التفاصيل البيبلوغرافية
| العنوان: |
Intensity modulated arc therapy implementation in a three phase adaptive (18)F-FDG-PET voxel intensity-based planning strategy for head-and-neck cancer. |
| المؤلفون: |
Berwouts, Dieter, Olteanu, Luiza Ana Maria, Speleers, Bruno, Duprez, Frédéric, Madani, Indira, Vercauteren, Tom, De Neve, Wilfried, De Gersem, Werner |
| المصدر: |
Radiation Oncology; 4/2/2016, Vol. 11, p1-9, 9p |
| مصطلحات موضوعية: |
HEAD & neck cancer treatment, INTENSITY modulated radiotherapy, TREATMENT effectiveness, RADIOTHERAPY treatment planning, BRAIN stem, ALGORITHMS, HUMAN body, COMPARATIVE studies, DEOXY sugars, HEAD tumors, DIGITAL image processing, RESEARCH methodology, MEDICAL cooperation, COMPUTERS in medicine, NECK tumors, RADIATION doses, RADIATION measurements, RADIOPHARMACEUTICALS, RADIOTHERAPY, RESEARCH, RESEARCH evaluation, SQUAMOUS cell carcinoma, EVALUATION research |
| مستخلص: |
Background: This study investigates the implementation of a new intensity modulated arc therapy (IMAT) class solution in comparison to a 6-static beam step-and-shoot intensity modulated radiotherapy (s-IMRT) for three-phase adaptive (18)F-FDG-PET-voxel-based dose-painting-by-numbers (DPBN) for head-and-neck cancer. Methods: We developed (18)F-FDG-PET-voxel intensity-based IMAT employing multiple arcs and compared it to clinically used s-IMRT DPBN. Three IMAT plans using (18)F-FDG-PET/CT acquired before treatment (phase I), after 8 fractions (phase II) and CT acquired after 18 fractions (phase III) were generated for each of 10 patients treated with 3 s-IMRT plans based on the same image sets. Based on deformable image registration (ABAS, version 0.41, Elekta CMS Software, Maryland Heights, MO), doses of the 3 plans were summed on the pretreatment CT using validated in-house developed software. Dosimetric indices in targets and organs-at-risk (OARs), biologic conformity of treatment plans set at ≤5 %, treatment quality and efficiency were compared between IMAT and s-IMRT for the whole group and for individual patients. Results: Doses to most organs-at-risk (OARs) were significantly better in IMAT plans, while target levels were similar for both types of plans. On average, IMAT ipsilateral and contralateral parotid mean doses were 14.0 % (p = 0.001) and 12.7 % (p < 0.001) lower, respectively. Pharyngeal constrictors D50% levels were similar or reduced with up to 54.9 % for IMAT compared to s-IMRT for individual patient cases. IMAT significantly improved biologic conformity by 2.1 % for treatment phases I and II. 3D phantom measurements reported an agreement of ≥95 % for 3 % and 3 mm criteria for both treatment modalities. IMAT delivery time was significantly shortened on average by 41.1 %. Conclusions: IMAT implementation significantly improved the biologic conformity as compared to s-IMRT in adaptive dose-escalated DPBN treatments. The better OAR sparing and faster delivery highly improved the treatment efficiency. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
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