scholarly journals Comparison of survival, acute toxicities, and dose–volume parameters between intensity‐modulated radiotherapy with or without internal target volume delineation method and three‐dimensional conformal radiotherapy in cervical cancer patients: A retrospective and propensity score‐matched analysis

2021 ◽  
Author(s):  
Yu‐Qin Liang ◽  
Sen‐Quan Feng ◽  
Wen‐Jia Xie ◽  
Qiong‐Zhi Jiang ◽  
Yan‐Fen Yang ◽  
...  
2013 ◽  
Vol 8 ◽  
Author(s):  
Li-Jie Yin ◽  
Xiao-Bin Yu ◽  
Yan-Gang Ren ◽  
Guang-Hai Gu ◽  
Tian-Gui Ding ◽  
...  

Background: To investigate the utilization of PET-CT in target volume delineation for three-dimensional conformal radiotherapy in patients with non-small cell lung cancer (NSCLC) and atelectasis. Methods: Thirty NSCLC patients who underwent radical radiotherapy from August 2010 to March 2012 were included in this study. All patients were pathologically confirmed to have atelectasis by imaging examination. PET-CT scanning was performed in these patients. According to the PET-CT scan results, the gross tumor volume (GTV) and organs at risk (OARs, including the lungs, heart, esophagus and spinal cord) were delineated separately both on CT and PET-CT images. The clinical target volume (CTV) was defined as the GTV plus a margin of 6-8 mm, and the planning target volume (PTV) as the GTV plus a margin of 10-15 mm. An experienced physician was responsible for designing treatment plans PlanCT and PlanPET-CT on CT image sets. 95% of the PTV was encompassed by the 90% isodose curve, and the two treatment plans kept the same beam direction, beam number, gantry angle, and position of the multi-leaf collimator as much as possible. The GTV was compared using a target delineation system, and doses distributions to OARs were compared on the basis of dose-volume histogram (DVH) parameters. Results: The GTVCT and GTVPET-CT had varying degrees of change in all 30 patients, and the changes in the GTVCT and GTVPET-CT exceeded 25% in 12 (40%) patients. The GTVPET-CT decreased in varying degrees compared to the GTVCT in 22 patients. Their median GTVPET-CT and median GTVPET-CT were 111.4 cm3 (range, 37.8 cm3-188.7 cm3) and 155.1 cm3 (range, 76.2 cm3-301.0 cm3), respectively, and the former was 43.7 cm3 (28.2%) less than the latter. The GTVPET-CT increased in varying degrees compared to the GTVCT in 8 patients. Their median GTVPET-CT and median GTVPET-CT were 144.7 cm3 (range, 125.4 cm3-178.7 cm3) and 125.8 cm3 (range, 105.6 cm3-153.5 cm3), respectively, and the former was 18.9 cm3 (15.0%) greater than the latter. Compared to PlanCT parameters, PlanPET-CT parameters showed varying degrees of changes. The changes in lung V20, V30, esophageal V50 and V55 were statistically significant (Ps< 0.05 for all), while the differences in mean lung dose, lung V5, V10, V15, heart V30, mean esophageal dose, esophagus Dmax, and spinal cord Dmax were not significant (Ps> 0.05 for all). Conclusions: PET-CT allows a better distinction between the collapsed lung tissue and tumor tissue, improving the accuracy of radiotherapy target delineation, and reducing radiation damage to the surrounding OARs in NSCLC patients with atelectasis.


2014 ◽  
Vol 41 (6Part7) ◽  
pp. 173-173
Author(s):  
M Descovich ◽  
D Pinnaduwage ◽  
N Kirby ◽  
A Gottschalk ◽  
S Yom ◽  
...  

Author(s):  
Yousif A. M. Yousif ◽  
Ali Judge ◽  
Jackson Zifodya

Abstract Aim: The aim of this study was to evaluate the use of Eclipse’s beam angle optimiser (BAO) for three-dimensional conformal radiotherapy planning. Materials and methods: Eleven 3D conformal lung plans, with varied tumour volumes, were retrospectively studied. For each clinical plan, a BAO plan was produced and then optimised by an experienced planner. Plan quality was assessed using International Commission on Radiation Units and Measurements (ICRU)-83 and  Radiation Therapy Oncology Group (RTOG) recommended dose reporting metrics for dose volume prescribing and reporting. Results: Differences in dose volume histograms for both methods showed no clinical significance. Planning target volume Dmax for both plans was comparable and within ICRU guidelines. Reported spinal cord Dmax and the doses to 33% and 67% volume of the heart were within the RTOG recommended limits. Mean lung V20 values for BAO and non-BAO plans were 20 and 16%, respectively. The average monitor units for the BAO plans were about 11% lower. The conformity and homogeneity indices were within the acceptable range for both cases. On average, it took 23 minutes to plan using the BAO compared to 68 minutes for the non-BAO plans. Conclusion: Eclipse BAO shows the potential to produce good quality conformal plans and reduce planning time. This process could be further refined with multi-leaf collimator and optimal collimator angle options.


2021 ◽  
Vol 46 (2) ◽  
pp. 59
Author(s):  
JaiPrakash Agrawal ◽  
Anil Tibdewal ◽  
Sabheen Bushra ◽  
Naveen Mummudi ◽  
Rajesh Kinhikar ◽  
...  

Author(s):  
Rhonda Alexander ◽  
Tom Boterberg ◽  
Karin Dieckmann ◽  
Mark Gaze ◽  
Hannah King ◽  
...  

Chapter 4 discusses radiotherapy preparation and treatment. There are many ways of delivering radiotherapy, and the best technique should be chosen for each child, teenager, or young adult for whom irradiation is indicated. Image-guided, intensity-modulated radiotherapy techniques are gradually replacing three-dimensional conformal approaches. Proton beam radiotherapy offers the advantage of lower normal tissue radiation doses in many circumstances, and its availability and use is growing. Highly specialized techniques including hypofractionated stereotactic radiotherapy, molecular radiotherapy, and brachytherapy offer important advantages in a small number of cases. Anaesthetic teams are essential for the immobilization of infants and most younger children requiring radiotherapy. Play specialists may reduce the need for anaesthesia in some cases, and greatly facilitate treatment of older children. Good imaging is essential for accurate target volume delineation, and careful prospective quality assurance of this process will help to improve outcomes.


2009 ◽  
Vol 8 (5) ◽  
pp. 369-377 ◽  
Author(s):  
Yong Bae Kim ◽  
Joo Ho Kim ◽  
Kyung Keun Jeong ◽  
Jinsil Seong ◽  
Chang Ok Suh ◽  
...  

Objectives The goal of this study was to dosimetrically compare 3-dimensional radiotherapy (3DCRT), intensity-modulated radiotherapy (IMRT), and helical tomotherapy (TOMO) plans for whole abdominopelvic radiotherapy (WART) in patients with gynecologic cancer. Methods Ten patients were selected for WART planning. Doses were prescribed to planning target volumes (PTVs) as the followings: 30 Gy to PTV-whole abdominopelvis (PTV-WA), 40 Gy to PTV-para-aortic lymph node (PTV-PALN), 44 Gy to PTV-pelvis, and 50 Gy to gross target volume (GTV) in 20 fractions. Dose to whole liver, both kidneys, and spinal cord were constrained below each tissue tolerance, and bone marrow (BM)-sparing technique was adopted in IMRT and TOMO. Dosimetric parameters and treatment times were compared among plans. Results Calculated doses in TOMO came most closely to the prescribed dose for coverage of PTV-WA, PTV-PALN, PTV-pelvis, and GTV compared to 3DCRT, and IMRT. In normal organs, TOMO had significantly better dosimetric profiles compared to IMRT and 3DCRT. TOMO significantly reduced V20Gy, and mean dose of whole liver, both kidneys, and spinal cord. The use of BM-sparing technique (BMS) did not impair coverage of target volume in IMRT and TOMO. While IMRT showed no differences of irradiated BM dose using BMS, TOMO with BMS reduced half V20Gy of BM compared to TOMO without BMS. Conclusions TOMO showed dosimetric superiority in target coverage, sparing BM, and other normal organs compared to 3DCRT and IMRT. Clinical experiences will be needed for evaluation of feasibility of WART using TOMO in patients with gynecologic cancer.


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