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Title: Radiation treatment planning techniques for lymphoma of the stomach

Abstract

Purpose: Involved-field radiation therapy of the stomach is often used in the curative treatment of gastric lymphoma. Yet, the optimal technique to irradiate the stomach with minimal morbidity has not been well established. This study was designed to evaluate treatment planning alternatives for stomach irradiation, including intensity-modulated radiation therapy (IMRT), to determine which approach resulted in improved dose distribution and to identify patient-specific anatomic factors that might influence a treatment planning choice. Methods and Materials: Fifteen patients with lymphoma of the stomach (14 mucosa-associated lymphoid tissue lymphomas and 1 diffuse large B-cell lymphoma) were categorized into 3 types, depending on the geometric relationship between the planning target volume (PTV) and kidneys. AP/PA and 3D conformal radiation therapy (3DCRT) plans were generated for each patient. IMRT was planned for 4 patients with challenging geometric relationship between the PTV and the kidneys to determine whether it was advantageous to use IMRT. Results: For type I patients (no overlap between PTV and kidneys), there was essentially no benefit from using 3DCRT over AP/PA. However, for patients with PTVs in close proximity to the kidneys (type II) or with high degree of overlap (type III), the 4-field 3DCRT plans were superior, reducing the kidneymore » V {sub 15Gy} by approximately 90% for type II and 50% for type III patients. For type III, the use of a 3DCRT plan rather than an AP/PA plan decreased the V {sub 15Gy} by approximately 65% for the right kidney and 45% for the left kidney. In the selected cases, IMRT led to a further decrease in left kidney dose as well as in mean liver dose. Conclusions: The geometric relationship between the target and kidneys has a significant impact on the selection of the optimum beam arrangement. Using 4-field 3DCRT markedly decreases the kidney dose. The addition of IMRT led to further incremental improvements in the left kidney and liver dose in selected patients.« less

Authors:
 [1];  [1];  [1];  [2];  [3]
  1. Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)
  2. Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)
  3. Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States). E-mail: yahalomj@mskcc.org
Publication Date:
OSTI Identifier:
20698574
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 62; Journal Issue: 3; Other Information: DOI: 10.1016/j.ijrobp.2004.10.025; PII: S0360-3016(04)02816-0; Copyright (c) 2005 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; DISEASE INCIDENCE; IRRADIATION; KIDNEYS; LIVER; LYMPHOMAS; MUCOUS MEMBRANES; PATIENTS; PLANNING; RADIATION DOSE DISTRIBUTIONS; RADIATION DOSES; RADIOTHERAPY; STOMACH

Citation Formats

Della Biancia, Cesar, Hunt, Margie, Furhang, Eli, Wu, Elisa, and Yahalom, Joachim. Radiation treatment planning techniques for lymphoma of the stomach. United States: N. p., 2005. Web. doi:10.1016/j.ijrobp.2004.10.025.
Della Biancia, Cesar, Hunt, Margie, Furhang, Eli, Wu, Elisa, & Yahalom, Joachim. Radiation treatment planning techniques for lymphoma of the stomach. United States. doi:10.1016/j.ijrobp.2004.10.025.
Della Biancia, Cesar, Hunt, Margie, Furhang, Eli, Wu, Elisa, and Yahalom, Joachim. Fri . "Radiation treatment planning techniques for lymphoma of the stomach". United States. doi:10.1016/j.ijrobp.2004.10.025.
@article{osti_20698574,
title = {Radiation treatment planning techniques for lymphoma of the stomach},
author = {Della Biancia, Cesar and Hunt, Margie and Furhang, Eli and Wu, Elisa and Yahalom, Joachim},
abstractNote = {Purpose: Involved-field radiation therapy of the stomach is often used in the curative treatment of gastric lymphoma. Yet, the optimal technique to irradiate the stomach with minimal morbidity has not been well established. This study was designed to evaluate treatment planning alternatives for stomach irradiation, including intensity-modulated radiation therapy (IMRT), to determine which approach resulted in improved dose distribution and to identify patient-specific anatomic factors that might influence a treatment planning choice. Methods and Materials: Fifteen patients with lymphoma of the stomach (14 mucosa-associated lymphoid tissue lymphomas and 1 diffuse large B-cell lymphoma) were categorized into 3 types, depending on the geometric relationship between the planning target volume (PTV) and kidneys. AP/PA and 3D conformal radiation therapy (3DCRT) plans were generated for each patient. IMRT was planned for 4 patients with challenging geometric relationship between the PTV and the kidneys to determine whether it was advantageous to use IMRT. Results: For type I patients (no overlap between PTV and kidneys), there was essentially no benefit from using 3DCRT over AP/PA. However, for patients with PTVs in close proximity to the kidneys (type II) or with high degree of overlap (type III), the 4-field 3DCRT plans were superior, reducing the kidney V {sub 15Gy} by approximately 90% for type II and 50% for type III patients. For type III, the use of a 3DCRT plan rather than an AP/PA plan decreased the V {sub 15Gy} by approximately 65% for the right kidney and 45% for the left kidney. In the selected cases, IMRT led to a further decrease in left kidney dose as well as in mean liver dose. Conclusions: The geometric relationship between the target and kidneys has a significant impact on the selection of the optimum beam arrangement. Using 4-field 3DCRT markedly decreases the kidney dose. The addition of IMRT led to further incremental improvements in the left kidney and liver dose in selected patients.},
doi = {10.1016/j.ijrobp.2004.10.025},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 3,
volume = 62,
place = {United States},
year = {2005},
month = {7}
}