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To create practical lookup tables containing percent depth dose (PDD) and profile parameters of electron beams and to demonstrate clinical application of the lookup tables to skin cancer treatment to ensure target coverage in a clinical setup.
Materials and methods
For 6 and 9 MeV electron energies, PDDs and profiles at clinically relevant depths [i.e., R95 (distal depth of 95% maximum dose), R90, R85 and R80] were measured in water at 100 cm source-to-surface distance for an 10×10 cm2 open field and circular cutouts with diameters of 4, 5, 6, 7 and 8 cm. Then PDD parameters along with profile parameters such as width of isodose lines and penumbra at the clinically relevant depths were determined. Output factors for the cutouts were measured at dmax in water and solid water.
Results
With PDD and profile parameters, dosimetry lookup tables were generated. Based upon the lookup tables, target coverage at prescribed depths was retrospectively reviewed for three skin cancer cases. The lookup tables suggested larger cutouts for adequate target coverage.
Findings
Dosimetry lookup tables for electron beam therapy should include profile parameters at clinically relevant depths and be provided to clinicians to ensure target coverage in a clinical setup.
This is a dosimetric study to compare the feasibility of carotid artery sparing as a primary objective, as well as planning target volume coverage and dose to spinal cord as a secondary objective, by using 3D conformal radiotherapy (3DCRT) and intensity-modulated radiotherapy (IMRT) for patients with early glottis cancer.
Patients and methods
Six patients who had been treated for early stage glottic carcinoma (stage T1-2 N0M0) were included in this study. All patients were immobilised in the supine position with a thermoplastic mask and treatment planning computed tomography scans were obtained from the top of the skull to the top of aortic arch with a 3-mm slice thickness. Two plans were created for every patient, one using 3DCRT and the second using IMRT. Comparison between the two plans was undertaken and analysis was made regarding the dose to the carotids arteries, target coverage and doses to the organs at risk.
Results
For target coverage, the V95% for both plans was the same with no significant difference, hot spots were the highest in 3DCRT with p=0·002, the homogeneity index for IMRT plan was better than 3DCRT (p=0·0001). Regarding the dose to the carotids, it was significantly lower in the IMRT plan compared with the 3DCRT plan (p=0·01). The spinal cord dose was significantly higher in the IMRT plan.
Conclusion
IMRT significantly reduces the radiation dose to the carotid arteries compared with 3DCRT while maintaining clinical target volume coverage. Such a results assists in decreasing the incidence of radiation-induced carotid stenosis, thus improving the quality of life for patients.
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