Helical Tomotherapy for Radiotherapy in Esophageal Cancer: A Preferred Plan With Better Conformal Target Coverage and More Homogeneous Dose Distribution

Journal Article · Mon Oct 01 00:00:00 EDT 2007 · Medical Dosimetry

DOI:https://doi.org/10.1016/j.meddos.2006.12.003· OSTI ID:21045969

Yijen, Chen; An, Liu; Chunhui, Han; Tsai, Peter T; Schultheiss, Timothy E; Pezner, Richard D; Vora, Nilesh ^[1]; Lim, Dean; Shibata, Stephen ^[2]; Kernstine, Kemp H ^[3]; Wong, Jeffrey Y C

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1. Internal Medicine, Harbor-UCLA Medical Center, Torrance, CA (United States)
2. Division of Radiation Oncology, Medical Oncology, City of Hope National Medical Center, Duarte, CA (United States)
3. Division of Radiation Oncology Thoracic Surgery, City of Hope National Medical Center, Duarte, CA (United States)

We compare different radiotherapy techniques-helical tomotherapy (tomotherapy), step-and-shoot IMRT (IMRT), and 3-dimensional conformal radiotherapy (3DCRT)-for patients with mid-distal esophageal carcinoma on the basis of dosimetric analysis. Six patients with locally advanced mid-distal esophageal carcinoma were treated with neoadjuvant chemoradiation followed by surgery. Radiotherapy included 50 Gy to gross planning target volume (PTV) and 45 Gy to elective PTV in 25 fractions. Tomotherapy, IMRT, and 3DCRT plans were generated. Dose-volume histograms (DVHs), homogeneity index (HI), volumes of lung receiving more than 10, 15, or 20 Gy (V{sub 10}, V{sub 15}, V{sub 20}), and volumes of heart receiving more than 30 or 45 Gy (V{sub 30}, V{sub 45}) were determined. Statistical analysis was performed by paired t-tests. By isodose distributions and DVHs, tomotherapy plans showed sharper dose gradients, more conformal coverage, and better HI for both gross and elective PTVs compared with IMRT or 3DCRT plans. Mean V{sub 20} of lung was significantly reduced in tomotherapy plans. However, tomotherapy and IMRT plans resulted in larger V{sub 10} of lung compared to 3DCRT plans. The heart was significantly spared in tomotherapy and IMRT plans compared to 3DCRT plans in terms of V{sub 30} and V{sub 45}. We conclude that tomotherapy plans are superior in terms of target conformity, dose homogeneity, and V{sub 20} of lung.

• OSTI ID: 21045969
• Journal Information: Medical Dosimetry, Journal Name: Medical Dosimetry Journal Issue: 3 Vol. 32; ISSN 0958-3947; ISSN MEDOEJ
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARCINOMAS
COMPUTERIZED TOMOGRAPHY
CT-GUIDED RADIOTHERAPY
HEART
LUNGS
PATIENTS
RADIATION DOSE DISTRIBUTIONS
RADIATION DOSES
SURGERY