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Optimizing laryngeal sparing with intensity modulated radiotherapy or volumetric modulated arc therapy for unilateral tonsil cancer.


ABSTRACT:

Background and purpose

Minimizing radiation dose exposure to nearby organs is key to limiting clinical toxicities associated with radiotherapy. Several treatment modalities such as split- or whole-field intensity-modulated radiotherapy (SF-IMRT, WF-IMRT) and volumetric modulated arc therapy (VMAT) are being used to treat tonsillar cancer patients with unilateral neck radiotherapy. Herein, we provide a modern dosimetric comparison of all three techniques.

Materials and methods

Forty patients with tonsillar cancer treated with definitive, ipsilateral neck SF-IMRT were evaluated. Each patient was re-planned with WF-IMRT and VMAT techniques, and doses to selected organs-at-risk (OARs) including the larynx, esophagus, and brainstem were compared.

Results

No significant differences in target coverage existed between plans; however, the heterogeneity index improved using WF-IMRT and VMAT relative to SF-IMRT. Compared to SF-IMRT, WF-IMRT and VMAT plans had significantly lower mean doses to the supraglottic larynx (31?Gy, 18.5?Gy, 17?Gy; p?ConclusionIn the setting of unilateral neck radiotherapy, WF-IMRT and VMAT plans can be optimized to significantly improve dose sparing of critical structures compared to SF-IMRT. VMAT offers additional advantages of shorter treatment times and fewer required monitor units.

SUBMITTER: Moreno AC 

PROVIDER: S-EPMC7807534 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature

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Publications

Optimizing laryngeal sparing with intensity modulated radiotherapy or volumetric modulated arc therapy for unilateral tonsil cancer.

Moreno Amy C AC   Wilke Christopher C   Wang He H   Tung Shi-Ming Samuel SS   Pollard Courtney C   Garden Adam S AS   Morrison William H WH   Rosenthal David I DI   Fuller Clifton D CD   Gunn Gary B GB   Reddy Jay P JP   Shah Shalin J SJ   Frank Steven J SJ   Takiar Vinita V   Phan Jack J  

Physics and imaging in radiation oncology 20190401


<h4>Background and purpose</h4>Minimizing radiation dose exposure to nearby organs is key to limiting clinical toxicities associated with radiotherapy. Several treatment modalities such as split- or whole-field intensity-modulated radiotherapy (SF-IMRT, WF-IMRT) and volumetric modulated arc therapy (VMAT) are being used to treat tonsillar cancer patients with unilateral neck radiotherapy. Herein, we provide a modern dosimetric comparison of all three techniques.<h4>Materials and methods</h4>Fort  ...[more]

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