Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-10T19:48:11.405Z Has data issue: false hasContentIssue false
  • English
  • Français

Comparative dosimetric analysis of whole abdominal radiotherapy with VMAT versus 3D conformal in patients with Wilms tumour

Published online by Cambridge University Press:  15 February 2019

Alejandro Olmos Open the ORCID record for Alejandro Olmos [Opens in a new window] ,
Alejandro Rodriguez ,
Estefania Beltran ,
Onix Garay ,
Armando Felix ,
Mario Alberto Ponce ,
Maurico Salcedo ,
Teresa Apresa ,
Lorena Lio  and
Martha Guzman
...Show all authors
Alejandro Olmos*
Affiliation:
Oncology Hospital, Radiotherapy Department, National Medical Center XXI Century, Mexican Social Security Institute, México City, Mexico
Alejandro Rodriguez
Affiliation:
Oncology Hospital, Radiotherapy Department, National Medical Center XXI Century, Mexican Social Security Institute, México City, Mexico
Estefania Beltran
Affiliation:
Oncology Hospital, Radiotherapy Department, National Medical Center XXI Century, Mexican Social Security Institute, México City, Mexico
Onix Garay
Affiliation:
Oncology Hospital, Radiotherapy Department, National Medical Center XXI Century, Mexican Social Security Institute, México City, Mexico
Armando Felix
Affiliation:
Oncology Hospital, Radiotherapy Department, National Medical Center XXI Century, Mexican Social Security Institute, México City, Mexico
Mario Alberto Ponce
Affiliation:
Oncology Hospital, Radiotherapy Department, National Medical Center XXI Century, Mexican Social Security Institute, México City, Mexico
Maurico Salcedo
Affiliation:
Oncology Hospital, Radiotherapy Department, National Medical Center XXI Century, Mexican Social Security Institute, México City, Mexico
Teresa Apresa
Affiliation:
Oncology Hospital, Radiotherapy Department, National Medical Center XXI Century, Mexican Social Security Institute, México City, Mexico
Lorena Lio
Affiliation:
Oncology Hospital, Radiotherapy Department, National Medical Center XXI Century, Mexican Social Security Institute, México City, Mexico
Martha Guzman
Affiliation:
Oncology Hospital, Radiotherapy Department, National Medical Center XXI Century, Mexican Social Security Institute, México City, Mexico
Fatima Chilaca
Affiliation:
Oncology Hospital, Radiotherapy Department, National Medical Center XXI Century, Mexican Social Security Institute, México City, Mexico
*
Author for correspondence: Alejandro Olmos, Oncology Hospital, Radiotherapy Department, National Medical Center XXI Century, Mexican Social Security Institute, México City, Mexico, Cuauthemoc 330, Col Doctores, Ciudad de Mexico, Ciudad de Mexico, 06720. (E-mail: alex_olmos13@hotmail.com)
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction

In this study, we undertake a dosimetric comparison of whole abdominal treatment plans of patients diagnosed with stage 3 Wilms tumour, to assess the benefits of treating these patients with volumetric arch therapy (VMAT) versus 3D conformal radiotherapy.

Material and methods

A retrospective study was undertaken on 23 patients receiving either VMAT or 3D conformal radiotherapy during 2013–2017. A dosimetric comparison was undertaken for both techniques, measuring planning target volume (PTV), conformity index (CI), homogeneity index (HI) and organs at risk (OAR).

Results

The dosimetric parameters for the PTV dose in the VMAT and 3D conformal technique showed no statistical difference (1,289·17 cGy versus 1,357·13 cGy, respectively, p=0·404). However, the VMAT technique had a better CI (1·04 VMAT versus 1·26 3D, p=0·004), and there was little difference in the HI (1·13 VMAT versus 1·15 3D, p=0·1606). In the statistical analysis, the decrease in dose to OAR for the VMAT technique is statistically significant for doses to lung and kidney (p=0·011 and p=0·002, respectively). Between the two techniques, there was no statistical significance in dose difference to the other OAR.

Conclusion

This work proposes using the VMAT technique in whole abdominal irradiation to improve conformity, without affecting the quality of the PTV coverage, when compared with the 3D conformal technique. In addition, VMAT reduces the doses to OAR such as the remaining kidney and lungs that are important to preserve to reduce the probability of radiation toxicity in these patients.

Keywords

3D conformal radiotherapyVMATWilms tumourwhole abdomen radiotherapy
Type
Technical Note
Information
Journal of Radiotherapy in Practice , Volume 18 , Issue 3 , September 2019 , pp. 301 - 303
Copyright
© Cambridge University Press 2019 

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.)

Footnotes

Cite this article: Olmos A, Rodriguez A, Beltran E, Garay O, Felix A, Ponce MA, Salcedo M, Apresa T, Lio L, Guzman M, Chilaca F. (2019) Comparative dosimetric analysis of whole abdominal radiotherapy with VMAT versus 3D conformal in patients with Wilms tumour. Journal of Radiotherapy in Practice18: 301–303. doi: 10.1017/S1460396918000778

References

1. Ehrlich, P F, Ritchey, M L, Hamilton, T E et al. Quality assessment for Wilms’ tumor: a report from the National Wilms’ Tumor Study-5. J Pediatr Surg 2005; 40 (1): 208–213.Google Scholar
2. Dalul, J, Nicolás, M, Nicolás, Q, Alberto, D, Diego, G, Rodolfo, R. Tumor de Wilms en el adulto. Revista Argentina de Urología 2011; 76 (3): 137–140.Google Scholar
3. Zapata, M, González, O, Pérez, F et al. “Tumor de Wilms” Capítulo 18 En Rivera, R. Protocolos técnicos, Cáncer de Niños. Consejo Nacional para la Prevención y el Tratamiento del Cáncer en la Infancia y la Adolescencia. 1ª Edición, Editores de Textos Mexicanos SA de CV, Ciudad de México, México, 2010.Google Scholar
4. Ferris, J, Berbel, O, Ortega, J A, López, J A, García, J, Balaguer, J. Factores de Riesgo para los tumores renales malignos pediátricos. Revista Española Pediátrica 2003; 59 (6): 527–536.Google Scholar
5. Hernández Fernández, R. El tumor de Wilms. Un paradigma de heterogeneidad genética, Revista Habanera de Ciencias Médicas, ciudad de la Habana Cuba 2011; 10 (2): 213–223.Google Scholar
6. Davidoff A M. Wilms tumor review. Adv Pediatr 2012; 59 (1): 247–267.10.1016/j.yapd.2012.04.001Google Scholar
7. Beckwith, J B, Palmer, N F. Histopathology and prognosis of Wilms tumors: results from the First National Wilms’ Tumor Study. Cancer 1978; 41: 1937–1948.10.1002/1097-0142(197805)41:5<1937::AID-CNCR2820410538>3.0.CO;2-U3.0.CO;2-U>Google Scholar
8. Grundy, P E, Breslow, N E, Li, S et al. Loss of heterozygosity for chromosomes 1p and 16q is an adverse prognostic factor in favorable-histology Wilms tumor: a report from the National Wilms Tumor Study Group. J Clin Oncol 2005; 23: 7312–7321.10.1200/JCO.2005.01.2799Google Scholar
9. Green, D M, Beckwith, J B, Weeks, D A, Moksness, J, Breslow, N E, D’Angio, G J. The relationship between microsubstaging variables, age at diagnosis, and tumor weight of children with stage I/favorable histology Wilms’ tumor. A report from the National Wilms’ Tumor study. Cancer 1994; 74 (6): 1817e20.10.1002/1097-0142(19940915)74:6<1817::AID-CNCR2820740626>3.0.CO;2-X3.0.CO;2-X>Google Scholar
10. Weirich, A, Ludwig, R, Graf, N et al. Survival in nephroblastoma treated according to the trial and study SIOP-9/ GPOH with respect to relapse and morbidity. Ann Oncol 2004; 15 (5): 808e20.Google Scholar
11. D’Angio, G J. The treatment of Wilms’ tumor. Results of the national Wilms’ tumor study. Cancer 1976; 38 (2): 633–646.10.1002/1097-0142(197608)38:2<633::AID-CNCR2820380203>3.0.CO;2-S3.0.CO;2-S>Google Scholar
12. Green, D M. The treatment of stages I–IV favorable histology Wilms’ tumor. J Clin Oncol 2004; 22: 1366–1372.10.1200/JCO.2004.08.008Google Scholar
13. De Kraker, J, Graf, N, van Tinteren, H, Pein, F, Sandstedt, B, Godzinski, J, Tournade, MF. Reduction of postoperative chemotherapy in children with stage I intermediaterisk and anaplastic Wilms’ tumour (SIOP 93-01 trial): a randomized controlled trial. Lancet 2004; 364 (9441): 1229–1235.10.1016/S0140-6736(04)17139-0Google Scholar
14. Halperin, E, Constine, L, Tarbell, N et al (eds.) Pediatric Radiation Oncology, 5th edition. Philadelphia, PA: Lippincott Williams & Wilkins, 2011: 257–289.Google Scholar
15. Van’t Riet, A, Mak, A C, Moerland, MA et al. A conformation number to quantify the degree of conformity in brachytherapy and external beam irradiation: application to the prostate. Int J Radiat Oncol Biol Phys 1997; 37: 731–736.10.1016/S0360-3016(96)00601-3Google Scholar
16. Feuvret, L, Noël, G, Mazeron, J-J, Bey, P. Conformity index: a review. Int J Radiat Oncol Biol Phys 2006; 64 (2): 333–342.10.1016/j.ijrobp.2005.09.028Google Scholar
17. Newhauser, W D, Durante, M. Assessing the risk of the second malignancies after modern radiotherapy. Nat Rev Cancer 2011; 11: 438–448.10.1038/nrc3069Google Scholar
18. Chojnacka, M, Zygmuntowicz-Piętka, A, Semaniak, A, Pędziwiatr, K, Dąbrowski, R, Skowrońska-Gardas, A. Volumetric modulated arc therapy versus 3D conformal radiotherapy for selected childhood neoplasms. J Radiother Practice 2014; 14 (01): 35–42.10.1017/S1460396914000466Google Scholar