Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-26T06:42:34.510Z Has data issue: false hasContentIssue false
  • English
  • Français

To segment or not to segment the PTV in SIB-VMAT of head-and-neck cancer: a dosimetric comparison with relevance to clinical practice

Published online by Cambridge University Press:  09 March 2021

Manu Mathew ,
Henry F. Godson ,
Abel J. Thomas ,
Sasidharan Balu Krishna Open the ORCID record for Sasidharan Balu Krishna [Opens in a new window] ,
Sathish Kumar A ,
Rajesh Isiah ,
Subhashini John  and
Simon P. Pavamani
Manu Mathew
Affiliation:
Department of Radiation Oncology, Dr Ida B. Scudder Cancer Center, Christian Medical College, Vellore, Tamil Nadu, India
Henry F. Godson
Affiliation:
Department of Radiation Oncology, Dr Ida B. Scudder Cancer Center, Christian Medical College, Vellore, Tamil Nadu, India
Abel J. Thomas
Affiliation:
Department of Radiation Oncology, Dr Ida B. Scudder Cancer Center, Christian Medical College, Vellore, Tamil Nadu, India
Sasidharan Balu Krishna*
Affiliation:
Department of Radiation Oncology, Dr Ida B. Scudder Cancer Center, Christian Medical College, Vellore, Tamil Nadu, India
Sathish Kumar A
Affiliation:
Department of Radiation Oncology, Dr Ida B. Scudder Cancer Center, Christian Medical College, Vellore, Tamil Nadu, India
Rajesh Isiah
Affiliation:
Department of Radiation Oncology, Dr Ida B. Scudder Cancer Center, Christian Medical College, Vellore, Tamil Nadu, India
Subhashini John
Affiliation:
Department of Radiation Oncology, Dr Ida B. Scudder Cancer Center, Christian Medical College, Vellore, Tamil Nadu, India
Simon P. Pavamani
Affiliation:
Department of Radiation Oncology, Dr Ida B. Scudder Cancer Center, Christian Medical College, Vellore, Tamil Nadu, India
*
Author for correspondence: Dr Sasidharan Balu Krishna, Department of Radiation Oncology, Unit 2, Dr Ida B. Scudder Cancer Center, Christian Medical College, Vellore, Tamil Nadu632004, India. Tel: 9626262296. E-mail: balunair@cmcvellore.ac.in
Get access Rights & Permissions [Opens in a new window]

Abstract

Aim:

This study aimed to evaluate and compare simultaneous integrated boost-based volumetric modulated arc therapy (SIB-VMAT) of head-and-neck plans optimised using segmented and non-segmented intermediate-risk target volumes.

Materials and methods:

CT data of 20 patients with locally advanced laryngeal cancer treated with radical chemoradiation were included retrospectively. Both segmented [planning target volume (PTV) IR!] and non-segmented PTV (PTV IR) volumes were created for the intermediate-risk volume. Correspondingly, two VMAT plans were generated for every CT dataset. Dosimetry parameters obtained from cumulative dose volume histogram and the quality indices such as conformity and homogeneity indices were evaluated for both plans and were statistically analysed.

Results:

Maximum dose of PTV IR! was observed to be higher in the non-segmented plans (7281·45 versus 7075·75 cGy) and was statistically significant (p = 0·002). Homogeneity index (HI) of PTV IR! in segmented plans fared better compared to non-segmented plans (0·1 versus 0·12, p = 0·01). All other dosimetry parameters were found to be similar in both plans.

Conclusion:

This study shows that using segmented volumes for planning will lead to more homogenous plans with regard to intermediate- and low-risk volumes, especially under controlled settings.

Keywords

head-and-neck cancerIMRTPTV IRsegmented volumesSIB-VMAT
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 21 , Issue 3 , September 2022 , pp. 377 - 382
Check for updates
Copyright
© The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Nutting, CM, Morden, JP, Harrington, KJ et al. Parotid-sparing intensity modulated versus conventional radiotherapy in head and neck cancer (PARSPORT): a phase 3 multicentre randomised controlled trial. Lancet Oncol 2011; 12: 127–136.CrossRefGoogle ScholarPubMed
Katsochi, D. Radiation therapy with a simultaneous integrated boost. Radiotherapy [Internet]. 2017 May 17 [cited 2020 Nov 19]; Available from: https://www.intechopen.com/books/radiotherapy/radiation-therapy-with-a-simultaneous-integrated-boost CrossRefGoogle Scholar
Mohan, R, Wu, Q, Manning, M, Schmidt-Ullrich, R. Radiobiological considerations in the design of fractionation strategies for intensity-modulated radiation therapy of head and neck cancers. Int J Radiat Oncol Biol Phys 2000; 46: 619–630.CrossRefGoogle ScholarPubMed
Mayo, CS, Moran, JM, Bosch, W et al. American association of physicists in medicine task group 263: standardizing nomenclatures in radiation oncology. Int J Radiat Oncol Biol Phys 2018; 100: 1057–1066.CrossRefGoogle Scholar
Fogliata, A, Bolsi, A, Cozzi, L, Bernier, J. Comparative dosimetric evaluation of the simultaneous integrated boost with photon intensity modulation in head and neck cancer patients. Radiother Oncol J Eur Soc Ther Radiol Oncol 2003; 69: 267–275.CrossRefGoogle ScholarPubMed
Chakraborty, S, Ghoshal, S, Patil, VM, Oinam, AS, Sharma, SC. Preliminary results of SIB-IMRT in head and neck cancers: report from a regional cancer center in northern India. J Cancer Res Ther 2009; 5: 165–172.CrossRefGoogle ScholarPubMed
Brouwer, CL, Steenbakkers, RJHM, Bourhis, J et al. CT-based delineation of organs at risk in the head and neck region: DAHANCA, EORTC, GORTEC, HKNPCSG, NCIC CTG, NCRI, NRG oncology and TROG consensus guidelines. Radiother Oncol J Eur Soc Ther Radiol Oncol 2015; 117: 83–90.CrossRefGoogle ScholarPubMed
Grégoire, V, Evans, M, Le, Q-T et al. Delineation of the primary tumour Clinical Target Volumes (CTV-P) in laryngeal, hypopharyngeal, oropharyngeal and oral cavity squamous cell carcinoma: AIRO, CACA, DAHANCA, EORTC, GEORCC, GORTEC, HKNPCSG, HNCIG, IAG-KHT, LPRHHT, NCIC CTG, NCRI, NRG Oncology, PHNS, SBRT, SOMERA, SRO, SSHNO, TROG consensus guidelines. Radiother Oncol J Eur Soc Ther Radiol Oncol 2018; 126: 3–24.CrossRefGoogle ScholarPubMed
Grégoire, V, Ang, K, Budach, W et al. Delineation of the neck node levels for head and neck tumors: a 2013 update. DAHANCA, EORTC, HKNPCSG, NCIC CTG, NCRI, RTOG, TROG consensus guidelines. Radiother Oncol J Eur Soc Ther Radiol Oncol 2014; 110: 172–181.CrossRefGoogle ScholarPubMed
Sasidharan, BK, Aljabab, S, Saini, J et al. Clinical Monte Carlo versus pencil beam treatment planning in nasopharyngeal patients receiving IMPT. Int J Part Ther 2019; 5: 32–40.CrossRefGoogle ScholarPubMed
Arbea, L, Ramos, LI, Martínez-Monge, R, Moreno, M, Aristu, J. Intensity-modulated radiation therapy (IMRT) versus. 3D conformal radiotherapy (3DCRT) in locally advanced rectal cancer (LARC): dosimetric comparison and clinical implications. Radiat Oncol Lond Engl 2010; 5: 17.CrossRefGoogle Scholar
Feuvret, L, Noël, G, Mazeron, J-J, Bey, P. Conformity index: a review. Int J Radiat Oncol Biol Phys 2006; 64: 333–342.CrossRefGoogle ScholarPubMed
Palazzi, M, Orlandi, E, Pignoli, E et al. Target coverage in head and neck cancer treated with intensity-modulated radiotherapy: a comparison between conventional and conformal techniques. Tumori 2006; 92: 503–510.CrossRefGoogle ScholarPubMed
Krishna, GS, Srinivas, V, Ayyangar, KM, Reddy, PY. Comparative study of old and new versions of treatment planning system using dose volume histogram indices of clinical plans. J Med Phys 2016; 41: 192–197.CrossRefGoogle ScholarPubMed
Kataria, T, Sharma, K, Subramani, V, Karrthick, KP, Bisht, SS. Homogeneity Index: an objective tool for assessment of conformal radiation treatments. J Med Phys Assoc Med Phys India 2012; 37: 207–213.Google ScholarPubMed
Rosenwald, JC, Gaboriaud, G, Pontvert, D. Conformal radiotherapy: principles and classification. Cancer Radiother J Soc Francaise Radiother Oncol 1999; 3: 367–377.Google ScholarPubMed
Studer, G, Huguenin, P, Davis, J, Kunz, G, Lütolf, U, Glanzmann, C. IMRT using simultaneously integrated boost (SIB) in head and neck cancer patients. Radiat Oncol Lond Engl 2006; 1: 7.CrossRefGoogle Scholar
Jiang, L, Zhang, Y, Yang, Z, Liang, F, Wu, J, Wang, R. A comparison of clinical outcomes between simultaneous integrated boost (SIB) versus sequential boost (SEQ) intensity modulated radiation therapy (IMRT) for head and neck cancer: a meta-analysis. Medicine (Baltimore) 2019; 98: e16942.CrossRefGoogle ScholarPubMed
Broglie, MA, Dulguerov, P, Henke, G et al. A review of controversial issues in the management of head and neck cancer: a Swiss multidisciplinary and multi-institutional patterns of care study—part 4 (biomarkers). Front Oncol 2019; 9: 1128.CrossRefGoogle Scholar
Vlacich, G, Stavas, MJ, Pendyala, P, Chen, S-C, Shyr, Y, Cmelak, AJ. A comparative analysis between sequential boost and integrated boost intensity-modulated radiation therapy with concurrent chemotherapy for locally-advanced head and neck cancer. Radiat Oncol 2017; 12: 13.CrossRefGoogle ScholarPubMed