Dose Variations in Tumor Volumes and Organs at Risk During IMRT for Head-and-neck Cancer

Overview

Journal J Appl Clin Med Phys

Specialties Biophysics
General Medicine

Date 2012 Nov 15

PMID 23149770

Citations 17

Authors

Merce Beltran

Monica Ramos

Juan Jose Rovira

Santiago Perez-Hoyos

Marc Sancho

Enrique Puertas

Sergi Benavente

Merce Ginjaume

Jordi Giralt

Affiliations

Soon will be listed here.

Abstract

Many head-and-neck cancer (HNC) patients treated with radiotherapy suffer significant anatomical changes due to tumor shrinkage or weight loss. The purpose of this study was to assess dose changes over target volumes and organs at risk during intensity-modulated radiotherapy for HNC patients. Sixteen HNC IMRT patients, all requiring bilateral neck irradiation, were enrolled in the study. A CTplan was performed and the initial dose distribution was calculated. During the treatment, two subsequent CTs at the 15th (CT15) and 25th (CT25) fractions were acquired. The initial plan was calculated on the CT15 and CT25, and dose-volume differences related to the CTplan were assessed. For target volumes, mean values of near-maximun absorbed dose (D2%) increased at the 25th fraction, and doses covering 95% and 98% of volume decreased significantly at the 15th fraction. Contralateral and ipsilateral parotid gland mean doses increased by 6.1% (range: -5.4, 23.5%) and 4.7% (range: -9.1, 22.3%), respectively, at CT25. The D2% in the spinal cord increased by 1.8 Gy at CT15. Mean absorbed dose increases at CT15 and CT25 were observed in: the lips, 3.8% and 5.3%; the oral cavity, 3.5% and 2.5%; and lower middle neck structure, 1.9% and 1.6%. Anatomical changes during treatment of HNC patients affect dose distribution and induce a loss of dose coverage to target volumes and an overdosage to critical structures. Appropriate organs at risk have to be contoured and monitored in order to know if the initial plan remains suitable during the course of the treatment. Reported dosimetric data can help to identify patients who could benefit from adaptive radiotherapy.

Citing Articles

Optimal Timing of Organs-at-Risk-Sparing Adaptive Radiation Therapy for Head- and-Neck Cancer under Re-planning Resource Constraints.

Nosrat F, Dede C, McCullum L, Garcia R, Mohamed A, Scott J medRxiv. 2024; .

PMID: 39417124 PMC: 11482873. DOI: 10.1101/2024.04.01.24305163.

Adaptive radiotherapy for head and neck cancer: Pitfalls and possibilities from the radiation oncologist's point of view.

Nuyts S, Bollen H, Eisbruch A, Strojan P, Mendenhall W, Ng S Cancer Med. 2024; 13(8):e7192.

PMID: 38650546 PMC: 11036082. DOI: 10.1002/cam4.7192.

Prospects for online adaptive radiation therapy (ART) for head and neck cancer.

Guberina M, Guberina N, Hoffmann C, Gogishvili A, Freisleben F, Herz A Radiat Oncol. 2024; 19(1):4.

PMID: 38191400 PMC: 10775598. DOI: 10.1186/s13014-023-02390-6.

Adaptive Volumetric-Modulated Arc Radiation Therapy for Head and Neck Cancer: Evaluation of Benefit on Target Coverage and Sparing of Organs at Risk.

Franzese C, Tomatis S, Bianchi S, Pelizzoli M, Teriaca M, Badalamenti M Curr Oncol. 2023; 30(3):3344-3354.

PMID: 36975467 PMC: 10047863. DOI: 10.3390/curroncol30030254.

Advances in Image-Guided Radiotherapy in the Treatment of Oral Cavity Cancer.

Nien H, Wang L, Liao L, Lin P, Wu C, Shueng P Cancers (Basel). 2022; 14(19).

PMID: 36230553 PMC: 9561985. DOI: 10.3390/cancers14194630.

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