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Radiobiological assessment of nasopharyngeal cancer IMRT using various collimator angles and non-coplanar fields

Published online by Cambridge University Press:  12 February 2020

G. Sharbo ,
B. Hashemi Open the ORCID record for B. Hashemi [Opens in a new window] ,
M. Bakhshandeh Open the ORCID record for M. Bakhshandeh [Opens in a new window]  and
A. Rakhsha Open the ORCID record for A. Rakhsha [Opens in a new window]
G. Sharbo
Affiliation:
Department of Medical Physics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
B. Hashemi*
Affiliation:
Department of Medical Physics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
M. Bakhshandeh
Affiliation:
Department of Radiology Technology, Faculty of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
A. Rakhsha
Affiliation:
Department of Radiation Oncology, Faculty of Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
*
Author for correspondence: Bijan Hashemi, Department of Medical Physics, Faculty of Medical Sciences, Tarbiat Modares University, Al-Ahmad and Chamran Cross, Tehran1411713116, Iran. Tel: +98-21-82883892. Fax: +98-21-88006544. E-mail: bhashemi@modares.ac.ir
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Abstract

Aim:

The aim of this study was to evaluate clinical efficacy and radiobiological outcome of intensity-modulated radiation therapy (IMRT) modalities using various collimator angles and non-coplanar fields for nasopharyngeal cancer (NPC).

Materials and methods:

A 70-Gy planning target volume dose was administered for 30 NPC patients referred for IMRT. Standard IMRT plans were constructed based on the target and organs at risk (OARs) volume; and dose constraints recommended by Radiation Therapy Oncology Group (RTOG). Using various collimator angles and non-coplanar fields, 11 different additional IMRT protocols were investigated. Homogeneity indexes (HIs) and conformation numbers (CNs) were calculated. Poisson and relative seriality models were utilised for estimating tumour control probability (TCP) and normal tissue complication probabilities (NTCPs), respectively.

Results:

Various collimator angles and non-coplanar fields had no significant effect on HI, CN and TCP, while significant effects were noted for some OARs, with a maximum mean dose (Dmax). No significant differences were observed among the calculated NTCPs of all the IMRT protocols. However, the protocol with 10° collimator angle (for five fields out of seven) and 8° couch angle had the lowest NTCP. Furthermore, the standard and some of non-coplanar IMRT protocols led to the reduction in OARs Dmax.

Conclusions:

Using appropriate standard/non-coplanar IMRT protocols for NPC treatment could potentially reduce the dose to the OARs and the probability of inducing secondary cancer in patients.

Keywords

angle of collimatorIMRTnasopharyngeal carcinomanon-coplanar fieldtreatment planning
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 20 , Issue 2 , June 2021 , pp. 168 - 175
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Copyright
© The Authors, 2020. Published by Cambridge University Press

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