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Influence of FDG-PET on Computed Tomography-Based Radiotherapy Planning for Locally Recurrent Nasopharyngeal Carcinoma

Journal Article · · International Journal of Radiation Oncology, Biology and Physics
 [1]; ; ;  [2];  [1]; ; ;  [3]
  1. Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou (China)
  2. Department of Nuclear Medicine, Nanfang Hospital, Southern Medical University, Guangzhou (China)
  3. Department of Radiology, Nanfang Hospital, Southern Medical University, Guangzhou (China)

Purpose: Assuming F-18-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET)/computed tomography (CT) to be more accurate in representing the true disease extent than CT alone, we prospectively designed this study to evaluate how the addition of FDG-PET influences CT-based radiotherapy planning for locally recurrent nasopharyngeal carcinoma. Patients and Methods: All patients underwent FDG-PET/CT simulation scans. For each patient, the gross tumor volume (GTV) was separately delineated with or without the addition of PET information and defined as GTV{sub PET/CT} and GTV{sub CT}, respectively. Corresponding planning target volumes (PTV) were generated for the GTV{sub CT} (PTV{sub CT}) and GTV{sub PET/CT} (PTV{sub PET/CT}). Three-dimensional conformal radiotherapy plans were separately created for PTV{sub CT} and PTV{sub PET/CT}. To assess the potential geographic miss of the PET/CT-based disease in CT-based treatment planning, the size and location of the GTV{sub PET/CT}, PTV{sub PET/CT}, and PTV{sub CT} were analyzed, and the three-dimensional conformal radiotherapy plans created using the PTV{sub CT} were evaluated with the GTV{sub PET/CT} and PTV{sub PET/CT} information. Results: A total of 43 patients were enrolled in this study. Distant metastasis was found in 4 patients with the addition of the PET information. The 39 patients without distant metastasis proceeded to three-dimensional conformal radiotherapy planning. Inadequate coverage of the GTV{sub PET/CT} and PTV{sub PET/CT} by the PTV{sub CT} occurred in 7 (18%) and 20 (51%) patients, respectively. This resulted in <95% of the GTV{sub PET/CT} and PTV{sub PET/CT} receiving {>=}95% of the prescribed dose in 4 (10%) and 13 (33%) patients, respectively. Conclusions: The addition of FDG-PET information might influence CT-based radiotherapy planning for locally recurrent nasopharyngeal carcinoma by altering the definition of the target volume, with the potential to avoid a geographic miss of true disease.

OSTI ID:
21039657
Journal Information:
International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 5 Vol. 69; ISSN IOBPD3; ISSN 0360-3016
Country of Publication:
United States
Language:
English

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