Dosimetric and radiobiologic comparison of 3<scp>D</scp> conformal, <scp>IMRT</scp>, <scp>VMAT</scp> and proton therapy for the treatment of early‐stage glottic cancer

Matthiesen, Chance; Singh, Hardev; Mascia, Anthony; Confer, Michael; Simpson, Hilarie; Higby, C; Arain, Abeer; Keole, Sameer R.; Herman, Terence; Bogardus, Carl R.; Zhao, Yan; Ahmad, Salahuddin

doi:10.1111/1754-9485.12227

Cited by 28 publications

(40 citation statements)

References 32 publications

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“…Several reports emphasize the dosimetric advantage of IMRT for carotid artery sparing, as carotid irradiation is well known to increase the relative risk of stroke and may limit the use of re‐irradiation if needed 13,15,38 . For example, a Surveillance, Epidemiology, and End Results (SEER)‐Medicare study showed that the 10‐year risk of cerebrovascular events for patients with head and neck cancer was 34% after conventionally delivered definitive RT vs 26% after surgery alone ( P < .01) 39 .…”

Section: Discussionmentioning

confidence: 99%

Outcomes after radiation therapy forT2N0/stageIIglottic squamous cell carcinoma

et al. 2020

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Background We report outcomes for patients with T2N0M0 glottic squamous cell carcinoma (SCC) treated with radiation therapy (RT). Methods Patients who received definitive RT for T2 glottic SCC from 2000 through 2013 were retrospectively reviewed. Results One hundred and thirteen patients were analyzed (median follow‐up time 91 months; 85 patients received three‐dimensional conformal radiotherapy [3D‐CRT] and 28 received intensity‐modulated radiation therapy [IMRT]). Fractionation was conventional (58%) or altered (42%); 20 patients (18%) received concurrent chemotherapy. Five‐year local control was 83% for the 3D‐CRT vs 81% for the IMRT group (P = .76). The ultimate locoregional control at 5 years was 100% for IMRT vs 91% for 3D‐CRT (P = .1). The 5‐year overall survival (OS) was 78% for 3D‐CRT vs 81% for IMRT (P = .83). On multivariate analysis, younger age was the only independent predictor of improved OS (P = .0002). Conclusions Oncologic and survival outcomes were excellent for patients with T2N0 glottic cancer. Patients treated with IMRT and 3D‐CRT had no statistically significant differences in all investigated endpoints.

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Section: Discussionmentioning

confidence: 99%

Outcomes after radiation therapy forT2N0/stageIIglottic squamous cell carcinoma

et al. 2020

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“…The use of magnetic resonance imaging for radiotherapy planning may improve tumor localization and quantification of motion during treatment [26]. For dose to the carotid PRV volumes, proton planning had superiority compared with 3D planning [27].…”

Section: Discussionmentioning

confidence: 99%

Intensity-modulated radiotherapy for stage I glottic cancer: a short-term outcomes compared with three-dimensional conformal radiotherapy

et al. 2019

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To investigate the differences in treatment outcomes between two radiation techniques, intensity-modulated radiotherapy (IMRT) and three-dimensional conformal radiotherapy (3DCRT). Materials and Methods: We retrospectively analyzed 160 (IMRT = 23, 3DCRT = 137) patients with stage I glottic cancer treated from January 2005 through December 2016. The IMRT was performed with TomoTherapy (16 patients), volumetric-modulated arc therapy (6 patients), and step-and-shoot technique (1 patient), respectively. The 3DCRT was performed with bilateral parallel opposing fields. The median follow-up duration was 30 months (range, 31 to 42 months) in the IMRT group and 65 months (range, 20 to 143 months) in the 3DCRT group. Results: The 5-year overall survival and 3-year local control rates of the 160 patients were 95.7% and 91.4%, respectively. There was no significant difference in 3-year local control rates between the IMRT and 3DCRT groups (94.4% vs. 91.0%; p = 0.587). Thirteen of 137 patients in the 3DCRT group had recurrences. In the IMRT group, one patient had a recurrence at the true vocal cord. Patients treated with IMRT had less grade 2 skin reaction than the 3DCRT group, but this had no statistical significance (4.3% vs. 21.2%; p = 0.080). Conclusion: IMRT had comparable outcomes with 3DCRT, and a trend of less acute skin reaction in stage I glottic cancer patients

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“…The clinical stage was determined according to the American Joint Committee on Cancer staging system, 7th edition. Patients were staged using direct laryngoscopy and CT [ 9 16 ].…”

Section: Methodsmentioning

confidence: 99%

“…Recently, carotid sparing conventional fixed-field intensity-modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) have been reported by several investigators, mainly as comparative studies based on small samples [ 2 8 9 10 11 12 13 14 15 ]. Prior treatment planning studies comparing VMAT and conventional IMRT showed that VMAT had equivocal to superior dosimetric outcomes with respect to carotid sparing [ 9 11 12 13 ]. In this study, we performed a dosimetric comparison between conventional fixed-field IMRT and VMAT to assess whether the latter was more beneficial for carotid artery sparing in the treatment of early glottic cancer.…”

Section: Introductionmentioning

confidence: 99%

Volumetric modulated arc therapy for carotid sparing in the management of early glottic cancer

et al. 2016

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PurposeRadiotherapy of the neck is known to cause carotid artery stenosis. We compared the carotid artery dose received between volumetric modulated arc therapy (VMAT) and conventional fixed-field intensity-modulated radiotherapy (IMRT) plans in patients with early glottic cancer.Materials and MethodsTwenty-one early glottic cancer patients who previously underwent definitive radiotherapy were selected for this study. For each patient, double arc VMAT, 8-field IMRT, 3-dimensional conformal radiotherapy (3DCRT), and lateral parallel-opposed photon field radiotherapy (LPRT) plans were created. The 3DCRT plan was generated using lateral parallel-opposed photon fields plus an anterior photon field. VMAT and IMRT treatment plan optimization was performed under standardized conditions to obtain adequate target volume coverage and spare the carotid artery. Dose-volume specifications for the VMAT, IMRT, 3DCRT, and LPRT plans were calculated with radiotherapy planning system. Monitor units (MUs) and delivery time were measured to evaluate treatment efficiency.ResultsTarget volume coverage and homogeneity results were comparable between VMAT and IMRT; however, VMAT was superior to IMRT for carotid artery dose sparing. The mean dose to the carotid arteries in double arc VMAT was reduced by 6.8% compared to fixed-field IMRT (p < 0.001). The MUs for VMAT and IMRT were not significantly different (p = 0.089). VMAT allowed an approximately two-fold reduction in treatment delivery time in comparison to IMRT (3 to 5 minutes vs. 5 to 10 minutes).ConclusionVMAT resulted in a lower carotid artery dose compared to conventional fixed-field IMRT, and maintained good target coverage in patients with early glottic cancer.

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Dosimetric and radiobiologic comparison of 3D conformal, IMRT, VMAT and proton therapy for the treatment of early‐stage glottic cancer

Abstract: All these three modalities showed superiority with less variation among themselves compared with 3D-CRT plans. Clinical investigation is warranted to determine if these treatment approaches will translate into a reduction in radiation therapy-induced toxicities.

Cited by 28 publications

References 32 publications

Outcomes after radiation therapy forT2N0/stageIIglottic squamous cell carcinoma

Outcomes after radiation therapy forT2N0/stageIIglottic squamous cell carcinoma

Intensity-modulated radiotherapy for stage I glottic cancer: a short-term outcomes compared with three-dimensional conformal radiotherapy

Volumetric modulated arc therapy for carotid sparing in the management of early glottic cancer

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