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06.02.2016 | Original Article

Unilateral and bilateral neck SIB for head and neck cancer patients

Intensity-modulated proton therapy, tomotherapy, and RapidArc

verfasst von: Carmen Stromberger, M.D., Luca Cozzi, Ph.D., Volker Budach, M.D., Ph.D., Antonella Fogliata, M.D., Pirus Ghadjar, M.D., Waldemar Wlodarczyk, Ph.D., Basil Jamil, M.D., Jan D. Raguse, M.D., D.M.D., Arne Böttcher, M.D., Simone Marnitz, M.D.

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 4/2016

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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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Titel: Unilateral and bilateral neck SIB for head and neck cancer patients
Intensity-modulated proton therapy, tomotherapy, and RapidArc
verfasst von: Carmen Stromberger, M.D.
Luca Cozzi, Ph.D.
Volker Budach, M.D., Ph.D.
Antonella Fogliata, M.D.
Pirus Ghadjar, M.D.
Waldemar Wlodarczyk, Ph.D.
Basil Jamil, M.D.
Jan D. Raguse, M.D., D.M.D.
Arne Böttcher, M.D.
Simone Marnitz, M.D.
Publikationsdatum: 06.02.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: Strahlentherapie und Onkologie / Ausgabe 4/2016
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-016-0945-4

Springer Medizin

Unilateral and bilateral neck SIB for head and neck cancer patients

Intensity-modulated proton therapy, tomotherapy, and RapidArc

Abstract