Locoregional Control and Toxicity in Head and Neck Carcinoma Patients following Helical Tomotherapy-Delivered Intensity-Modulated Radiation Therapy Compared with 3D-CRT Data

Oncology ◽  
2018 ◽  
Vol 95 (2) ◽  
pp. 61-68 ◽  
Author(s):  
Olalla Santa Cruz ◽  
Pelagia Tsoutsou ◽  
Cyril  Castella ◽  
Kaouthar Khanfir ◽  
Sandro Anchisi ◽  
...  
2007 ◽  
Vol 12 (5) ◽  
pp. 555-564 ◽  
Author(s):  
Vincent Grégoire ◽  
Wilfried De Neve ◽  
Avraham Eisbruch ◽  
Nancy Lee ◽  
Danielle Van den Weyngaert ◽  
...  

2013 ◽  
Vol 2013 ◽  
pp. 1-12 ◽  
Author(s):  
Vassilis Kouloulias ◽  
Stella Thalassinou ◽  
Kalliopi Platoni ◽  
Anna Zygogianni ◽  
John Kouvaris ◽  
...  

A descriptive analysis was made in terms of the related radiation induced acute and late mucositis and xerostomia along with survival and tumor control rates (significance level at 0.016, bonferroni correction), for irradiation in head and neck carcinomas with either 2D Radiation Therapy (2DRT) and 3D conformal (3DCRT) or Intensity Modulated Radiation Therapy (IMRT). The mean score of grade>II xerostomia for IMRT versus 2-3D RT was 0.31 ± 0.23 and 0.56 ± 0.23, respectively (Mann Whitney,P<0.001). The parotid-dose for IMRT versus 2-3D RT was 29.56 ± 5.45 and 50.73 ± 6.79, respectively (Mann Whitney,P=0.016). The reported mean parotid-gland doses were significantly correlated with late xerostomia (spearman test, rho = 0.5013,P<0.001). A trend was noted for the superiority of IMRT concerning the acute oral mucositis. The 3-year overall survival for either IMRT or 2-3DRT was 89.5% and 82.7%, respectively (P=0.026, Kruskal-Wallis test). The mean 3-year locoregional control rate was 83.6% (range: 70–97%) and 74.4 (range: 61–82%), respectively (P=0.025, Kruskal-Wallis). In conclusion, no significant differences in terms of locoregional control, overall survival and acute mucositis could be noted, while late xerostomia is definitely higher in 2-3D RT versus IMRT. Patients with head and neck carcinoma should be referred preferably to IMRT techniques.


Author(s):  
Yashaswini B. R. ◽  
Kumara Swamy

Background: This study was conducted to compare dosimetric parameters and dose to specific organs at risk (spinal cord and parotids) between intensity modulated radiation therapy (IMRT) and helical tomotherapy (HT) in head and neck squamous cell carcinomas (HNSCC).Methods: Thirty patients with histologically proven HNSCC were treated with chemo radiotherapy, to a dose of 60-70 Gray in 30-35 fractions. This study consists of two arms; IMRT arm and tomotherapy arm. Fifteen consecutive patients treated under IMRT and 15 patients were treated under helical tomotherapy, along with concurrent chemotherapy. PTV1 encompasses low risk planning target volume (PTV) which receives 50 Gy; PTV2 encompasses intermediate risk PTV which receives 54-60 Gy and PTV3 encompasses high risk PTV which receives 66-70 Gy. After completion of planning, dose to the organs at risk (OARs) and targets, homogeneity index and conformity index were evaluated, and tabulated.Results: On evaluation of plans we found that V95% in PTV1, PTV2 and PTV3 were 91.82%, 96.85% and 90.67% respectively for IMRT and 99.25%, 99.68% and 99.73% respectively for tomotherapy. For PTV3, V110% was 0.11% for IMRT and 0.01% for tomotherapy. Homogeneity index in IMRT arm was 0.285 and it was 0.206 in tomotherapy arm. Conformity index was found to be 1.04 for IMRT plans and 1.06 for tomotherapy plans. When mean dose to contra lateral parotids was evaluated, it was 26.91 Gy in IMRT arm and 25.97 Gy in tomotherapy arm. Max dose to spinal cord was better in tomotherapy (43.07 Gy in IMRT and 34.41 Gy in tomotherapy).Conclusions: There was statistically significant reduction in spinal cord maximum dose and point doses in tomotherapy plans compared to IMRT plans. The decrease in spinal cord dose can increase the tolerance reserve which can be useful in dose escalation or re-irradiation if required. There was also decrease in contra lateral parotid doses (not statistically significant). There was significant improvement in V95% in tomotherapy arm compared to IMRT arm, indicating the significantly superior coverage of target volumes in helical tomotherapy plans compared to IMRT plans. V110% (hot spots) inside the target was very minimal in tomotherapy arm compared to IMRT arm. Conformity index, homogeneity index between two arms were comparable.


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