scholarly journals Comparison of three and four-field radiotherapy technique and the effect of laryngeal shield on vocal and spinal cord radiation dose in radiotherapy of non-laryngeal head and neck tumors

2018 ◽  
Vol 24 (1) ◽  
pp. 25-31
Author(s):  
Noushin Hassan Pour ◽  
Alireza Farajollahi ◽  
Masoud Jamali ◽  
Ahad Zeinali ◽  
Amir Ghasemi Jangjou
Keyword(s):  
Spinal Cord ◽  
Head And Neck ◽  
Treatment Planning ◽  
Head And Neck Tumors ◽  
Planning System ◽  
Treatment Planning System ◽  
Field Methods ◽  
Normal Tissues ◽  
Neck Tumors ◽  
Significant Difference

AbstractIntroduction: Due to the effect of radiation on both the tumor and the surrounding normal tissues, the side effects of radiation in normal tissues are expected. One of the important complications in the head and neck radiotherapy is the doses reached to the larynx and spinal cord of patients with non-laryngeal head and neck tumors.Materials and Methods: In this study, CT scan images of 25 patients with non-laryngeal tumors including; lymph nodes, tongue, oropharynx and nasopharynx were used. A three-field and a four-field treatment planning with and without laryngeal shield in 3D CRT technique were planned for each patient. Subsequently, the values of Dmin, Dmean, Dmax and Dose Volume Histogram from the treatment planning system and NTCP values of spinal cord and larynx were calculated with BIOPLAN and MATLAB software for all patients.Results: Statistical results showed that mean values of doses of larynx in both three and four-field methods were significantly different between with and without shield groups. Comparison of absorbed dose didn’t show any difference between the three and four field methods (P>0.05). Using Shield, just the mean and minimum doses of spinal cord decreased in both three and four fields. The NTCP of the spinal cord and larynx by three and four-field methods with shield in the LKB and EUD models significantly are less than that of the three and four fields without shields, and in the four-field method NTCP of larynx is less than three radiation field.Conclusion: The results of this study indicate that there is no significant difference in doses reached to larynx and spinal cord between the treatments techniques, but laryngeal shield reduce dose and NTCP values in larynx considerably.

Quality assurance of volumetric-modulated arc therapy head and neck cancer treatment using PRESAGE® dosimeter

2018 ◽  
Vol 17 (4) ◽  
pp. 441-446 ◽  
Author(s):  
Jalil ur Rehman ◽  
Muhammad Isa ◽  
Nisar Ahmad ◽  
H. M. Noor ul Huda Khan Asghar ◽  
Zaheer A. Gilani ◽  
...  
Keyword(s):  
Quality Assurance ◽  
Cancer Treatment ◽  
Head And Neck ◽  
Treatment Planning ◽  
Volumetric Modulated Arc Therapy ◽  
Planning System ◽  
Treatment Planning System ◽  
Ct Scans ◽  
Arc Therapy ◽  
Calculated Dose

AbstractBackgroundAccurate three-dimensional dosimetry is essential in modern radiotherapy techniques such as volumetric-modulated arc therapy (VMAT) and intensity-modulated radiation therapy (IMRT). In this research work, the PRESAGE® dosimeter was used as quality assurance (QA) tool for VMAT planning for head and neck (H&N) cancer.Material and methodComputer tomography (CT) scans of an Image Radiation Oncology Core (IROC) H&N anthropomorphic phantom with both IROC standard insert and PRESAGE® insert were acquired separately. Both CT scans were imported into the Pinnacle (9.4 version) TPS for treatment planning, where the structures [planning target volume (PTV), organs at risk) and thermoluminescent detectors (TLDs) were manually contoured and used to optimise a VMAT plan. Treatment planning was done using VMAT (dual arc: 182°–178°, 178°–182°). Beam profile comparisons and gamma analysis were used to quantify agreement with film, PRESAGE® measurement and treatment planning system (TPS) calculated dose distribution.ResultsThe average ratio of TLD measured to calculated doses at the four PTV locations in the H&N phantom were between 0·95 to 0·99 for all three VMAT deliveries. Dose profiles were taken along the left–right, the anterior–posterior and superior–inferior axes, and good agreement was found between the PRESAGE® and Pinnacle profile. The mean value of gamma results for three VMAT deliveries in axial and sagittal planes were found to be 94·24 and 93·16% when compared with film and Pinnacle, respectively. The average values comparing the PRESAGE® results and dose values calculated on Pinnacle were observed to be 95·29 and 94·38% in the said planes, respectively, using a 5%/3 mm gamma criteria.ConclusionThe PRESAGE® dose measurements and calculated dose of pinnacle show reasonable agreement in both axial and sagittal planes for complex dual arc VMAT treatment plans. In general, the PRESAGE® dosimeter is found to be a feasible QA tool of VMAT plan for H&N cancer treatment.

scholarly journals Benchmarking techniques for stereotactic body radiotherapy for early-stage glottic laryngeal cancer: LINAC-based non-coplanar VMAT vs. Cyberknife planning

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
You Zhang ◽  
Tsuicheng Chiu ◽  
Jeffrey Dubas ◽  
Zhen Tian ◽  
Pam Lee ◽  
...  
Keyword(s):  
Treatment Planning ◽  
Laryngeal Cancer ◽  
Statistical Significance ◽  
Dose Calculation ◽  
Monte Carlo Algorithm ◽  
Planning System ◽  
Treatment Planning System ◽  
Conformity Index ◽  
Plan Quality ◽  
Significant Difference

Abstract Introduction Stereotactic body radiation therapy (SBRT) was found effective in treating laryngeal cancer with only five treatment fractions by a recent clinical trial (NCT01984502, ClinicalTrials.gov). Nevertheless, this trial used the Cyberknife system, which is not widely accessible enough to benefit all patients affected by laryngeal cancer. Our study investigates the feasibility of larynx SBRT treatment planning on a conventional gantry-based LINAC and compares its plan quality with that from the Cyberknife. Materials & methods Ten larynx SBRT cases were originally treated by Cyberknife using fixed cones in our institution, with plans created and optimized using the Monte-Carlo algorithm in the MultiPlan treatment planning system. These cases were retrospectively planned in the Eclipse planning system for a LINAC with the same prescription dose. We used volumetric modulated arc therapy (VMAT) for larynx SBRT planning in Eclipse and incorporated non-coplanar arcs to approach the Cyberknife’s large solid angle delivery space. We used both anisotropic analytical algorithm (AAA) and Acuros XB (AXB) algorithm for dose calculation and compared their accuracy by measurements on an in-house larynx phantom. We compared the LINAC VMAT plans (VMAT-AAA and VMAT-AXB) with the original Cyberknife plans using dosimetric endpoints such as the conformity index, gradient indices (R50, R20), OAR maximum/mean doses, and the monitor units. Results Phantom measurement showed that both the AAA and the AXB algorithms provided adequate dose calculation accuracy (94.7% gamma pass rate on 2%/2 mm criteria for AAA vs. 97.3% for AXB), though AXB provided better accuracy in the air cavity. The LINAC-based VMAT plans achieved similar dosimetric endpoints as the Cyberknife planning, and all plans met the larynx SBRT dosimetric constraints. Cyberknife plans achieved an average conformity index of 1.13, compared to 1.20 of VMAT-AXB and 1.19 of VMAT-AAA. The VMAT plans spared the thyroid gland better with average Dmean of 2.4 Gy (VMAT-AXB) and 2.7 Gy (VMAT-AAA), as compared to 4.3 Gy for Cyberknife plans. The VMAT-AAA plans had a slightly lower contralateral arytenoid Dmax (average: 15.2 Gy) than Cyberknife plans (average: 17.9 Gy) with statistical significance, while the contralateral arytenoid Dmax was similar between VMAT-AXB and Cyberknife plans with no statistically significant difference. Cyberknife plans offered slightly better R50 (average: 5.0) than VMAT-AXB (5.9) and VMAT-AAA (5.7) plans. The VMAT plans substantially reduced the plan MUs to less than 1/3 of the Cyberknife plans, and the differences were statistically significant. The other metrics were similar between VMAT and Cyberknife plans with no statistically significant differences. Conclusions Gantry-based LINACs can achieve similar plan quality to Cyberknife systems. Treatment outcome with both methods remains to be investigated.

Validation of a deformable image registration produced by a commercial treatment planning system in head and neck

2015 ◽  
Vol 31 (3) ◽  
pp. 219-223 ◽  
Author(s):  
Rafael García-Mollá ◽  
Noelia de Marco-Blancas ◽  
Jorge Bonaque ◽  
Laura Vidueira ◽  
Juan López-Tarjuelo ◽  
...  
Keyword(s):  
Image Registration ◽  
Head And Neck ◽  
Treatment Planning ◽  
Deformable Image Registration ◽  
Planning System ◽  
Treatment Planning System

scholarly journals Verifying the accuracy of 3D-CRT dose distributions calculated by the Prowess Panther treatment planning system (TPS) with Monte Carlo (MC) simulation for head-and-neck (H&N) patients

2019 ◽  
Vol 3 (2) ◽  
pp. 90-99
Author(s):  
Luong Thi Oanh ◽  
Duong Thanh Tai ◽  
Hoang Duc Tuan ◽  
Truong Thi Hong Loan
Keyword(s):  
Monte Carlo ◽  
Head And Neck ◽  
Treatment Planning ◽  
Planning System ◽  
Treatment Planning System ◽  
Average Dose ◽  
Monte Carlo Code ◽  
Dose Distributions ◽  
Mc Simulation ◽  
3D Crt

The purpose of this study is to verify and compare the three Dimensional Conformal Radiation Therapy (3D-CRT) dose distributions calculated by the Prowess Panther treatment planning system (TPS) with Monte Carlo (MC) simulation for head-and-neck (H&N) patients. In this study, we used the EGSnrc Monte Carlo code which includes BEAMnrc and DOSXYZnrc programs. Firstly, the clinical 6 MV photon beams form Siemens Primus linear accelerator at Dong Nai General Hospital were simulated using the BEAMnrc. Secondly, the absorbed dose to patients treated by 3D-CRT was computed using the DOSXYZnrc. Finally, the simulated dose distributions were then compared with the ones calculated by the Fast Photon Effective algorithm on the TPS, using the relative dose error comparison and the gamma index using global methods implemented in PTW-VeriSoft with 3%/3 mm. There is a good agreement between the MC and TPS dose. The average gamma passing rates were 92.8% based on the 3%/3 mm. The average dose in the PTV agreed well between the TPS with 0.97% error. MC predict dose was higher than the mean dose to the parotid glands and spinal cord compared to TPS. We have implemented the EGSnrc-based Monte Carlo simulation to verify the 3D-CRT plans generated by Prowess Panther TPS. Our results showed that the TPS agreed with the one of MC.  

scholarly journals Prognostic Worth of Epidermal Growth Factor Receptor (EGFR) in Patients with Head and Neck Tumors

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Precious Barnes ◽  
F. A. Yeboah ◽  
Jinling Zhu ◽  
Roland Osei Saahene ◽  
Christian Obirikorang ◽  
...  
Keyword(s):  
Epidermal Growth Factor Receptor ◽  
Growth Factor ◽  
Epidermal Growth Factor ◽  
Head And Neck ◽  
Growth Factor Receptor ◽  
Head And Neck Tumors ◽  
Neck Tumors ◽  
Egfr Expression ◽  
Significant Difference ◽  
Epidermal Growth

Introduction. Head and neck tumors (HNT) are tumors that normally occur at the head and neck region of the body. Epidermal growth factor receptor (EGFR) has been found to be highly expressed in breast and other tumors; therefore, there is the need to investigate the level of EGFR expression among patients with head and neck tumors in Ghana. Method. The level of EGFR expression was determined in head and neck tumor and control head and neck tissues with quantitative real-time PCR and immunohistochemistry analysis. Results. The level of EGFR expressions was high in tumor tissues than in the control tissues. There was a significant difference of p value 0.025 among the ages >40 and ≤ 40 when the high and low level of EGFR was compared in the head and neck malignant tumor. The area under the curve for the high expression of EGFR among the malignant head and neck tumors was 0.901 with a specificity of 86.4%. Conclusion. EGFR can serve as a prognostic marker in monitoring patients with HNT as well as a molecular therapeutic target.

scholarly journals Application of dose-volume histogram prediction in biologically related models for nasopharyngeal carcinomas treatment planning

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Wufei Cao ◽  
Yongdong Zhuang ◽  
Lixin Chen ◽  
Xiaowei Liu
Keyword(s):  
Spinal Cord ◽  
At Risk ◽  
Treatment Planning ◽  
Organs At Risk ◽  
Planning System ◽  
Treatment Planning System ◽  
Dose Volume Histogram ◽  
Parotid Glands ◽  
Dose Volume ◽  
Dose Sparing

Abstract Purpose In this study, we employed a gated recurrent unit (GRU)-based recurrent neural network (RNN) using dosimetric information induced by individual beam to predict the dose-volume histogram (DVH) and investigated the feasibility and usefulness of this method in biologically related models for nasopharyngeal carcinomas (NPC) treatment planning. Methods and materials One hundred patients with NPC undergoing volumetric modulated arc therapy (VMAT) between 2018 and 2019 were randomly selected for this study. All the VMAT plans were created using the Monaco treatment planning system (Elekta, Sweden) and clinically approved: > 98% of PGTVnx received the prescribed doses of 70 Gy, > 98% of PGTVnd received the prescribed doses of 66 Gy and > 98% of PCTV received 60 Gy. Of these, the data from 80 patients were used to train the GRU-RNN, and the data from the other 20 patients were used for testing. For each NPC patient, the DVHs of different organs at risk were predicted by a trained GRU-based RNN using the information given by individual conformal beams. Based on the predicted DVHs, the equivalent uniform doses (EUD) were calculated and applied as dose constraints during treatment planning optimization. The regenerated VMAT experimental plans (EPs) were evaluated by comparing them with the clinical plans (CPs). Results For the 20 test patients, the regenerated EPs guided by the GRU-RNN predictive model achieved good consistency relative to the CPs. The EPs showed better consistency in PTV dose distribution and better dose sparing for many organs at risk, and significant differences were found in the maximum/mean doses to the brainstem, brainstem PRV, spinal cord, lenses, temporal lobes, parotid glands and larynx with P-values < 0.05. On average, compared with the CPs, the maximum/mean doses to these OARs were altered by − 3.44 Gy, − 1.94 Gy, − 1.88 Gy, 0.44 Gy, 1.98 Gy, − 1.82 Gy and 2.27 Gy, respectively. In addition, significant differences were also found in brainstem and spinal cord for the dose received by 1 cc volume with 4.11 and 1.67 Gy dose reduction in EPs on average. Conclusion The GRU-RNN-based DVH prediction method was capable of accurate DVH prediction. The regenerated plans guided by the predicted EUDs were not inferior to the manual plans, had better consistency in PTVs and better dose sparing in critical OARs, indicating the usefulness and effectiveness of biologically related model in knowledge-based planning.

PO-1883 Evaluation of an automated treatment planning system for head and neck treatment

2021 ◽  
Vol 161 ◽  
pp. S1603-S1604
Author(s):  
L. calmels ◽  
D. Sjöström ◽  
Z. Pohl ◽  
P. Sibolt
Keyword(s):  
Head And Neck ◽  
Treatment Planning ◽  
Planning System ◽  
Treatment Planning System
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