Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-10T12:04:46.740Z Has data issue: false hasContentIssue false
  • English
  • Français

Comparing treatment plans for stomach cancer: three-dimensional conformal radiotherapy (3D-CRT), physical wedge-based conformal RT (WB-CRT) and intensity-modulated radiotherapy (IMRT)

Published online by Cambridge University Press:  18 January 2021

Gokcen Inan Open the ORCID record for Gokcen Inan [Opens in a new window]  and
Osman Vefa Gul Open the ORCID record for Osman Vefa Gul [Opens in a new window]
Gokcen Inan*
Affiliation:
Faculty of Medicine, Department of Radiation Oncology, Selcuk University, Konya, Turkey
Osman Vefa Gul
Affiliation:
Faculty of Medicine, Department of Radiation Oncology, Selcuk University, Konya, Turkey
*
Author for correspondence: Gokcen Inan, Faculty of Medicine, Department of Radiation Oncology, Selcuk University, Konya, Turkey. E-mail: gokceninan85@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

The aim of this study was to find the optimal radiotherapy (RT) method using three-dimensional (3D) conformal RT (CRT), physical wedge-based CRT (WB-CRT) and dynamic intensity-modulated RT (D-IMRT) techniques for stomach cancer.

Methods:

Ten patients with gastric cancer were selected for this study. For each patient, three different treatment plans were generated. 3D-CRT, WB-CRT and IMRT plans were evaluated in terms of dosimetry. Treatment plans were compared with respect to the planning target volume and organs at risk (OARs) volumes including right and left kidney doses (V13, V20 and V28), heart mean and maximum doses, spinal cord maximum doses, dose homogeneity index, conformity index (CI), delivery time and the monitor unit counts for the treatment. Statistical analysis was performed using the SPSS (Statistical Package for the Social Sciences) v25.1 software (IBM Inc., Chicago, IL, USA).

Results:

In stomach plans, IMRT showed a significantly lower dose for the left and right kidneys than that of WB-CRT or 3D-CRT (p < 0·05). Compared with WB-CRT or 3D-CRT, IMRT reduced the V28, V20, V13 and mean dose to bilateral kidneys (p < 0·05). IMRT plans indicated better dosimetry for at the Dmean of the liver and heart. Concerning the calculated CI, values for IMRT plans gave significant results than other plans (p < 0·05).

Conclusions:

IMRT plans provided better protection for the kidneys, liver, heart and spinal cord. For the treatment of stomach cancer, considering the dose to the OARs, IMRT appears to be the most superior technique.

Keywords

conformal radiotherapyintensity-modulated radiotherapyphysical wedge-based conformal radiotherapy
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 21 , Issue 3 , September 2022 , pp. 303 - 308
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

Global Burden of Disease Cancer Collaboration; Fitzmaurice, C, Allen, C, Barber, RM, et al. Global, regional, and national cancer incidence, mortality years of life lost, years lived with disability, and disability-adjusted life-years for 32 cancer groups, 1990 to 2015: a systematic analysis for the global burden of disease study. J Am Med Assoc Oncol 2017; 3 (4): 524–548.Google ScholarPubMed
Kamran, SC, Hong, TS, Wo, JY. Advances in the management of gastric and gastroesophageal cancers. Curr Oncol Rep 2016; 18: 13.CrossRefGoogle ScholarPubMed
Boda-Heggemann, J, Hofheinz, RD, Weiss, C, et al. Combined adjuvant radiochemotherapy with IMRT/XELOX improves outcome with low renal toxicity in gastric cancer. Int J Radiat Oncol Biol Phys 2009, 75 (4): 1187–1195.CrossRefGoogle ScholarPubMed
Oblak, I, Vidmar, MS, Anderluh, F, Velenik, V, Jeromen, A. Capecitabine in postoperative radiochemotherapy for gastric adenocarcinoma. Ann Oncol 2013; 24: iv42.CrossRefGoogle Scholar
Perez, C, Brady, WL, Halperin, CE, Wazwe, DE. Principles and Practice of Radiation Oncology, 7th edition. 2019: 4445–4446.Google Scholar
Bortfeld, TR, Kahler, DL, Waldron, TJ, et al. X-ray field compensation with multileaf collimators. Int J Radiat Oncol Biol Phys 1994; 28 (3): 723–730.CrossRefGoogle ScholarPubMed
Xia, P, Verhey, LJ. Multileaf collimator leaf sequencing algorithm for intensity modulated beams with multiple static segments. Med Phys 1998; 25 (8): 1424–1434.CrossRefGoogle ScholarPubMed
Chung, HT, Lee, B, Park, E, Lu, JJ, Xia, P. Can all centers plan intensity-modulated radiotherapy (IMRT) effectively? An external audit of Dosimetric comparisons between three-dimensional conformal radiotherapy and IMRT for adjuvant Chemoradiation for gastric Cancer. Int J Radiat Oncol 2008; 71: 1167–1174.CrossRefGoogle ScholarPubMed
Wang, X, Li, G, Zhang, Y, Bai, S, Xu, F,Wei, Y, Gong, Y. Single arc volumetric-modulated arc therapy (sVMAT) as adjuvant treatment for gastric cancer: Dosimetric comparisons with three-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT). Med Dosim 2013; 38: 395–400.CrossRefGoogle Scholar
Milano, MT, Garofalo, MC, Chmura, SJ, et al. Intensity-modulated radiation therapy in the treatment of gastric cancer: early clinical outcome and dosimetric comparison with conventional techniques. Br J Radiol 2006; 79 (942): 497–503.CrossRefGoogle ScholarPubMed
Alani, S, Soyfer, V, Strauss, N, Schifter, D, Corn, BW. Limited advantages of intensity-modulated radiotherapy over 3D conformal radiation therapy in the adjuvant management of gastric cancer. Int J Radiat Oncol Biol Phys 2009; 74 (2): 562–566.CrossRefGoogle ScholarPubMed
Dahele, M, Skinner, M, Schultz, B, Cardoso, M, Bell, C, Ung, YC. Adjuvant radiotherapy for gastric Cancer: a Dosimetric comparison of 3-dimensional conformal radiotherapy, Tomotherapy® and conventional intensity modulated radiotherapy treatment plans. Med Dosim 2010; 35: 115–121.CrossRefGoogle Scholar
ICRU Report 83. Prescribing, recording, and reporting photon beam intensity modulated radiation therapy(IMRT). J ICRU 2010; 10 (1): 106.Google Scholar
Yoon, M, Park, SY, Shin, D et al. A new homogeneity index based on statistical analysis of the dose-volume histogram. J Appl Clin Med Phys 2007; 8: 9–17.CrossRefGoogle Scholar
Serarslan, A, Okumus, NO, Gursel, B, Meydan, D, Dastan, Y, Aksu, T. Dosimetric comparison of three different radiotherapy techniques in Antrum-located stomach cancer. Asian Pacific Journal of Cancer Prevention 2017; 18 (3): 741.Google Scholar
Zhang, T, Liang, ZW, Han, J, et al. Double-Arc volumetric modulated therapy improves dose distribution compared to static gantry IMRT and 3D conformal radiotherapy for adjuvant therapy of gastric cancer. Radiat Oncol 2015; 10: 114.CrossRefGoogle ScholarPubMed
Minn, AY, Hsu, A, La, T, et al. Comparison of intensity-modulated radiotherapy and 3-dimensional conformal radiotherapy as adjuvant therapy for gastric cancer. Cancer 2010; 116: 3943–3952.CrossRefGoogle ScholarPubMed
Kim, T, Kim, D, Park, J, et al. Dose-volumetric parameters predicting radiation induced hepatic toxicity in unresectable hepatocellular carcinoma patients treated with three-dimensional conformal radiotherapy. Int J Radiat Oncol Biol Phys 2007; 67: 225–231.CrossRefGoogle ScholarPubMed
Xu, J, Zhu, H, Zhao, Y, et al. Factors associated with hepatic dysfunction in hepatitis B-positive patients with postgastrectomy adenocarcinoma. Oncol Lett 2012; 4: 471–476.CrossRefGoogle ScholarPubMed