Clinical Relevance of Different Dose Calculation Strategies for Mediastinal IMRT in Hodgkin's Disease

Overview

Journal Strahlenther Onkol

Specialties Oncology
Radiology

Date 2012 Jun 29

PMID 22740169

Citations 4

Authors

J Koeck

Y Abo-Madyan

H T Eich

F Stieler

J Fleckenstein

J Kriz

R-P Mueller

F Wenz

F Lohr

Affiliations

Soon will be listed here.

Abstract

Background And Purpose: Conventional algorithms show uncertainties in dose calculation already for three-dimensional conformal radiotherapy (3D-CRT). Intensity-modulated radiotherapy (IMRT) might even increase these. We wanted to assess differences in dose distribution for pencil beam (PB), collapsed cone (CC), and Monte Carlo (MC) algorithm for both 3D-CRT and IMRT in patients with mediastinal Hodgkin lymphoma.

Patients And Methods: Based on 20 computed tomograph (CT) datasets of patients with mediastinal Hodgkin lymphoma, we created treatment plans according to the guidelines of the German Hodgkin Study Group (GHSG) with PB and CC algorithm for 3D-CRT and with PB and MC algorithm for IMRT. Doses were compared for planning target volume (PTV) and organs at risk.

Results: For 3D-CRT, PB overestimated PTV(95) and V(20) of the lung by 6.9% and 3.3% and underestimated V(10) of the lung by 5.8%, compared to the CC algorithm. For IMRT, PB overestimated PTV(95), V(20) of the lung, V(25) of the heart and V(10) of the female left/right breast by 8.1%, 25.8%, 14.0% and 43.6%/189.1%, and underestimated V(10) of the lung, V(4) of the heart and V(4) of the female left/right breast by 6.3%, 6.8% and 23.2%/15.6%, compared to MC.

Conclusion: The PB algorithm underestimates low doses to the organs at risk and overestimates dose to PTV and high doses to the organs at risk. For 3D-CRT, a well-modeled PB algorithm is clinically acceptable; for IMRT planning, however, an advanced algorithm such as CC or MC should be used at least for part of the plan optimization.

Citing Articles

Treatment planning and evaluation of gated radiotherapy in left-sided breast cancer patients using the Catalyst/Sentinel system for deep inspiration breath-hold (DIBH).

Schonecker S, Walter F, Freislederer P, Marisch C, Scheithauer H, Harbeck N Radiat Oncol. 2016; 11(1):143.

PMID: 27784326 PMC: 5080745. DOI: 10.1186/s13014-016-0716-5.

Breath-hold technique in conventional APPA or intensity-modulated radiotherapy for Hodgkin's lymphoma: Comparison of ILROG IS-RT and the GHSG IF-RT.

Kriz J, Spickermann M, Lehrich P, Schmidberger H, Reinartz G, Eich H Strahlenther Onkol. 2015; 191(9):717-25.

PMID: 25876905 DOI: 10.1007/s00066-015-0839-x.

Novel radiotherapy techniques for involved-field and involved-node treatment of mediastinal Hodgkin lymphoma: when should they be considered and which questions remain open?.

Lohr F, Georg D, Cozzi L, Eich H, Weber D, Koeck J Strahlenther Onkol. 2014; 190(10):864-6, 868-71.

PMID: 25209551 DOI: 10.1007/s00066-014-0719-9.

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Linthorst M, van Geel A, Baartman E, Oei S, Ghidey W, van Rhoon G Strahlenther Onkol. 2013; 189(5):387-93.

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