Three-dimensional conformal vs. intensity-modulated radiotherapy in head-and-neck cancer patients: comparative analysis of dosimetric and technical parameters

Cozzi, Luca; Fogliata, Antonella; Bolsi, Alessandra; Nicolini, G.; Bernier, Jacques

doi:10.1016/j.ijrobp.2003.09.059

Cited by 82 publications

(45 citation statements)

References 15 publications

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“…The volume of normal tissues that are irradiated to a high dose is commonly reduced with 3D-CRT and especially with IMRT compared with other conventional techniques. For tumours arising in the head and neck area this has been shown in several comparative treatment planning studies (4,5) and in clinical studies (6). However, the volume that receives low radiation doses is usually larger with IMRT and, thus, the integral dose to the surrounding normal tissues may increase.…”

mentioning

confidence: 94%

Can Photon IMRT be improved by combination with mixed electron and photon techniques?

Mu¹,

Olofsson²,

Karlsson³

et al. 2004

Acta Oncologica

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mentioning

confidence: 94%

Can Photon IMRT be improved by combination with mixed electron and photon techniques?

Mu¹,

Olofsson²,

Karlsson³

et al. 2004

Acta Oncologica

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“…Intensity‐modulated radiotherapy (IMRT) and volumetric‐modulated arc therapy (VMAT) are capable of creating highly conformal treatment plans, with steep dose gradients providing efficient organ at risk (OAR) sparing 1 , 2 . IMRT has been shown to benefit patients in the head and neck, 3 , 4 , 5 with the PARSPORT trial (Institute of Cancer Research, London, UK) demonstrating reduced incidence of xerostomia in patients treated with parotid‐sparing IMRT relative to those treated with conformal radiotherapy (6) .…”

Section: Introductionmentioning

confidence: 99%

The suitability of common metrics for assessing parotid and larynx autosegmentation accuracy

Beasley

McWilliam

Aitkenhead

et al. 2016

J Applied Clin Med Phys

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Contouring structures in the head and neck is time‐consuming, and automatic segmentation is an important part of an adaptive radiotherapy workflow. Geometric accuracy of automatic segmentation algorithms has been widely reported, but there is no consensus as to which metrics provide clinically meaningful results. This study investigated whether geometric accuracy (as quantified by several commonly used metrics) was associated with dosimetric differences for the parotid and larynx, comparing automatically generated contours against manually drawn ground truth contours. This enabled the suitability of different commonly used metrics to be assessed for measuring automatic segmentation accuracy of the parotid and larynx. Parotid and larynx structures for 10 head and neck patients were outlined by five clinicians to create ground truth structures. An automatic segmentation algorithm was used to create automatically generated normal structures, which were then used to create volumetric‐modulated arc therapy plans. The mean doses to the automatically generated structures were compared with those of the corresponding ground truth structures, and the relative difference in mean dose was calculated for each structure. It was found that this difference did not correlate with the geometric accuracy provided by several metrics, notably the Dice similarity coefficient, which is a commonly used measure of spatial overlap. Surface‐based metrics provided stronger correlation and are, therefore, more suitable for assessing automatic segmentation of the parotid and larynx.PACS number(s): 87.57.nm, 87.55.D, 87.55.Qr

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“…In clinical practice, volume constraints are often imposed at specific points, to achieve desired dose distributions (e.g.,

{normalV}_{95}

on tumor) (16) . In order to meet these DVH constraints, the weights on other clinical objectives are adjusted and at times completely relaxed.…”

Section: Resultsmentioning

confidence: 99%

On correlations in IMRT planning aims

Roy

Das

Nohadani

2016

J Applied Clin Med Phys

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The purpose was to study correlations amongst IMRT DVH evaluation points and how their relaxation impacts the overall plan. 100 head‐and‐neck cancer cases, using the Eclipse treatment planning system with the same protocol, are statistically analyzed for PTV, brainstem, and spinal cord. To measure variations amongst the plans, we use (i) interquartile range (IQR) of volume as a function of dose, (ii) interquartile range of dose as a function of volume, and (iii) dose falloff. To determine correlations for institutional and ICRU goals, conditional probabilities and medians are computed. We observe that most plans exceed the median PTV dose (average normalD50 = 104% prescribed dose). Furthermore, satisfying normalD50 reduced the probability of also satisfying normalD98, constituting a negative correlation of these goals. On the other hand, satisfying normalD50 increased the probability of satisfying normalD2, suggesting a positive correlation. A positive correlation is also observed between the PTV normalV105 and normalV110. Similarly, a positive correlation between the brainstem normalV45 and normalV50 is measured by an increase in the conditional median of normalV45, when normalV50 is violated. Despite the imposed institutional and international recommendations, significant variations amongst DVH points can occur. Even though DVH aims are evaluated independently, sizable correlations amongst them are possible, indicating that some goals cannot be satisfied concurrently, calling for unbiased plan criteria.PACS number(s): 87.55.dk, 87.53.Bn, 87.55.Qr, 87.55.de.

show abstract

Three-dimensional conformal vs. intensity-modulated radiotherapy in head-and-neck cancer patients: comparative analysis of dosimetric and technical parameters

Cited by 82 publications

References 15 publications

Can Photon IMRT be improved by combination with mixed electron and photon techniques?

Can Photon IMRT be improved by combination with mixed electron and photon techniques?

The suitability of common metrics for assessing parotid and larynx autosegmentation accuracy

On correlations in IMRT planning aims

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