Can Dose Reduction to One Parotid Gland Prevent Xerostomia? — A Feasibility Study for Locally Advanced Head and Neck Cancer Patients Treated with Intensity-modulated Radiotherapy

Anand, Aman; Jain, Jayanshu; Negi, P S; Chaudhoory, Amal Roy; Sinha, Subhajit; Choudhury, Partha S; Kumar, Rejnish; Munjal, Ram Kishan

doi:10.1016/j.clon.2006.04.014

Cited by 34 publications

(28 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…reported on a 3D-CRT technique to spare the contralateral parotid gland, while deliberately accepting underdosage in the surrounding target volume with supposedly “lower” risk to contain disease [18]. With the introduction of IMRT, this technique was refined and the contralateral gland could be spared without hazarding underdosage in the target volume; however, often at the price of still sacrificing the ipsilateral gland [19]. It seems that the paradigm “ sacrificing one parotid gland to achieve better sparing of the contralateral gland ” often applied with advanced HNC can be revisited with the advent of VMAT.…”

Section: Discussionmentioning

confidence: 99%

Multi-institutional comparison of volumetric modulated arc therapy vs. intensity-modulated radiation therapy for head-and-neck cancer: a planning study

Holt

Gestel²,

Arends

et al. 2013

Radiat Oncol

View full text Add to dashboard Cite

BackgroundCompared to static beam Intensity-Modulated Radiation Therapy (IMRT), the main advantage of Volumetric Modulated Arc Therapy (VMAT) is a shortened delivery time, which leads to improved patient comfort and possibly smaller intra-fraction movements. This study aims at a treatment planner-independent comparison of radiotherapy treatment planning of IMRT and VMAT for head-and-neck cancer performed by several institutes and based on the same CT- and contouring data.MethodsFive institutes generated IMRT and VMAT plans for five oropharyngeal cancer patients using either Pinnacle3 or Oncentra Masterplan to be delivered on Elekta linear accelerators.ResultsComparison of VMAT and IMRT plans within the same patient and institute showed significantly better sparing for almost all OARs with VMAT. The average mean dose to the parotid glands and oral cavity was reduced from 27.2 Gy and 39.4 Gy for IMRT to 25.0 Gy and 36.7 Gy for VMAT, respectively. The dose conformity at 95% of the prescribed dose for PTVboost and PTVtotal was 1.45 and 1.62 for IMRT and 1.37 and 1.50 for VMAT, respectively. The average effective delivery time was reduced from 13:15 min for IMRT to 5:54 min for VMAT.ConclusionsIndependently of institution-specific optimization strategies, the quality of the VMAT plans including double arcs was superior to step-and-shoot IMRT plans including 5–9 beam ports, while the effective treatment delivery time was shortened by ~50% with VMAT.

show abstract

Section: Discussionmentioning

confidence: 99%

Multi-institutional comparison of volumetric modulated arc therapy vs. intensity-modulated radiation therapy for head-and-neck cancer: a planning study

Holt

Gestel²,

Arends

et al. 2013

Radiat Oncol

View full text Add to dashboard Cite

show abstract

“…This helps the oncologist to escalate the dose to the tumor volume, which results in a higher cure rate of cancers. Many authors have reported the advantages of IMRT over three-dimensional radiotherapy [1,2]. IMRT plans can be delivered by use of a static multi-leaf collimator (MLC) and a dynamic MLC technique [3].…”

Section: Introductionmentioning

confidence: 99%

Analyzing the performance of the planning system by use of AAPM TG 119 test cases

Nithya¹,

Raj

Rathinamuthu³

et al. 2015

Radiol Phys Technol

View full text Add to dashboard Cite

Our objective in this study was to create AAPM TG 119 test plans for intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) in the Monaco planning system. The results were compared with the published studies, and the performance of the Monaco planning system was analyzed. AAPM TG 119 proposed a set of test cases called multi-target, mock prostate, mock head and neck and C-shape to ascertain the overall accuracy of IMRT planning, measurement, and analysis. We used these test cases to investigate the performance of the Monaco planning system for the complex plans. For these test cases, we created IMRT plans with static multi-leaf collimator (MLC) and dynamic MLC by using 7-9 static beams as explained in TG-119. VMAT plans were also created with a 320° arc length and a single or double arc. The planning objectives and dose were set as described in TG 119. The dose prescriptions for multi-target, mock prostate, mock head and neck, and C-shape were taken as 50, 75.6, 50 and 50 Gy, respectively. All plans were compared with the results of TG 119 and the study done by Mynampati et al. Point dose and fluence measurements were done with a CC13 chamber and ArcCHECK phantom, respectively. Gamma analysis was done for the calculated and measured dose. Using the Monaco planning system, we achieved the goals mentioned in AAPM TG-119, and the plans were comparable to those of other studies. A comparison of point dose and fluence showed good results. From these results, we conclude that the performance of the Monaco planning system is good for complex plans.

show abstract

“…IMRT gives less radiation-related toxicity than 3D-CRT for head and neck cancers. [2] Using IMRT we are able to achieve good uniformity of dose to concave-shaped head and neck tumor and dose conformal to target volumes. Treatment planning of head neck cases are challenging due to the large number of OARs and the proximity of OARs with tumors.…”

Section: Introductionmentioning

confidence: 99%

Comparative analysis of volumetric-modulated arc therapy and intensity-modulated radiotherapy for base of tongue cancer

Nithya¹,

Raj

Kumar³

et al. 2014

J Med Phys

View full text Add to dashboard Cite

The aim of this study was to compare the various dosimetric parameters of dynamic multileaf collimator (MLC) intensity modulated radiation therapy (IMRT) plans with volumetric modulated arc therapy (VMAT) plans for base of tongue cases. All plans were done in Monaco planning system for Elekta synergy linear accelerator with 80 MLC. IMRT plans were planned with nine stationary beams, and VMAT plans were done for 360° arc with single arc or dual arc. The dose to the planning target volumes (PTV) for 70, 63, and 56 Gy was compared. The dose to 95, 98, and 50% volume of PTV were analyzed. The homogeneity index (HI) and the conformity index (CI) of the PTV70 were also analyzed. IMRT and VMAT plan showed similar dose coverage, HI, and CI. Maximum dose and dose to 1-cc volume of spinal cord, planning risk volume (PRV) cord, and brain stem were compared. IMRT plan and VMAT plan showed similar results except for the 1 cc of PRV cord that received slightly higher dose in VMAT plan. Mean dose and dose to 50% volume of right and left parotid glands were analyzed. VMAT plan gave better sparing of parotid glands than IMRT. In normal tissue dose analyses VMAT was better than IMRT. The number of monitor units (MU) required for delivering the good quality of the plan and the time required to deliver the plan for IMRT and VMAT were compared. The number of MUs for VMAT was higher than that of IMRT plans. However, the delivery time was reduced by a factor of two for VMAT compared with IMRT. VMAT plans yielded good quality of the plan compared with IMRT, resulting in reduced treatment time and improved efficiency for base of tongue cases.

show abstract

Can Dose Reduction to One Parotid Gland Prevent Xerostomia? — A Feasibility Study for Locally Advanced Head and Neck Cancer Patients Treated with Intensity-modulated Radiotherapy

Cited by 34 publications

References 24 publications

Multi-institutional comparison of volumetric modulated arc therapy vs. intensity-modulated radiation therapy for head-and-neck cancer: a planning study

Multi-institutional comparison of volumetric modulated arc therapy vs. intensity-modulated radiation therapy for head-and-neck cancer: a planning study

Analyzing the performance of the planning system by use of AAPM TG 119 test cases

Comparative analysis of volumetric-modulated arc therapy and intensity-modulated radiotherapy for base of tongue cancer

Contact Info

Product

Resources

About