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Strahlentherapie und Onkologie

Erschienen in:

01.08.2012 | Original article

Clinical relevance of different dose calculation strategies for mediastinal IMRT in Hodgkin’s disease

verfasst von: J. Koeck, Y. Abo-Madyan, H.T. Eich, F. Stieler, J. Fleckenstein, J. Kriz, R.-P. Mueller, F. Wenz, F. Lohr

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 8/2012

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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 PTV₉₅ and V₂₀ of the lung by 6.9% and 3.3% and underestimated V₁₀ of the lung by 5.8%, compared to the CC algorithm. For IMRT, PB overestimated PTV₉₅, V₂₀ of the lung, V₂₅ of the heart and V₁₀ of the female left/right breast by 8.1%, 25.8%, 14.0% and 43.6%/189.1%, and underestimated V₁₀ of the lung, V₄ of the heart and V₄ 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.

Gagliardi G, Constine LS, Moiseenko V et al (2010) Radiation dose-volume effects in the heart. Int J Radiat Oncol Biol Phys 76:77–85CrossRef

Darby SC, Cutter DJ, Boerma M et al (2010) Radiation-related heart disease: current knowledge and future prospects. Int J Radiat Oncol Biol Phys 76:656–665PubMedCrossRef

Ng AK, Kenney LB, Gilbert ES, Travis LB (2010) Secondary malignancies across the age spectrum. Semin Radiat Oncol 20:67–78PubMedCrossRef

Nilsson G, Holmberg L, Garmo H et al (2012) Distribution of coronary artery stenosis after radiation for breast cancer. J Clin Oncol 30:380–386PubMedCrossRef

Adams MJ, Lipsitz SR, Colan SD et al (2004) Cardiovascular status in long-term survivors of Hodgkin’s disease treated with chest radiotherapy. J Clin Oncol 22:3139–3148PubMedCrossRef

Goodman KA, Toner S, Hunt M et al (2005) Intensity-modulated radiotherapy for lymphoma involving the mediastinum. Int J Radiat Oncol Biol Phys 62:198–206PubMedCrossRef

Girinsky T, Pichenot C, Beaudre A et al (2006) Is intensity-modulated radiotherapy better than conventional radiation treatment and three-dimensional conformal radiotherapy for mediastinal masses in patients with Hodgkin’s disease, and is there a role for beam orientation optimization and dose constraints assigned to virtual volumes? Int J Radiat Oncol Biol Phys 64:218–226PubMedCrossRef

Koeck J, Abo-Madyan Y, Lohr F et al (2012) Radiotherapy for early mediastinal hodgkin lymphoma according to the German Hodgkin Study Group (GHSG): the roles of intensity-modulated radiotherapy and involved-node radiotherapy. Int J Radiat Oncol Biol Phys 83:268–276PubMedCrossRef

Oshiro Y, Aruga T, Tsuboi K et al (2010) Stereotactic body radiotherapy for lung tumors at the pulmonary hilum. Strahlenther Onkol 186:274–279PubMedCrossRef

10.

Boda-Heggemann J, Lohr F, Wenz F et al (2011) kV cone-beam CT-based IGRT. Strahlenther Onkol 187:284–291PubMedCrossRef

11.

Krieger T, Sauer OA (2005) Monte Carlo- versus pencil-beam-/collapsed-cone-dose calculation in a heterogeneous multi-layer phantom. Phys Med Biol 50:859–868PubMedCrossRef

12.

Seco J, Adams L, Partridge M et al (2005) Evaluation of pencil beam, collapsed cone and Monte Carlo IMRT dose calculation algorithms for dual target sites. Radiother Oncol 76:18CrossRef

13.

Dobler B, Walter C, Knopf A et al (2006) Optimization of extracranial stereotactic radiation therapy of small lung lesions using accurate dose calculation algorithms. Radiat Oncol 1:45PubMedCrossRef

14.

Keall PJ, Siebers JV, Arnfield M et al (2001) Monte Carlo dose calculations for dynamic IMRT treatments. Phys Med Biol 46:929–941PubMedCrossRef

15.

Vanderstraeten B, Reynaert N, Paelinck L et al (2006) Accuracy of patient dose calculation for lung IMRT: a comparison of Monte Carlo, convolution/superposition, and pencil beam computations. Med Phys 33:3149–3158PubMedCrossRef

16.

Sharma S, Ott J, Williams J, Dickow D (2011) Dose calculation accuracy of the Monte Carlo algorithm for cyberknife compared with other commercially available dose calculation algorithms. Med Dosim 36:347–350PubMedCrossRef

17.

Polednik M, Abo Madyan Y, Schneider F et al (2007) Evaluation of calculation algorithms implemented in different commercial planning systems on an anthropomorphic breast phantom using film dosimetry. Strahlenther Onkol 183:667–672PubMedCrossRef

18.

Gray A, Oliver LD, Johnston PN (2009) The accuracy of the pencil beam convolution and anisotropic analytical algorithms in predicting the dose effects due to attenuation from immobilization devices and large air gaps. Med Phys 36:3181–3191PubMedCrossRef

19.

Sikora M, Muzik J, Sohn M et al (2009) Monte Carlo vs. pencil beam based optimization of stereotactic lung IMRT. Radiat Oncol 4:64PubMedCrossRef

20.

Fotina I, Kragl G, Kroupa B et al (2011) Clinical comparison of dose calculation using the enhanced collapsed cone algorithm vs. a new Monte Carlo algorithm. Strahlenther Onkol 187:433–441PubMedCrossRef

21.

Brualla L, Palanco-Zamora R, Steuhl KP et al (2011) Monte Carlo simulations applied to conjunctival lymphoma radiotherapy treatment. Strahlenther Onkol 187:492–498PubMedCrossRef

22.

Irvine C, Morgan A, Crellin A et al (2004) The clinical implications of the collapsed cone planning algorithm. Clin Oncol (R Coll Radiol) 16:148–154

23.

Chen H, Lohr F, Fritz P et al (2010) Stereotactic, single-dose irradiation of lung tumors: a comparison of absolute dose and dose distribution between pencil beam and Monte Carlo algorithms based on actual patient CT scans. Int J Radiat Oncol Biol Phys 78:955–963PubMedCrossRef

24.

Koelbl O, Krieger T, Haedinger U et al (2004) Influence of calculation algorithm on dose distribution in irradiation of non-small cell lung cancer (NSCLC) collapsed cone versus pencil beam. Strahlenther Onkol 180:783–788PubMedCrossRef

25.

Haedinger U, Krieger T, Flentje M, Wulf J (2005) Influence of calculation model on dose distribution in stereotactic radiotherapy for pulmonary targets. Int J Radiat Oncol Biol Phys 61:239–249PubMedCrossRef

26.

Jang SY, Liu HH, Wang X et al (2006) Dosimetric verification for intensity-modulated radiotherapy of thoracic cancers using experimental and Monte Carlo approaches. Int J Radiat Oncol Biol Phys 66:939–948PubMedCrossRef

27.

Jang SY, Liu HH, Mohan R (2008) Underestimation of low-dose radiation in treatment planning of intensity-modulated radiotherapy. Int J Radiat Oncol Biol Phys 71:1537–1546PubMedCrossRef

28.

Eich HT, Engenhart-Cabillic R, Hansemann K et al (2008) Quality control of involved field radiotherapy in patients with early-favorable (HD10) and early-unfavorable (HD11) Hodgkin’s lymphoma: an analysis of the German Hodgkin Study Group. Int J Radiat Oncol Biol Phys 71:1419–1424PubMedCrossRef

29.

ICRU50 (1993) International Commission on Radiation Units and Measurements. Prescribing, recording and reporting photon beam therapy. Washington, Report 50

30.

Alber M, Nüsslin F (2002) A concept for the optimization of clinical IMRT. Z Med Phys 12:109–113PubMed

31.

Alber M, Nüsslin F (1999) An objective function for radiation treatment optimization based on local biological measures. Phys Med Biol 44:479–493PubMedCrossRef

32.

Fippel M (1999) Fast Monte Carlo dose calculation for photon beams based on the VMC electron algorithm. Med Phys 26:1466–1475PubMedCrossRef

33.

Fippel M, Haryanto F, Dohm O et al (2003) A virtual photon energy fluence model for Monte Carlo dose calculation. Med Phys 30:301–311PubMedCrossRef

34.

Ahnesjö A, Saxner M, Trepp A (1992) A pencil beam model for photon dose calculation. Med Phys 19:263–273PubMedCrossRef

35.

Ahnesjö A (1989) Collapsed cone convolution of radiant energy for photon dose calculation in heterogeneous media. Med Phys 16:577–592PubMedCrossRef

36.

Fippel M, Laub W, Huber B, Nüsslin F (1999) Experimental investigation of a fast Monte Carlo photon beam dose calculation algorithm. Phys Med Biol 44:3039–3054PubMedCrossRef

37.

Verhaegen F, Seuntjens J (2003) Monte Carlo modelling of external radiotherapy photon beams. Phys Med Biol 48:107–164CrossRef

38.

Ahnesjö A, Aspradakis MM (1999) Dose calculations for external photon beams in radiotherapy. Phys Med Biol 44:99–155CrossRef

39.

Eich HT, Muller RP, Engenhart-Cabillic R et al (2008) Involved-node radiotherapy in early-stage Hodgkin’s lymphoma. Definition and guidelines of the German Hodgkin Study Group (GHSG). Strahlenther Onkol 184:406–410PubMedCrossRef

40.

Girinsky T, van der Maazen R, Specht L et al (2006) Involved-node radiotherapy (INRT) in patients with early Hodgkin lymphoma: concepts and guidelines. Radiother Oncol 79:270–277PubMedCrossRef

41.

Liu HH (2002) Dm rather than Dw should be used in Monte Carlo treatment planning. For the proposition. Med Phys 29:922–923PubMedCrossRef

42.

Siebers JV, Keall PJ, Nahum AE, Mohan R (2000) Converting absorbed dose to medium to absorbed dose to water for Monte Carlo based photon beam dose calculations. Phys Med Biol 45:983–995PubMedCrossRef

43.

Wertz H, Jahnke L, Schneider F et al (2011) A novel lateral disequilibrium inclusive (LDI) pencil-beam based dose calculation algorithm: evaluation in inhomogeneous phantoms and comparison with Monte Carlo calculations. Med Phys 38:1627–1634PubMedCrossRef

Titel: Clinical relevance of different dose calculation strategies for mediastinal IMRT in Hodgkin’s disease
verfasst von: J. Koeck
Y. Abo-Madyan
H.T. Eich
F. Stieler
J. Fleckenstein
J. Kriz
R.-P. Mueller
F. Wenz
F. Lohr
Publikationsdatum: 01.08.2012
Verlag: Springer-Verlag
Erschienen in: Strahlentherapie und Onkologie / Ausgabe 8/2012
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-012-0144-x

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Clinical relevance of different dose calculation strategies for mediastinal IMRT in Hodgkin’s disease