Treatment planning and delivery of intensity-modulated radiation therapy for primary nasopharynx cancer

Hunt, Margie; Zeléfsky, Michael J.; Wolden, Suzanne L.; Chui, Chen‐Shou; LoSasso, Thomas; Rosenzweig, Kenneth E.; Chong, Lanceford M.; Spirou, Spiridon V.; Fromme, Lisa; Lumley, Moira; Amols, H; Ling, C. Clifton; Leibel, Steven A.

doi:10.1016/s0360-3016(00)01389-4

Cited by 278 publications

(133 citation statements)

References 31 publications

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“…Reduction of spinal cord dose from 49Gy (2D) to 44Gy and 34.5Gy from 3D and IMRT respectively. Moreover volume of mandible and temporal lobes getting more than 60Gy also decreased by 10-15% with IMRT (Hunt et al, 2001). This finding were confirmed by Chang et al (2011) who compared two different techniques of IMRT (fixed field and serial tomotherapy) with conventional 3DRT in 12 patients and found that IMRT resulted in better CTV and GTV coverage for the primary tumor and neck nodes (Chung et al, 2011).…”

Section: Discussionmentioning

confidence: 97%

“…The potential of IMRT for better tumor coverage especially for concave tumor volume has been demonstrated in nasopharyngeal cancer patients (Tribius et al, 2011). In a series of 23 patients of nasopharyngeal cancer treated with IMRT, Hunt et al (2001) compared IMRT treatment plan with 2DRT and 3DRT. They found that IMRT resulted in an escalation of the mean target (PTV) dose to 77.3Gy as compared to 67.9Gy from conventional plan and 74.6Gy from 3D plan.…”

Section: Discussionmentioning

confidence: 99%

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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

Abbası

Hafiz²,

Nasir³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

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

Hafiz²,

Nasir³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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“…The third was a 7‐beam‐angle arrangement selected by an experienced dosimetrist and derived from FP‐IMRT. The fourth was a posterior‐weighted 7‐beam‐angle configuration based on a Memorial Sloan–Kettering technique described by Hunt et al (10) The fifth was a simple 5‐beam‐angle arrangement (including 1 anterior field, 2 anterior‐oblique fields, and 2 posterior‐oblique fields) to test whether a reduction in the number of beams was feasible. A template of planning dose constraints was constructed based on our previous planning experience in the Corvus planning system and was adapted for the Pinnacle planning system as shown in Table 4.…”

Section: Methodsmentioning

confidence: 99%

Simplifying intensity‐modulated radiotherapy plans with fewer beam angles for the treatment of oropharyngeal carcinoma

Takamiya

Missett

Weinberg

et al. 2007

J Applied Clin Med Phys

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The first aim of the present study was to investigate the feasibility of using fewer beam angles to improve delivery efficiency for the treatment of oropharyngeal cancer (OPC) with inverse‐planned intensity‐modulated radiation therapy (IP‐IMRT). A secondary aim was to evaluate whether the simplified IP‐IMRT plans could reduce the indirect radiation dose. The treatment plans for 5 consecutive OPC patients previously treated with a forward‐planned IMRT (FP‐IMRT) technique were selected as benchmarks for this study. The initial treatment goal for these patients was to deliver 70 Gy to ≥95% of the planning gross tumor volume (PTV‐70) and 59.4 Gy to ≥95% of the planning clinical tumor volume (PTV‐59.4) simultaneously. Each case was re‐planned using IP‐IMRT with multiple beam‐angle arrangements, including four complex IP‐IMRT plans using 7 or more beam angles, and one simple IMRT plan using 5 beam angles. The complex IP‐IMRT plans and simple IP‐IMRT plans were compared to each other and to the FP‐IMRT plans by analyzing the dose coverage of the target volumes, the plan homogeneity, the dose–volume histograms of critical structures, and the treatment delivery parameters including delivery time and the total number of monitor units (MUs). When comparing the plans, we found no significant difference between the complex IP‐IMRT, simple IP‐IMRT, and FP‐IMRT plans for tumor target coverage (PTV‐70: p=0.56; PTV‐59.4: p=0.20). The plan homogeneity, measured by the mean percentage isodose, did not significantly differ between the IP‐IMRT and FP‐IMRT plans (p=0.08), although we observed a trend toward greater inhomogeneity of dose in the simple IP‐IMRT plans. All IP‐IMRT plans either met or exceeded the quality of the FP‐IMRT plans in terms of dose to adjacent critical structures, including the parotids, spinal cord, and brainstem. As compared with the complex IP‐IMRT plans, the simple IP‐IMRT plans significantly reduced the mean treatment time (maximum probability for four pairwise comparisons: p=0.0003). In conclusion, our study demonstrates that, as compared with complex IP‐IMRT, simple IP‐IMRT can significantly improve treatment delivery efficiency while maintaining similar target coverage and sparing of critical structures. However, the improved efficiency does not significantly reduce the total number of MUs nor the indirect radiation dose.PACS number: 87.53.tf

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“…Clinically, this should be expected to translate to maximal local control and survival with as little toxicity as possible. Comparison of dosimetry for NPC treatment between 3DCRT to IMRT has been done in several studies and these studies have collectively shown advantages of IMRT over 3DRT with regards to tumour coverage and OARs (Cheng et al, 2001;Hunt et al, 2001;Kam et al, 2003;Kristensen et al, 2007). However, these studies were done with different protocols from that of our institution and included different total doses to different target volumes.…”

Section: Introductionmentioning

confidence: 99%

Dose Planning Study of Target Volume Coverage with Intensity-Modulated Radiotherapy for Nasopharyngeal Carcinoma: Penang General Hospital Experience

Phua

Tan²,

Tan³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Treatment planning and delivery of intensity-modulated radiation therapy for primary nasopharynx cancer

Cited by 278 publications

References 31 publications

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

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

Simplifying intensity‐modulated radiotherapy plans with fewer beam angles for the treatment of oropharyngeal carcinoma

Dose Planning Study of Target Volume Coverage with Intensity-Modulated Radiotherapy for Nasopharyngeal Carcinoma: Penang General Hospital Experience

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