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Title: A comparative study of standard intensity-modulated radiotherapy and RapidArc planning techniques for ipsilateral and bilateral head and neck irradiation

Abstract

The purpose of this study was to investigate class solutions using RapidArc volumetric-modulated arc therapy (VMAT) planning for ipsilateral and bilateral head and neck (H&N) irradiation, and to compare dosimetric results with intensity-modulated radiotherapy (IMRT) plans. A total of 14 patients who received ipsilateral and 10 patients who received bilateral head and neck irradiation were retrospectively replanned with several volumetric-modulated arc therapy techniques. For ipsilateral neck irradiation, the volumetric-modulated arc therapy techniques included two 360° arcs, two 360° arcs with avoidance sectors around the contralateral parotid, two 260° or 270° arcs, and two 210° arcs. For bilateral neck irradiation, the volumetric-modulated arc therapy techniques included two 360° arcs, two 360° arcs with avoidance sectors around the shoulders, and 3 arcs. All patients had a sliding-window-delivery intensity-modulated radiotherapy plan that was used as the benchmark for dosimetric comparison. For ipsilateral neck irradiation, a volumetric-modulated arc therapy technique using two 360° arcs with avoidance sectors around the contralateral parotid was dosimetrically comparable to intensity-modulated radiotherapy, with improved conformity (conformity index = 1.22 vs 1.36, p < 0.04) and lower contralateral parotid mean dose (5.6 vs 6.8 Gy, p < 0.03). For bilateral neck irradiation, 3-arc volumetric-modulated arc therapy techniques were dosimetrically comparablemore » to intensity-modulated radiotherapy while also avoiding irradiation through the shoulders. All volumetric-modulated arc therapy techniques required fewer monitor units than sliding-window intensity-modulated radiotherapy to deliver treatment, with an average reduction of 35% for ipsilateral plans and 67% for bilateral plans. Thus, for ipsilateral head and neck irradiation a volumetric-modulated arc therapy technique using two 360° arcs with avoidance sectors around the contralateral parotid is recommended. For bilateral neck irradiation, 2- or 3-arc techniques are dosimetrically comparable to intensity-modulated radiotherapy, but more work is needed to determine the optimal approaches by disease site.« less

Authors:
 [1];  [2]; ; ;  [1];  [1];  [2];  [1]
  1. Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women's Hospital, Boston, MA (United States)
  2. (United States)
Publication Date:
OSTI Identifier:
22685178
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Dosimetry; Journal Volume: 42; Journal Issue: 1; Other Information: Copyright (c) 2017 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
61 RADIATION PROTECTION AND DOSIMETRY; 62 RADIOLOGY AND NUCLEAR MEDICINE; AVOIDANCE; BENCHMARKS; COMPARATIVE EVALUATIONS; DELIVERY; DOSES; DOSIMETRY; HEAD; IRRADIATION; MONITORS; NECK; NEOPLASMS; PATIENTS; PLANNING; RADIOTHERAPY; STANDARDS

Citation Formats

Pursley, Jennifer, E-mail: jpursley@mgh.harvard.edu, Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA, Damato, Antonio L., Czerminska, Maria A., Margalit, Danielle N., Sher, David J., Department of Radiation Oncology, UT Southwestern Medical Center, Dallas, TX, and Tishler, Roy B. A comparative study of standard intensity-modulated radiotherapy and RapidArc planning techniques for ipsilateral and bilateral head and neck irradiation. United States: N. p., 2017. Web. doi:10.1016/J.MEDDOS.2016.10.004.
Pursley, Jennifer, E-mail: jpursley@mgh.harvard.edu, Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA, Damato, Antonio L., Czerminska, Maria A., Margalit, Danielle N., Sher, David J., Department of Radiation Oncology, UT Southwestern Medical Center, Dallas, TX, & Tishler, Roy B. A comparative study of standard intensity-modulated radiotherapy and RapidArc planning techniques for ipsilateral and bilateral head and neck irradiation. United States. doi:10.1016/J.MEDDOS.2016.10.004.
Pursley, Jennifer, E-mail: jpursley@mgh.harvard.edu, Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA, Damato, Antonio L., Czerminska, Maria A., Margalit, Danielle N., Sher, David J., Department of Radiation Oncology, UT Southwestern Medical Center, Dallas, TX, and Tishler, Roy B. Sat . "A comparative study of standard intensity-modulated radiotherapy and RapidArc planning techniques for ipsilateral and bilateral head and neck irradiation". United States. doi:10.1016/J.MEDDOS.2016.10.004.
@article{osti_22685178,
title = {A comparative study of standard intensity-modulated radiotherapy and RapidArc planning techniques for ipsilateral and bilateral head and neck irradiation},
author = {Pursley, Jennifer, E-mail: jpursley@mgh.harvard.edu and Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA and Damato, Antonio L. and Czerminska, Maria A. and Margalit, Danielle N. and Sher, David J. and Department of Radiation Oncology, UT Southwestern Medical Center, Dallas, TX and Tishler, Roy B.},
abstractNote = {The purpose of this study was to investigate class solutions using RapidArc volumetric-modulated arc therapy (VMAT) planning for ipsilateral and bilateral head and neck (H&N) irradiation, and to compare dosimetric results with intensity-modulated radiotherapy (IMRT) plans. A total of 14 patients who received ipsilateral and 10 patients who received bilateral head and neck irradiation were retrospectively replanned with several volumetric-modulated arc therapy techniques. For ipsilateral neck irradiation, the volumetric-modulated arc therapy techniques included two 360° arcs, two 360° arcs with avoidance sectors around the contralateral parotid, two 260° or 270° arcs, and two 210° arcs. For bilateral neck irradiation, the volumetric-modulated arc therapy techniques included two 360° arcs, two 360° arcs with avoidance sectors around the shoulders, and 3 arcs. All patients had a sliding-window-delivery intensity-modulated radiotherapy plan that was used as the benchmark for dosimetric comparison. For ipsilateral neck irradiation, a volumetric-modulated arc therapy technique using two 360° arcs with avoidance sectors around the contralateral parotid was dosimetrically comparable to intensity-modulated radiotherapy, with improved conformity (conformity index = 1.22 vs 1.36, p < 0.04) and lower contralateral parotid mean dose (5.6 vs 6.8 Gy, p < 0.03). For bilateral neck irradiation, 3-arc volumetric-modulated arc therapy techniques were dosimetrically comparable to intensity-modulated radiotherapy while also avoiding irradiation through the shoulders. All volumetric-modulated arc therapy techniques required fewer monitor units than sliding-window intensity-modulated radiotherapy to deliver treatment, with an average reduction of 35% for ipsilateral plans and 67% for bilateral plans. Thus, for ipsilateral head and neck irradiation a volumetric-modulated arc therapy technique using two 360° arcs with avoidance sectors around the contralateral parotid is recommended. For bilateral neck irradiation, 2- or 3-arc techniques are dosimetrically comparable to intensity-modulated radiotherapy, but more work is needed to determine the optimal approaches by disease site.},
doi = {10.1016/J.MEDDOS.2016.10.004},
journal = {Medical Dosimetry},
number = 1,
volume = 42,
place = {United States},
year = {Sat Apr 01 00:00:00 EDT 2017},
month = {Sat Apr 01 00:00:00 EDT 2017}
}