Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Typ-2-Diabetes und Adipositas Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende

Die Highlights vom Kongress des American College of Cardiology 2024

Im April diskutierten die Herz-Kreislauf-Spezialisten aus der ganzen Welt auf dem  Kongress des American College of Cardiology (ACC) u.a. neue Therapieansätze bei akutem Myokardinfarkt, koronarer Herzerkrankung, kardiogenem Schock oder Aortenklappenstenose. In unserem Kongress-Dossier haben wir für Sie Berichte über die „Late-Breaking Trials“ und andere wichtige Studien zusammengestellt. 
Erweiterte Suche
Anmelden
nach oben
Strahlentherapie und Onkologie
Erschienen in: Strahlentherapie und Onkologie 7/2013

01.07.2013 | Original article

Comparison of two different IMRT planning techniques in the treatment of nasopharyngeal carcinoma

Effect on parotid gland radiation doses

verfasst von: Dr. E.K. Uzel, S. Karaçam, O. Eliçin, Ö. Uzel

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 7/2013

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To compare the effect of two different intensity-modulated radiation therapy (IMRT) planning techniques on parotid gland doses in patients with nasopharyngeal carcinoma (NPC).

Patients and methods

Radiotherapy for 10 NPC patients referred to the University of Istanbul Cerrahpasa Medical School was planned with arc- and static seven-field IMRT. The simultaneous integrated boost (SIB) technique was used to deliver 70 Gy (2.12 Gy per fraction) to the primary tumor and involved nodes; 60 Gy (1.81 Gy per fraction) to the entire nasopharynx and 54 Gy (1.63 Gy per fraction) to elective lymph nodes in 33 fractions. Plans also aimed to keep the mean parotid dose below 26 Gy and limit the maximum doses to the spinal cord and brain stem to 45 and 54 Gy, respectively. Mean parotid gland doses for the two planning techniques were compared using a paired t-test. Target coverage and dose inhomogeneity were evaluated by calculating conformity- (CI) and homogeneity index (HI) values.

Results

Target coverage and dose homogeneity were identical and good for both planning techniques: CI = 1.05 ± 0.08 and 1.05 ± 0.08; HI = 1.08 ± 0.02 and 1.07 ± 0.01 for arc- and static field IMRT, respectively. Mean doses to contralateral parotid glands were 25.73 ± 4.27 and 27.73 ± 3.5 Gy(p = 0.008) for arc- and static field IMRT plans, respectively, whereas mean ipsilateral parotid doses were 30.65 ± 6.25 and 32.55 ± 5.93 Gy (non-significant p-value), respectively. Mean monitor units (MU) per fraction for the 10 patients were considerably lower for arc- than for static field treatments—540.5 ± 130.39 versus 1288.4 ± 197.28 (p < 0.001).

Conclusion

Normal tissues—particularly the parotid glands—are better spared with the arc technique in patients with NPC. MU and treatment times are considerably reduced in arc IMRT plans.
Literatur
1.
Otto K et al (2008) Volumetric modulated arc therapy: IMRT in a single arc. Med Phys 35:310–317PubMedCrossRef
2.
Duthoy W, De Gersem W, Vergote K et al (2003) Whole abdominal radiotherpay (WAPRT) using intensity modulated arc therapy (IMAT): first clinical experience. Int J Radiat Oncol Biol Phys 57:1019–1032PubMedCrossRef
3.
Doornaert P, Verbakel WF, Bieker M et al (2011) RapidArc planning and delivery in patients with locally advanced head-and-neck cancer undergoing chemoradiotherapy. Int J. Radiat Oncol Biol Phys 79:429–435CrossRef
4.
Vanetti E et al (2009) Volumetric modulated arc radiotherapy for carcinomas of the oro-pharynx, hypo-pharynx and larynx: a treatment planning comparison with fixed field IMRT. Radiother Oncol 92:111–117PubMedCrossRef
5.
Yu CX et al (1995) Intensity-modulated arc therapy with dynamic multileaf collimation: an alternative to tomotherapy. Phys Med Biol 40:1435–1449PubMedCrossRef
6.
Yu CX, Li XA, Ma L et al (2002) Clinical implementation of intensity-modulated arc therapy. Int J Radiat Oncol Biol Phys 53:453–463PubMedCrossRef
7.
Duthoy W, De Gersem W, Vergote K et al (2004) Clinical implementation of intensity modulated arc therapy (IMAT) for rectal cancer. Int J Radiat Oncol Biol Phys 60:794–806PubMedCrossRef
8.
Lee N, Puri D, Blanco AI, Chao KS (2007) Intensity modulated radiation therapy in head and neck cancers: an update. Head Neck 29:387–400PubMedCrossRef
9.
Garg AK, Malo M (1997) Manifestation and treatment of xerostomia and associated oral effects secondary to head and neck radiation therapy. J Am Dent Assoc 128:1128–1133PubMed
10.
Greenspan D (1996) Xerostomia. Diagnosis and management. Oncology 10:7–11PubMed
11.
Verbakel WF, Cuijpers JP (2009) Volumetric intensity-modulated arc therapy vs. conventional IMRT in head-and-neck cancer: a comparative planning and dosimetric study. Int J. Radiat Oncol Biol Phys 74:252–259CrossRef
12.
Kjaer-Kristoffersen F, Ohlhues L (2009) RapidArc volumetric modulated therapy planning for prostate cancer patients. Acta Oncol 48:227–232PubMedCrossRef
13.
MacKenzie MA, Robinson DM (2002) Intensity modulated arc deliveries approximated by a large number of fixed gantry position sliding window dynamic multileaf collimator fields. Med Phys 29:2359–2365PubMedCrossRef
14.
ICRU Report 50 (1993) Prescribing, recording, and reporting photon beam therapy
15.
ICRU Report 62 (1999) Prescribing, recording, and reporting photon beam therapy (supplement to ICRU Report 50)
16.
ICRU Report 83 (2010) Prescribing, recording, and reporting photon beam therapy ıntensity-modulated radiation therapy (IMRT)
17.
Grégoire V, Coche E, Cosnard G et al (2000) Selection and delineation of lymph node target volumes in head and neck conformal radiotherapy. Proposal for standardizing terminology and procedure based on the surgical experience. Radiother Oncol 56:135–150PubMedCrossRef
18.
Som PM, Curtin HD et al (1999) An imaging-based classification for the cervical nodes designed as an adjunct to recent clinically based nodal classifications. Arch Otolaryngol Head Neck Surg 125:388–396PubMed
19.
http://www.rtog.org “CT-based delineation of lymph node levels in the N0 neck: DAHANCA, EORTC, GORTEC, RTOG consensus guidelines. Accessed January 2009
20.
Gregoire V, De neve W, Eisbruch A et al (2007) Intensity modulated radiation therapy for head and neck carcinoma. Oncologist 12:555–564PubMedCrossRef
21.
Earl M, Shepard D, Naqvi S et al (2003) Inverse planning for intensity modulated arc therapy using direct aperture optimization. Phys Med Biol 21:1075–1089CrossRef
22.
Chao KS, Majhail N, Huang CJ et al (2001) Intensity-modulated radiation therapy reduces late salivary toxicity without compromising tumor control in patients with oropharyngeal carcinoma: a comparison with conventional techniques. Radiother Oncol 61:275–280PubMedCrossRef
23.
Rasch C, Keus R, Pameijer FA et al (1997) The potential impact of CT-MRI matching on tumor volume delineation in advanced head and neck cancer. Int J Radiat Oncol Biol Phys 39:841–848PubMedCrossRef
24.
Steenbakkers R, Duppen J, Fitton I et al (2004) Observer variation in delineation of nasopharyngeal carcinoma for radiotherapy, A 3-D analysis. Int J Radiat Oncol Biol Phys 60(suppl):S160–S161CrossRef
25.
Emami B, Lyman J et al (1991) Tolerance of normal tissue to therapeutic irradiation. Int J Radiat Oncol Biol Phys 15(21):109–122CrossRef
26.
Joseph OD, Vitali M et al (2010) Radiotherapy dose-volüm effects on salivary gland function (QUANTEC: organ specific repair). Int J Radiat Oncol Biol Phys supplement 76:58–63CrossRef
27.
Feuvret L, Noel G et al (2006) Conformity index: a review. Int J Radiat Oncol Biol Phys 64:333–342PubMedCrossRef
28.
Deasy JO, Chao KSC (2001) Uncertainties in model based outcome predictions for treatment planning. Int J Radiat Oncol Biol Phys 51:1389–1399PubMedCrossRef
29.
Corvo R (2007) Evidance- based radiation oncology in head and neck squamous cell carcinoma. Radiother Oncol 85:156–170PubMedCrossRef
30.
Bailey BJ et al (2006) Head and neck surgery-otolaringology, 4th edn. lippincott Williams & Wilkins
31.
Gregoire V et al (2007) Intensity modulated radiation therapy for head and neck carcinama. Oncologist 12:555–564PubMedCrossRef
32.
Palma D, Vollans E, James K et al (2008) Volumetric modulated arc therapy for delivery of prostate radiotherapy. Comparison with intensity modulated radiotherapy and threedimensional conformal radiotherapy. Int J Radiat Oncol Biol Phys 72:996–1001PubMedCrossRef
33.
Cozzi L, Dinshaw KA, Shrivastava SK et al (2008) A treatment planning study comparing volumetric arc modulation with RapidArc and fixed field IMRT for cervix uteri radiotherapy. Radiother Oncol 89:180–191PubMedCrossRef
34.
Fogliata A, Clivio A, Nicolini G et al (2008) Intensity modulation with photons for benign intracranial tumours. A planning comparison of volumetric single arc, helical arc and fixed gantry techniques. Radiother Oncol 89:254–262PubMedCrossRef
35.
Aydogan B, Yeginer M, Kavak GO et al (2011) Total marrow irradiation with RapidArc volumetric arc therapy. Int J Radiat Oncol Biol Phys 81:592–599PubMedCrossRef
36.
Holt A, Van Gestel D, Arends MP et al (2013) Multi-institutional comparison of volumetric modulated arc therapy vs. intensity-modulated radiation therapy for head-and-neck cancer: a planning study. Radiat Oncol 8:26 (Epub ahead of print)PubMedCrossRef
37.
Wiehle R, Knippen S, Grosu AL et al (2011) VMAT and step-and-shoot IMRT in head and neck cancer Strahlenther Onkol 187:820–825
38.
Pasler M, Wirtz H, Lutterbach J (2011) Impact of gantry rotation time on plan quality and dosimetric verification—Volumetric Modulated Arc Therapy (VMAT) vs. Intensity Modulated Radiotherapy (IMRT) Strahlenther Onkol 187:812–819
39.
Sathiyan S, Ravikumar M, Boyer AL, Shoales J (2011) Comparison of IMRT and rapidarc treatment plans using AAPM task group test suites. Gulf J oncolog 1:11–17PubMed
40.
Lu SH, Cheng JC, Kuo SH et al (2012) Volumetric modulated arc therapy for nasopharyngeal carcinoma: a dosimetric comparison with TomoTherapy and step-and-shoot IMRT. Radiother Oncol 104:324–330PubMedCrossRef
Metadaten
Titel
Comparison of two different IMRT planning techniques in the treatment of nasopharyngeal carcinoma
Effect on parotid gland radiation doses
verfasst von
Dr. E.K. Uzel
S. Karaçam
O. Eliçin
Ö. Uzel
Publikationsdatum
01.07.2013
Verlag
Springer-Verlag
Erschienen in
Strahlentherapie und Onkologie / Ausgabe 7/2013
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-013-0344-z

Weitere Artikel der Ausgabe 7/2013

Strahlentherapie und Onkologie 7/2013 Zur Ausgabe

Case study

Ewing’s sarcoma of the larynx

Mitteilungen der Fachgesellschaften

Mitteilungen der Fachgesellschaften

Original article

Validation and practical implementation of a multidisciplinary cancer distress screening questionnaire

Originalien

Effekte systematischer Informationen über psychosoziale Angebote während der ambulanten Strahlentherapie

Original article

Acute mucosal reactions in patients with head and neck cancer

Original article

Time course of late rectal- and urinary bladder side effects after MRI-guided adaptive brachytherapy for cervical cancer

Neu im Fachgebiet Onkologie

Mehr Lebenszeit mit Abemaciclib bei fortgeschrittenem Brustkrebs?

24.05.2024 Mammakarzinom Nachrichten

In der MONARCHE-3-Studie lebten Frauen mit fortgeschrittenem Hormonrezeptor-positivem, HER2-negativem Brustkrebs länger, wenn sie zusätzlich zu einem nicht steroidalen Aromatasehemmer mit Abemaciclib behandelt wurden; allerdings verfehlte der numerische Zugewinn die statistische Signifikanz.

ADT zur Radiatio nach Prostatektomie: Wenn, dann wohl länger

24.05.2024 Prostatakarzinom Nachrichten

Welchen Nutzen es trägt, wenn die Strahlentherapie nach radikaler Prostatektomie um eine Androgendeprivation ergänzt wird, hat die RADICALS-HD-Studie untersucht. Nun liegen die Ergebnisse vor. Sie sprechen für länger dauernden Hormonentzug.

Das sind die führenden Symptome junger Darmkrebspatienten

23.05.2024 Leitsymptome in der Hausarztpraxis Nachrichten

Darmkrebserkrankungen in jüngeren Jahren sind ein zunehmendes Problem, das häufig längere Zeit übersehen wird, gerade weil die Patienten noch nicht alt sind. Welche Anzeichen Ärzte stutzig machen sollten, hat eine Metaanalyse herausgearbeitet.

„Überwältigende“ Evidenz für Tripeltherapie beim metastasierten Prostata-Ca.

22.05.2024 Prostatakarzinom Nachrichten

Patienten mit metastasiertem hormonsensitivem Prostatakarzinom sollten nicht mehr mit einer alleinigen Androgendeprivationstherapie (ADT) behandelt werden, mahnt ein US-Team nach Sichtung der aktuellen Datenlage. Mit einer Tripeltherapie haben die Betroffenen offenbar die besten Überlebenschancen.

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise