Helical tomotherapy provides efficacy similar to that of intensity-modulated radiation therapy with dosimetric benefits for endometrial carcinoma

Abstract

BackgroundThe purpose of this study was to compare the efficacy of intensity-modulated radiotherapy (IMRT) and helical tomotherapy for endometrial cancer.MethodsBetween November 1, 2006 and November 31, 2010, 31 patients with histologically confirmed endometrial cancer were enrolled. All enrolled patients received total abdominal hysterectomy and bilateral salpingo-oophorectomy with adjuvant whole pelvic IMRT or helical tomotherapy.ResultsThe actuarial 3-year overall survival, disease-free survival, locoregional control, and distant metastasis-free rates for the IMRT and helical tomotherapy groups were 87.5% versus 100%, 91.7% versus 51.7%, 91.7% versus 83.3%, and 91.7% versus 51.7%, respectively. The conformal index and uniformity index for IMRT versus helical tomotherapy was 1.25 versus 1.17 (P = 0.04) and 1.08 versus 1.05 (P < 0.01), respectively. Two of 31 patients with cervical stump failure were noted, one in the IMRT group and the other in the helical tomotherapy group. No acute or late grade 3 or 4 toxicities were noted, including proctitis, or genitourinary or gastrointestinal disturbances.ConclusionHelical tomotherapy is as effective as IMRT and has better uniformity and conformal indices, and critical organ-sparing properties. Prospective clinical trials are needed to evaluate the comparative efficacy of IMRT versus helical tomotherapy.

Safety of adjuvant intensity-modulated postoperative radiation therapy in endometrial cancer: Clinical data and dosimetric parameters according to the International Commission on Radiation Units (ICRU) 83 report

“…These findings are similar to the preliminary results that are available in the literature. 17,[29][30][31]33,34 The in-field vaginalnodal recurrence rate (11.8%) observed here did not differ from those of historical series [3][4][5][6] or those of recent IMRT publications; 17,31,[33][34][35] ; only Shih et al 29 showed a lower rate on in-field vaginal recurrence. Eleven patients (14.4%) developed only metastatic disease at the 29-month follow-up.…”

“…Bouchard et al 33 reported a 27-month DFS of 100% among 15 patients. Chen-Hsi Hsieh et al 34 observed 3-year DFS and OS rates of 94% and 88%, respectively, and a 6.5% rate of local failure in 31 patients. Shih et al 29 reported a 5-year relapse rate of 9%.…”

Effectiveness of tomotherapy v s linear accelerator image-guided intensity-modulated radiotherapy for localized pharyngeal cancer treated with definitive concurrent chemoradiotherapy: a Taiwanese population-based propensity score-matched analysis

“…8 Similar scenarios (dosimetric merit did not lead to improved "hard" disease outcome via T-IMRT) have been observed in studies evaluating other disease sites. 34,35 However, because of a lack of data availability, we did not investigate the potential benefits of reduced side effects or improved quality of life. These endpoints may be even more important than OS when comparing T-IMRT and L-IMRT.…”

Impact of postoperative daily image-guided intensity-modulated radiotherapy on overall and local progression-free survival in patients with oral cavity cancer

“…2 and 3 , Table 3 ). One possible reason for the striking improvement in overall survival and local disease control outcomes might be attributed to the better target volume dose conformity, homogeneity of daily image-guided HT compared to non-image-guided IMRT [ 12 – 14 , 22 ]. More importantly, IGRT allows for daily adjustment in setup error.…”