; on the other hand, the best sparing of parotid glands is achieved using the FIF and ConPas techniques, with a mean dose of 26 Gy to parotid glands for a PTV prescription dose of 54 Gy. After taking into account both PTV coverage and parotid sparing, the best global performance was achieved by the FIF technique with results comparable to that of IMRT plans. This technique can be proposed as a valid alternative when IMRT equipment is not available or patient is not suitable for IMRT treatment.

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Three-dimensional conformal radiotherapy for locally advanced (Stage II and worse) head-and-neck cancer: Dosimetric and clinical evaluation

Cited by 16 publications

References 21 publications

A systematic review of salivary gland hypofunction and xerostomia induced by cancer therapies: prevalence, severity and impact on quality of life

A systematic review of salivary gland hypofunction and xerostomia induced by cancer therapies: prevalence, severity and impact on quality of life

Radiotherapy Dose–Volume Effects on Salivary Gland Function

Comparative study of four advanced 3d-conformal radiation therapy treatment planning techniques for head and neck cancer

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