Three-dimensional treatment planning for para-aortic node irradiation in patients with cervical cancer

Journal Article · Wed May 15 00:00:00 EDT 1991 · International Journal of Radiation Oncology, Biology and Physics; (USA)

DOI:https://doi.org/10.1016/0360-3016(91)90181-3· OSTI ID:5603329

Munzenrider, J E; Doppke, K P; Brown, A P; Burman, C; Cheng, E; Chu, J; Chui, C; Drzymala, R E; Goitein, M; Manolis, J M ^[1]

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1. Massachusetts General Hospital, Boston, MA (USA)

Three-dimensional treatment planning has been used by four cooperating centers to prepare and analyze multiple treatment plans on two cervix cancer patients. One patient had biopsy-proven and CT-demonstrable metastasis to the para-aortic nodes, while the other was at high risk for metastatic involvement of para-aortic nodes. Volume dose distributions were analyzed, and an attempt was made to define the role of 3-D treatment planning to the para-aortic region, where moderate to high doses (50-66 Gy) are required to sterilize microscopic and gross metastasis. Plans were prepared using the 3-D capabilities for tailoring fields to the target volumes, but using standard field arrangements (3-D standard), and with full utilization of the 3-D capabilities (3-D unconstrained). In some but not all 3-D unconstrained plans, higher doses were delivered to the large nodal volume and to the volume containing gross nodal disease than in plans analyzed but not prepared with full 3-D capability (3-D standard). The small bowel was the major dose limiting organ. Its tolerance would have been exceeded in all plans which prescribed 66 Gy to the gross nodal mass, although some reduction in small bowel near-maximum dose was achieved in the 3-D unconstrained plans. All plans were able to limit doses to other normal organs to tolerance levels or less, with significant reductions seen in doses to spinal cord, kidneys, and large bowel in the 3-D unconstrained plans, as compared to the 3-D standard plans. A high probability of small bowel injury was detected in one of four 3-D standard plans prescribed to receive 50 Gy to the large para-aortic nodal volume; the small bowel dose was reduced to an acceptable level in the corresponding 3-D unconstrained plan. An optimum beam energy for treating this site was not identified, with plans using 4, 6, 10, 15, 18, and 25 MV photons all being equally acceptable. (Abstract Truncated)

• OSTI ID: 5603329
• Journal Information: International Journal of Radiation Oncology, Biology and Physics; (USA), Vol. 21:1; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
NEOPLASMS
RADIOTHERAPY
PLANNING
UTERUS
COMPUTER CALCULATIONS
LYMPH NODES
PATIENTS
PHOTONS
PROBABILITY
RADIATION DOSES
BODY
BOSONS
DISEASES
DOSES
ELEMENTARY PARTICLES
FEMALE GENITALS
LYMPHATIC SYSTEM
MASSLESS PARTICLES
MEDICINE
NUCLEAR MEDICINE
ORGANS
RADIOLOGY
THERAPY
550603* - Medicine- External Radiation in Therapy- (1980-)