A Dosimetric Planning Study Comparing Intensity-modulated Radiotherapy with Four-field Conformal Pelvic Radiotherapy for the Definitive Treatment of Cervical Carcinoma

Forrest, J.; Presutti, J; Davidson, Melanie; Hamilton, Paul; Kiss, Alex; Thomas, Gillian

doi:10.1016/j.clon.2011.06.008

Cited by 43 publications

(25 citation statements)

References 37 publications

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“…Any dose of radiation can lead to both acute and chronic radiation damage to the BM. 14 Because approximately 50% of active BM is located in the lumbar sacrum, ilium, ischium, pubis, and proximal femur, when radiation damage is applied to hematopoietic stem cells and the BM microenvironment, it results in myelosuppression. Other studies have suggested that CRT-associated HT depends on the radiation dose and the volume of BM that is irradiated.…”

Section: Discussionmentioning

confidence: 99%

Correlations Between Radiation Dose in Bone Marrow and Hematological Toxicity in Patients With Cervical Cancer

Chang¹,

Yang²,

Li³

et al. 2016

International Journal of Gynecological Cancer

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Section: Discussionmentioning

confidence: 99%

Correlations Between Radiation Dose in Bone Marrow and Hematological Toxicity in Patients With Cervical Cancer

Chang¹,

Yang²,

Li³

et al. 2016

International Journal of Gynecological Cancer

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“…remains superior after 30 Gy external beam radiation therapy, despite tumor regression and internal organ motion. Recently in study done by Forrest et al (17) comparing intensity modulated whole pelvis RT (IM-WPRT) with 4 Field conformal pelvic radiotherapy (4F-WPRT) for de7initive management of Ca Cx showed a single, initial IM-WPRT plan with appropriate margins encompassing initial gross and potential microscopic pelvic disease leads a signi7icant reduction in the dose to OAR at the V50, V45, V40 and V30 level with difference of 84% for bladder, 58% for small bowel, 54% for sigmoid and 84% in rectum for V50 in most patients without compromising target coverage with mean target volume covered by 95% dose was 99.7% for 4F-WPRT and 98.8% for IM-WPRT. Mell et al (18) compared IMRT, 3DCRT, and anterior-posterior parallel opposed pair with concurrent chemotherapy for treatment of Ca Cx and found that IMRT reduced doses to the bone marrow and small bowel but the reduction to the rectum and bladder was less impressive.…”

Section: Discussionmentioning

confidence: 99%

Dosimetric comparison between intensity modulated radiotherapy and three dimensional conformal radiotherapy planning in patients with locally advanced cervical carcinoma

Naik

Gurjar

Bagdare

et al. 2016

IJRR

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Background: External beam radiotherapy (EBRT) is mainstay of treatment in pa ents with locally advanced cervical carcinoma (LACC). Three dimensional conformal radiotherapy (3DCRT) and intensity modulated radiotherapy (IMRT) are mainly used in EBRT. However which one is superior is s ll controversial. Materials and Methods: Forty pa ents of LACC treated with IMRT were selected for this study. 3DCRT plans were also created for all the pa ents. 3DCRT and IMRT plans were compared on the basis of planning target volume (PTV) coverage, dose to normal organs, homogeneity index (HI) and conformity index (CI 95% ). Results: In both the techniques 99% of PTV was covered with more than 96% of prescribed dose (PD). D 15, D 35 and D 50 (Dose to 15%, 35% and 50% volume respec vely) for bladder was reduced by 2.09%, 14.623% and 32.57% and for the rectum it was reduced by 7.46% ,23.82% and 43.68% in IMRT compared to 3DCRT. V 45 (volume receiving 45 Gy) in case of bowel were found to be much less in IMRT in comparison to 3DCRT. Insignificant difference found between doses to femoral heads in IMRT and 3DCRT. The CI 95% in IMRT plans was found much be:er than that in 3DCRT whereas HI in both the techniques were found almost same. Conclusion: IMRT significantly reduced the irradiated volume of OAR and improved dose conformity in the PTV compared to that by 3DCRT. So, it can be concluded that IMRT should be chosen as preferred technique for the EBRT of LACC with proper immobilizing devices and imaging.

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“…In the treatment of gynecologic malignancies, multiple studies have shown that intensity-modulated radiotherapy (IMRT) is dosimetrically superior in limiting the radiation delivered to normal tissue [9–11], and is associated with favorable clinical outcomes such as lower rates of gastrointestinal, genitourinary and hematologic toxicity after whole pelvic irradiation [12–14]. Optimizing IMRT plans may make further dose escalation possible without increasing normal tissue toxicities [15, 16].…”

Section: Introductionmentioning

confidence: 99%

RapidArc radiotherapy for whole pelvic lymph node in cervical cancer with 6 and 15 MV: a treatment planning comparison with fixed field IMRT

Zhai

Yin

Gong

et al. 2012

Journal of Radiation Research

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Dosimetric differences were investigated among single and dual arc RapidArc and fixed-field intensity-modulated radiotherapy (f-IMRT) treatment plans for whole pelvic irradiation of lymph nodes. A total of 12 patients who had undergone radical surgery for cervical cancer and who had demonstrated multiple pelvic lymph node metastases were treated with radiotherapy. For all 12 cases, 7-field IMRT, single-arc RapidArc and dual-arc RapidArc were applied with 6 MV and 15 MV X-ray energies. The radiation dosimetric parameters for the different plans were compared with one another. All the plans met the clinical requirements. The homogeneity, conformity and external volume indices of f-IMRT and dual-arc RapidArc were better than for single-arc RapidArc (P < 0.05), while the differences between f-IMRT and dual-arc RapidArc were not significant. There were no significant differences in the radiation dose to organs at risk, except for the small bowel receiving >40 Gy (f-IMRT and dual-arc < single-arc, P < 0.05). The differences in dose distributions between the two applied X-ray energies for each of the modality plans were not significant. RapidArc plans resulted in fewer monitor units than the corresponding f-IMRT plans. Also, there were no differences between the two photon energies, except for a reduction in the number of MUs for 15 MV (P > 0.05). Compared to f-IMRT, no significant dosimetric benefits were found using RapidArc for whole pelvic lymph node irradiation. However, RapidArc has been associated with shorter treatment time and fewer monitor units, supporting the case for its safety and efficacy for pelvic irradiation.

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A Dosimetric Planning Study Comparing Intensity-modulated Radiotherapy with Four-field Conformal Pelvic Radiotherapy for the Definitive Treatment of Cervical Carcinoma

Cited by 43 publications

References 37 publications

Correlations Between Radiation Dose in Bone Marrow and Hematological Toxicity in Patients With Cervical Cancer

Correlations Between Radiation Dose in Bone Marrow and Hematological Toxicity in Patients With Cervical Cancer

Dosimetric comparison between intensity modulated radiotherapy and three dimensional conformal radiotherapy planning in patients with locally advanced cervical carcinoma

RapidArc radiotherapy for whole pelvic lymph node in cervical cancer with 6 and 15 MV: a treatment planning comparison with fixed field IMRT

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