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Title: Intensity-modulated radiotherapy (IMRT) and conventional three-dimensional conformal radiotherapy for high-grade gliomas: Does IMRT increase the integral dose to normal brain?

Abstract

Purpose: To determine whether intensity-modulated radiotherapy (IMRT) treatment increases the total integral dose of nontarget tissue relative to the conventional three-dimensional conformal radiotherapy (3D-CRT) technique for high-grade gliomas. Methods and Materials: Twenty patients treated with 3D-CRT for glioblastoma multiforme were selected for a comparative dosimetric evaluation with IMRT. Original target volumes, organs at risk (OAR), and dose-volume constraints were used for replanning with IMRT. Predicted isodose distributions, cumulative dose-volume histograms of target volumes and OAR, normal tissue integral dose, target coverage, dose conformity, and normal tissue sparing with 3D-CRT and IMRT planning were compared. Statistical analyses were performed to determine differences. Results: In all 20 patients, IMRT maintained equivalent target coverage, improved target conformity (conformity index [CI] 95% 1.52 vs. 1.38, p < 0.001), and enabled dose reductions of normal tissues, including brainstem (D{sub mean} by 19.8% and D{sub max} by 10.7%), optic chiasm (D{sub mean} by 25.3% and D{sub max} by 22.6%), right optic nerve (D{sub mean} by 37.3% and D{sub max} by 28.5%), and left optic nerve (D{sub mean} by 40.6% and D{sub max} by 36.7%), p {<=} 0.01. This was achieved without increasing the total nontarget integral dose by greater than 0.5%. Overall, total integral dose wasmore » reduced by 7-10% with IMRT, p < 0.001, without significantly increasing the 0.5-5 Gy low-dose volume. Conclusions: These results indicate that IMRT treatment for high-grade gliomas allows for improved target conformity, better critical tissue sparing, and importantly does so without increasing integral dose and the volume of normal tissue exposed to low doses of radiation.« less

Authors:
 [1];  [2];  [2];  [1];  [1];  [3]
  1. Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)
  2. Department of Radiation Physics, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)
  3. Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States). E-mail: SYWoo@mdanderson.org
Publication Date:
OSTI Identifier:
20944773
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 67; Journal Issue: 4; Other Information: DOI: 10.1016/j.ijrobp.2006.10.032; PII: S0360-3016(06)03341-4; Copyright (c) 2007 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BRAIN; EVALUATION; GLIOMAS; HEALTH HAZARDS; INTEGRAL DOSES; PATIENTS; PLANNING; RADIOTHERAPY

Citation Formats

Hermanto, Ulrich, Frija, Erik K., Lii, MingFwu J., Chang, Eric L., Mahajan, Anita, and Woo, Shiao Y. Intensity-modulated radiotherapy (IMRT) and conventional three-dimensional conformal radiotherapy for high-grade gliomas: Does IMRT increase the integral dose to normal brain?. United States: N. p., 2007. Web. doi:10.1016/j.ijrobp.2006.10.032.
Hermanto, Ulrich, Frija, Erik K., Lii, MingFwu J., Chang, Eric L., Mahajan, Anita, & Woo, Shiao Y. Intensity-modulated radiotherapy (IMRT) and conventional three-dimensional conformal radiotherapy for high-grade gliomas: Does IMRT increase the integral dose to normal brain?. United States. doi:10.1016/j.ijrobp.2006.10.032.
Hermanto, Ulrich, Frija, Erik K., Lii, MingFwu J., Chang, Eric L., Mahajan, Anita, and Woo, Shiao Y. Thu . "Intensity-modulated radiotherapy (IMRT) and conventional three-dimensional conformal radiotherapy for high-grade gliomas: Does IMRT increase the integral dose to normal brain?". United States. doi:10.1016/j.ijrobp.2006.10.032.
@article{osti_20944773,
title = {Intensity-modulated radiotherapy (IMRT) and conventional three-dimensional conformal radiotherapy for high-grade gliomas: Does IMRT increase the integral dose to normal brain?},
author = {Hermanto, Ulrich and Frija, Erik K. and Lii, MingFwu J. and Chang, Eric L. and Mahajan, Anita and Woo, Shiao Y.},
abstractNote = {Purpose: To determine whether intensity-modulated radiotherapy (IMRT) treatment increases the total integral dose of nontarget tissue relative to the conventional three-dimensional conformal radiotherapy (3D-CRT) technique for high-grade gliomas. Methods and Materials: Twenty patients treated with 3D-CRT for glioblastoma multiforme were selected for a comparative dosimetric evaluation with IMRT. Original target volumes, organs at risk (OAR), and dose-volume constraints were used for replanning with IMRT. Predicted isodose distributions, cumulative dose-volume histograms of target volumes and OAR, normal tissue integral dose, target coverage, dose conformity, and normal tissue sparing with 3D-CRT and IMRT planning were compared. Statistical analyses were performed to determine differences. Results: In all 20 patients, IMRT maintained equivalent target coverage, improved target conformity (conformity index [CI] 95% 1.52 vs. 1.38, p < 0.001), and enabled dose reductions of normal tissues, including brainstem (D{sub mean} by 19.8% and D{sub max} by 10.7%), optic chiasm (D{sub mean} by 25.3% and D{sub max} by 22.6%), right optic nerve (D{sub mean} by 37.3% and D{sub max} by 28.5%), and left optic nerve (D{sub mean} by 40.6% and D{sub max} by 36.7%), p {<=} 0.01. This was achieved without increasing the total nontarget integral dose by greater than 0.5%. Overall, total integral dose was reduced by 7-10% with IMRT, p < 0.001, without significantly increasing the 0.5-5 Gy low-dose volume. Conclusions: These results indicate that IMRT treatment for high-grade gliomas allows for improved target conformity, better critical tissue sparing, and importantly does so without increasing integral dose and the volume of normal tissue exposed to low doses of radiation.},
doi = {10.1016/j.ijrobp.2006.10.032},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 4,
volume = 67,
place = {United States},
year = {Thu Mar 15 00:00:00 EDT 2007},
month = {Thu Mar 15 00:00:00 EDT 2007}
}