Unilateral and Bilateral Neck SIB for Head and Neck Cancer Patients : Intensity-modulated Proton Therapy, Tomotherapy, and RapidArc

Overview

Journal Strahlenther Onkol

Specialties Oncology
Radiology

Date 2016 Feb 8

PMID 26852243

Citations 10

Authors

Carmen Stromberger

Luca Cozzi

Volker Budach

Antonella Fogliata

Pirus Ghadjar

Waldemar Wlodarczyk

Basil Jamil

Jan D Raguse

Arne Bottcher

Simone Marnitz

Affiliations

Soon will be listed here.

Abstract

Aim: To compare simultaneous integrated boost plans for intensity-modulated proton therapy (IMPT), helical tomotherapy (HT), and RapidArc therapy (RA) for patients with head and neck cancer.

Patients And Methods: A total of 20 patients with squamous cell carcinoma of the head and neck received definitive chemoradiation with bilateral (n = 14) or unilateral (n = 6) neck irradiation and were planned using IMPT, HT, and RA with 54.4, 60.8, and 70.4 GyE/Gy in 32 fractions. Dose distributions, coverage, conformity, homogeneity to planning target volumes (PTV)s and sparing of organs at risk and normal tissue were compared.

Results: All unilateral and bilateral plans showed excellent PTV coverage and acceptable dose conformity. For unilateral treatment, IMPT delivered substantially lower mean doses to contralateral salivary glands (< 0.001-1.1 Gy) than both rotational techniques did (parotid gland: 6-10 Gy; submandibular gland: 15-20 Gy). Regarding the sparing of classical organs at risk for bilateral treatment, IMPT and HT were similarly excellent and RA was satisfactory.

Conclusion: For unilateral neck irradiation, IMPT may minimize the dry mouth risk in this subgroup but showed no advantage over HT for bilateral neck treatment regarding classical organ-at-risk sparing. All methods satisfied modern standards regarding toxicity and excellent target coverage for unilateral and bilateral treatment of head and neck cancer at the planning level.

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References

Kraan A, van de Water S, Teguh D, Al-Mamgani A, Madden T, Kooy H . Dose uncertainties in IMPT for oropharyngeal cancer in the presence of anatomical, range, and setup errors. Int J Radiat Oncol Biol Phys. 2013; 87(5):888-96. DOI: 10.1016/j.ijrobp.2013.09.014. View

Gregoire V, Levendag P, Ang K, Bernier J, Braaksma M, Budach V . CT-based delineation of lymph node levels and related CTVs in the node-negative neck: DAHANCA, EORTC, GORTEC, NCIC,RTOG consensus guidelines. Radiother Oncol. 2003; 69(3):227-36. DOI: 10.1016/j.radonc.2003.09.011. View

Otto K . Volumetric modulated arc therapy: IMRT in a single gantry arc. Med Phys. 2008; 35(1):310-7. DOI: 10.1118/1.2818738. View

Maes A, Weltens C, Flamen P, Lambin P, Bogaerts R, Liu X . Preservation of parotid function with uncomplicated conformal radiotherapy. Radiother Oncol. 2002; 63(2):203-11. View

Smet S, Lambrecht M, Vanstraelen B, Nuyts S . Clinical and dosimetric evaluation of RapidArc versus standard sliding window IMRT in the treatment of head and neck cancer. Strahlenther Onkol. 2014; 191(1):43-50. DOI: 10.1007/s00066-014-0742-x. View

Chen A, Daly M, Cui J, Wooten H, Farwell D, Purdy J . Helical tomotherapy with simultaneous integrated boost dose painting for the treatment of synchronous primary cancers involving the head and neck. Br J Radiol. 2014; 87(1040):20130697. PMC: 4112398. DOI: 10.1259/bjr.20130697. View

Cozzia L, Bolsi A, Nicolini G, Fogliata A . The simultaneous integrated boost with proton beams in head and neck patients. Z Med Phys. 2004; 14(3):180-8. DOI: 10.1078/0939-3889-00218. View

Stromberger C, Ghadjar P, Marnitz S, Thieme A, Jahn U, Raguse J . Comparative treatment planning study on sequential vs. simultaneous integrated boost in head and neck cancer patients: Differences in dose distributions and potential implications for clinical practice. Strahlenther Onkol. 2015; 192(1):17-24. DOI: 10.1007/s00066-015-0913-4. View

Eisbruch A, Kim H, Terrell J, Marsh L, Dawson L, Ship J . Xerostomia and its predictors following parotid-sparing irradiation of head-and-neck cancer. Int J Radiat Oncol Biol Phys. 2001; 50(3):695-704. DOI: 10.1016/s0360-3016(01)01512-7. View

10.

Gora J, Kuess P, Stock M, Andrzejewski P, Knausl B, Paskeviciute B . ART for head and neck patients: On the difference between VMAT and IMPT. Acta Oncol. 2015; 54(8):1166-74. DOI: 10.3109/0284186X.2015.1028590. View

11.

Mohan R, Wu Q, Manning M, Schmidt-Ullrich R . Radiobiological considerations in the design of fractionation strategies for intensity-modulated radiation therapy of head and neck cancers. Int J Radiat Oncol Biol Phys. 2000; 46(3):619-30. DOI: 10.1016/s0360-3016(99)00438-1. View

12.

Scorsetti M, Fogliata A, Castiglioni S, Bressi C, Bignardi M, Navarria P . Early clinical experience with volumetric modulated arc therapy in head and neck cancer patients. Radiat Oncol. 2010; 5:93. PMC: 2974741. DOI: 10.1186/1748-717X-5-93. View

13.

Eisbruch A, Ten Haken R, Kim H, Marsh L, Ship J . Dose, volume, and function relationships in parotid salivary glands following conformal and intensity-modulated irradiation of head and neck cancer. Int J Radiat Oncol Biol Phys. 1999; 45(3):577-87. DOI: 10.1016/s0360-3016(99)00247-3. View

14.

Jakobi A, Bandurska-Luque A, Stutzer K, Haase R, Lock S, Wack L . Identification of Patient Benefit From Proton Therapy for Advanced Head and Neck Cancer Patients Based on Individual and Subgroup Normal Tissue Complication Probability Analysis. Int J Radiat Oncol Biol Phys. 2015; 92(5):1165-1174. DOI: 10.1016/j.ijrobp.2015.04.031. View

15.

Rancati T, Schwarz M, Allen A, Feng F, Popovtzer A, Mittal B . Radiation dose-volume effects in the larynx and pharynx. Int J Radiat Oncol Biol Phys. 2010; 76(3 Suppl):S64-9. PMC: 2833104. DOI: 10.1016/j.ijrobp.2009.03.079. View

16.

Greco C, Wolden S . Current status of radiotherapy with proton and light ion beams. Cancer. 2007; 109(7):1227-38. DOI: 10.1002/cncr.22542. View

17.

Thomson D, Ho K, Ashcroft L, Denton K, Betts G, Mais K . Dose intensified hypofractionated intensity-modulated radiotherapy with synchronous cetuximab for intermediate stage head and neck squamous cell carcinoma. Acta Oncol. 2014; 54(1):88-98. DOI: 10.3109/0284186X.2014.958528. View

18.

Alongi F, Bignardi M, Garassino I, Pentimalli S, Cavina R, Mancosu P . Prospective phase II trial of cetuximab plus VMAT-SIB in locally advanced head and neck squamous cell carcinoma. Feasibility and tolerability in elderly and chemotherapy-ineligible patients. Strahlenther Onkol. 2011; 188(1):49-55. DOI: 10.1007/s00066-011-0006-y. View

19.

van de Water T, Lomax A, Bijl H, de Jong M, Schilstra C, Hug E . Potential benefits of scanned intensity-modulated proton therapy versus advanced photon therapy with regard to sparing of the salivary glands in oropharyngeal cancer. Int J Radiat Oncol Biol Phys. 2010; 79(4):1216-24. DOI: 10.1016/j.ijrobp.2010.05.012. View

20.

Levendag P, Teguh D, Voet P, van der Est H, Noever I, de Kruijf W . Dysphagia disorders in patients with cancer of the oropharynx are significantly affected by the radiation therapy dose to the superior and middle constrictor muscle: a dose-effect relationship. Radiother Oncol. 2007; 85(1):64-73. DOI: 10.1016/j.radonc.2007.07.009. View