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Erschienen in: Strahlentherapie und Onkologie 1/2016

01.01.2016 | Original Article

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

verfasst von: Carmen Stromberger, M.D., Pirus Ghadjar, M.D., Simone Marnitz, M.D., Alexander Henry Thieme, M.D., Ulrich Jahn, Ph.D., Jan D Raguse, M.D., D.M.D, Evis Karaj-Rossbacher, M.sc., Arne Böttcher, M.D., Basil Jamil, M.D., Volker Budach, M.D., Ph.D.

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 1/2016

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Abstract

Aim

The purpose of this work was to compare sequential (SeqB) versus simultaneous integrated boost (SIB) radiotherapy plans delivered with volumetric modulated arc therapy (VMAT) for patients with locally advanced squamous cell cancer of the head and neck (HNSCC).

Patients and methods

SeqB and SIB plans using VMAT for 10 HNSCC patients given definitive chemoradiation were generated and analysed for differences in dose distribution, coverage, conformity and homogeneity to the planning target volumes (PTV) 1–3 and sparing of organs at risk (OAR).

Results

The mean delineated volumes ± standard deviations were 137.7 ± 44.8, 351.3 ± 83.9 and 895.6 ± 120.5 cm3 for PTV1–3. The mean volumes encompassed by the corresponding 95 % isodoses were 281 (+ 110 %) ± 73.4, 712.2 (+ 115 %) ± 146.4 and 1381.1 (+ 54 %) ± 217.3 cm3 with SeqB and 138.2 (+ 7 %) ± 40.1, 380.4 (+ 11 %) ± 91.9 and 1057.3 (+ 21 %) ± 161.4 cm3 with SIB for PTV1–3, respectively. Both strategies achieved excellent PTV coverage. SeqB provided significantly better coverage of PTV1 and 3, worse conformity for PTV1–3 and a higher mean dose than prescribed (111–115 %) to PTV2 and 3 (p ≤ 0.007). Both strategies provided satisfactory OAR sparing.

Conclusion

This study showed significant dosimetric differences with potential clinical relevance between two VMAT boost strategies regarding coverage, conformity and dose to the PTVs. SIB might cause less toxicity. A clinical phase III/IV trial endorsed by the German Head and Neck Clinical Trials Group (IAG-KHT) will evaluate differences in acute/late toxicity as well as in locoregional recurrences between the two boost techniques.
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Metadaten
Titel
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
verfasst von
Carmen Stromberger, M.D.
Pirus Ghadjar, M.D.
Simone Marnitz, M.D.
Alexander Henry Thieme, M.D.
Ulrich Jahn, Ph.D.
Jan D Raguse, M.D., D.M.D
Evis Karaj-Rossbacher, M.sc.
Arne Böttcher, M.D.
Basil Jamil, M.D.
Volker Budach, M.D., Ph.D.
Publikationsdatum
01.01.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Strahlentherapie und Onkologie / Ausgabe 1/2016
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-015-0913-4

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