scholarly journals Dose estimation after a mixed field exposure: Radium-223 and intensity modulated radiotherapy

2021 ◽  
Author(s):  
Isabella Bastiani ◽  
Stephen J. McMahon ◽  
Philip Turner ◽  
Kelly M. Redmond ◽  
Conor K. McGarry ◽  
...  
Keyword(s):  
Intensity Modulated Radiotherapy ◽  
Dose Estimation ◽  
Field Exposure ◽  
Intensity Modulated ◽  
Radium 223 ◽  
Mixed Field

Helical tomotherapy for advanced esophageal cancer improves target conformity and homogeneity: A comparison with fixed-field intensity-modulated radiotherapy

2015 ◽  
Vol 11 (3) ◽  
pp. 3146-3155
Author(s):  
Luhua Wang
Keyword(s):  
Esophageal Cancer ◽  
Field Intensity ◽  
Helical Tomotherapy ◽  
Intensity Modulated Radiotherapy ◽  
Matched Pair ◽  
Conformity Index ◽  
Target Coverage ◽  
Advanced Esophageal Cancer ◽  
Fixed Field ◽  
Intensity Modulated

Purpose: To evaluate the usefulness of helical tomotherapy (HT) in the treatment of advanced esophageal cancer (EC) and compare target homogeneity, conformity and normal tissue doses between HT and fixed-field intensity-modulated radiotherapy (ff-IMRT).Methods: In all, 23 patients with cT3-4N0-1M0-1a thoracic EC (upper esophagus, 9 patients; middle esophagus, 6; distal esophagus, 6 and esophagogastric junction, 2) who were treated with ff-IMRT (60 Gy in 30 fractions) were re-planned for HT and ff-IMRT with the same clinical require­ments. Comparisons were performed using the Wilcoxon matched-pair signed-rank test.Results: Compared with ff-IMRT, HT significantly reduced the homogeneity index for thoracic, upper, middle and distal ECs by 38%, 31%, 36% and 33%, respectively (P < 0.05). The conformity index was increased by HT for thoracic, upper and middle ECs by 9%, 9% and 18%, respectively (P < 0.05). Target coverage was improved by 1% with HT (P < 0.05). The mean lung dose was significantly reduced by HT for thoracic and upper ECs (P < 0.05). The V20 (volume receiving at least 20 Gy) and higher dose volumes of the lungs were decreased by HT in all cases, but the differences were significant for thoracic, upper and distal ECs (P < 0.05), with reductions of 2.1%, 3.1% and 2.2%, respectively. HT resulted in a larger lung V5 for thoracic, upper, middle and distal ECs, with increases of 3.5%, 1.5%, 7.2% and 3.2%, respectively. Heart sparing was significantly better with HT than with ff-IMRT in terms of the V30 and V40 for thoracic, upper, middle and distal ECs (P < 0.05).Conclusions: Compared to ff-IMRT, HT provides superior target coverage, conformity and homogeneity, with reduced the volume of high doses to the lungs and heart for advanced EC. HT may be a treatment option for advanced EC, especially upper EC.

scholarly journals Intensity-modulated Radiotherapy for Rectal Cancer in the UK in 2020

2021 ◽  
Author(s):  
C.R. Hanna ◽  
F. Slevin ◽  
A. Appelt ◽  
M. Beavon ◽  
R. Adams ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Intensity Modulated Radiotherapy ◽  
Intensity Modulated ◽  
The Uk

scholarly journals Impact of Geometric Uncertainties on Dose Distribution During Intensity Modulated Radiotherapy of Head-and-neck Cancer: The Need for a Planning Target Volume and A Planning Organ-at-Risk Volume

2006 ◽  
Vol 13 (3) ◽  
pp. 108-115 ◽  
Author(s):  
O. Ballivy ◽  
W. Parker ◽  
T. Vuong ◽  
G. Shenouda ◽  
H. Patrocinio
Keyword(s):  
Spinal Cord ◽  
At Risk ◽  
Neck Cancer ◽  
Intensity Modulated Radiotherapy ◽  
Target Volume ◽  
Ct Scans ◽  
Target Coverage ◽  
Geometric Uncertainties ◽  
Intensity Modulated ◽  
Organ At Risk

We assessed the effect of geometric uncertainties on target coverage and on dose to the organs at risk (OARS) during intensity-modulated radiotherapy (IMRT) for head-and-neck cancer, and we estimated the required margins for the planning target volume (PTV) and the planning organ-at-risk volume (PRV). For eight headand- neck cancer patients, we generated IMRT plans with localization uncertainty margins of 0 mm, 2.5 mm, and 5.0 mm. The beam intensities were then applied on repeat computed tomography (CT) scans obtained weekly during treatment, and dose distributions were recalculated. The dose–volume histogram analysis for the repeat CT scans showed that target coverage was adequate (V100 ≥ 95%) for only 12.5% of the gross tumour volumes, 54.3% of the upper-neck clinical target volumes (CTVS), and 27.4% of the lower-neck CTVS when no margins were added for PTV. The use of 2.5-mm and 5.0-mm margins significantly improved target coverage, but the mean dose to the contralateral parotid increased from 25.9 Gy to 29.2 Gy. Maximum dose to the spinal cord was above limit in 57.7%, 34.6%, and 15.4% of cases when 0-mm, 2.5-mm, and 5.0-mm margins (respectively) were used for PRV. Significant deviations from the prescribed dose can occur during IMRT treatment delivery for headand- neck cancer. The use of 2.5-mm to 5.0-mm margins for PTV and PRV greatly reduces the risk of underdosing targets and of overdosing the spinal cord.

scholarly journals Relevance of Combined Electron and Photon Beams in Radiotherapy of Head and Neck Cancers in the Era of Intensity-Modulated Radiotherapy

2020 ◽  
Author(s):  
Vinod Pandey ◽  
K. C. Pandey ◽  
N. K. Pant ◽  
L. P. Verma
Keyword(s):  
Head And Neck ◽  
Electron Beams ◽  
External Beam Radiotherapy ◽  
Intensity Modulated Radiotherapy ◽  
Modern Technology ◽  
Head And Neck Cancers ◽  
Photon Beams ◽  
Average Percentage ◽  
Intensity Modulated ◽  
Electron And Photon

Abstract Introduction External beam radiotherapy (EBRT) for head and neck (H&N) cancers continues to be delivered using varied technologies, ranging from the old two-dimensional conventional radiotherapy (2DRT) techniques to the modern three-dimensional conformal radiotherapy (3DCRT), intensity-modulated radiotherapy (IMRT), and volumetric modulated arc therapy (VMAT) in different centers in India. Due to limitations of spinal cord tolerance, electron and photon beams are combined in 2DRT and 3DCRT techniques for treating nodal volume of the H&N cases. However, many centers having modern technology practice IMRT/VMAT in place of electron beams. The purpose of this study is to analyze the role of combined electron and photon beams in radiotherapy of H&N cancers and its relevance in the modern era of IMRT/VMAT. Materials and Methods Data were collected through a survey conducted on cancer centers in India where radiotherapy is being given by 2DRT, 3DCRT, and IMR/VMAT for the treatment of head and neck cancers. Results The mean percentage of H&N (H&N) cases among all cases were 39.2% (standard deviation [SD]: 14.22), out of which 16.63% (SD: 20.83) were treated with a combination of photon and electron beams and 49.73% (SD: 37.41) were treated with IMRT/VMAT. The average percentage of H&N cases of government institutes was 38.39% (SD: 14.11) and that of private institutes was 40.14% (SD: 14.11). Patients treated with photon and electron combination and IMRT/VMAT were 22.19% (SD: 11.24) and 24.05% (SD: 23.99), respectively, in government institutes, and 10.29% (SD: 11.24) and 79.09% (SD: 26.75) in private institutes. Conclusion As per this study, we conclude that despite the availability of IMRT/VMAT, a combination of electron and photon beams is still relevant in India. Since a large proportion of the patients are still treated with the electron and photon combination, it is imperative that further studies on field–junction dosimetry should be conducted to ensure accurate dose delivery.

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