Clinical and dosimetric impact of adaptive intensity-modulated radiotherapy in locally advanced head-and-neck cancer

Maheshwari, Guncha; Dhanawat, Aditya; Kumar, Harvindra Singh; Sharma, Neeti; Jakhar, Shankar Lal

doi:10.4103/jcrt.jcrt_928_19

Cited by 9 publications

(7 citation statements)

References 22 publications

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“…21 PTV was created by using a 3-5 mm margin around the CTV. The replanning was executed either at specific time points 38,57,68,78 or at the discretion of the radiation oncologist (RO). 20,21,63,77 A large prospective, non-randomized trial on adaptive replanning was performed on patients with T A B L E 3 Clinical benefits of ART in HNC patients treated with IMRT: results of replanning studies.…”

Section: Replanning: Clinical Outcomesmentioning

confidence: 99%

“…Lower parotid doses are known to result in reduced severe xerostomia and better salivary flow although the relationship between RT dose and patient‐reported xerostomia is complex 69–74 . Regarding the spinal cord, eight trials reported a dosimetric advantage, resulting in a decrease of the Dmax by 0.1–6 Gy over multiple fractions 25–27,57,60,63,66,68 . The clinical relevance of these dosimetric differences remains uncertain.…”

Section: Evidence For Adaptive Replanning: Benefits Of Dosimetrymentioning

confidence: 99%

“… 69 , 70 , 71 , 72 , 73 , 74 Regarding the spinal cord, eight trials reported a dosimetric advantage, resulting in a decrease of the Dmax by 0.1–6 Gy over multiple fractions. 25 , 26 , 27 , 57 , 60 , 63 , 66 , 68 The clinical relevance of these dosimetric differences remains uncertain. No data exist on the benefit of ART on other important OAR, e.g.…”

Section: Evidence For Adaptive Replanning: Benefits Of Dosimetrymentioning

confidence: 99%

“…Acute and late toxicity scores are reported, as well as loco‐regional control (LRC) and overall survival (OS) rates. Four studies had a prospective study design, 57 , 68 , 77 , 78 of which one was randomized. 68 The remaining trials were retrospective, 20 , 21 , 38 , 63 of which two studies used case‐matched cohorts.…”

Section: Evidence For Adaptive Replanning: Clinical Outcomesmentioning

confidence: 99%

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Adaptive radiotherapy for head and neck cancer: Pitfalls and possibilities from the radiation oncologist's point of view

Nuyts,

Bollen,

Eisbruch

et al. 2024

Cancer Medicine

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BackgroundPatients with head and neck cancer (HNC) may experience substantial anatomical changes during the course of radiotherapy treatment. The implementation of adaptive radiotherapy (ART) proves effective in managing the consequent impact on the planned dose distribution.MethodsThis narrative literature review comprehensively discusses the diverse strategies of ART in HNC and the documented dosimetric and clinical advantages associated with these approaches, while also addressing the current challenges for integration of ART into clinical practice.Results and ConclusionAlthough based on mainly non‐randomized and retrospective trials, there is accumulating evidence that ART has the potential to reduce toxicity and improve quality of life and tumor control in HNC patients treated with RT. However, several questions remain regarding accurate patient selection, the ideal frequency and timing of replanning, and the appropriate way for image registration and dose calculation. Well‐designed randomized prospective trials, with a predetermined protocol for both image registration and dose summation, are urgently needed to further investigate the dosimetric and clinical benefits of ART.

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Section: Replanning: Clinical Outcomesmentioning

confidence: 99%

Section: Evidence For Adaptive Replanning: Benefits Of Dosimetrymentioning

confidence: 99%

Section: Evidence For Adaptive Replanning: Benefits Of Dosimetrymentioning

confidence: 99%

Section: Evidence For Adaptive Replanning: Clinical Outcomesmentioning

confidence: 99%

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Adaptive radiotherapy for head and neck cancer: Pitfalls and possibilities from the radiation oncologist's point of view

Nuyts,

Bollen,

Eisbruch

et al. 2024

Cancer Medicine

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“…Nasopharyngeal carcinoma (NPC) is one of the most common malignancies in Southeast Asia and China 1 . In modern intensity-modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT), adequately delivering dose to the target volumes while sparing the critical organs at risk (OAR) is key to the success of radiation therapy for NPC 2 , 3 . Adaptive radiation therapy (ART) may be crucial for radiotherapy of NPC 4 .…”

Section: Introductionmentioning

confidence: 99%

CBCT-based synthetic CT generated using CycleGAN with HU correction for adaptive radiotherapy of nasopharyngeal carcinoma

Chen

Kerun

Chen

et al. 2023

Sci Rep

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This study aims to utilize a hybrid approach of phantom correction and deep learning for synthesized CT (sCT) images generation based on cone-beam CT (CBCT) images for nasopharyngeal carcinoma (NPC). 52 CBCT/CT paired images of NPC patients were used for model training (41), validation (11). Hounsfield Units (HU) of the CBCT images was calibrated by a commercially available CIRS phantom. Then the original CBCT and the corrected CBCT (CBCT_cor) were trained separately with the same cycle generative adversarial network (CycleGAN) to generate SCT1 and SCT2. The mean error and mean absolute error (MAE) were used to quantify the image quality. For validations, the contours and treatment plans in CT images were transferred to original CBCT, CBCT_cor, SCT1 and SCT2 for dosimetric comparison. Dose distribution, dosimetric parameters and 3D gamma passing rate were analyzed. Compared with rigidly registered CT (RCT), the MAE of CBCT, CBCT_cor, SCT1 and SCT2 were 346.11 ± 13.58 HU, 145.95 ± 17.64 HU, 105.62 ± 16.08 HU and 83.51 ± 7.71 HU, respectively. Moreover, the average dosimetric parameter differences for the CBCT_cor, SCT1 and SCT2 were 2.7% ± 1.4%, 1.2% ± 1.0% and 0.6% ± 0.6%, respectively. Using the dose distribution of RCT images as reference, the 3D gamma passing rate of the hybrid method was significantly better than the other methods. The effectiveness of CBCT-based sCT generated using CycleGAN with HU correction for adaptive radiotherapy of nasopharyngeal carcinoma was confirmed. The image quality and dose accuracy of SCT2 were outperform the simple CycleGAN method. This finding has great significance for the clinical application of adaptive radiotherapy for NPC.

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Quality Assurance in Radiotherapy (RT)-Specific Trials: Indian Scenario

Mahata,

Chakraborty,

Mandal

et al. 2024

Clinical Oncology

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Clinical and dosimetric impact of adaptive intensity-modulated radiotherapy in locally advanced head-and-neck cancer

Cited by 9 publications

References 22 publications

Adaptive radiotherapy for head and neck cancer: Pitfalls and possibilities from the radiation oncologist's point of view

Adaptive radiotherapy for head and neck cancer: Pitfalls and possibilities from the radiation oncologist's point of view

CBCT-based synthetic CT generated using CycleGAN with HU correction for adaptive radiotherapy of nasopharyngeal carcinoma

Quality Assurance in Radiotherapy (RT)-Specific Trials: Indian Scenario

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