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Title: Dose planning objectives in anal canal cancer IMRT: the TROG ANROTAT experience

Intensity modulated radiotherapy (IMRT) is ideal for anal canal cancer (ACC), delivering high doses to irregular tumour volumes whilst minimising dose to surrounding normal tissues. Establishing achievable dose objectives is a challenge. The purpose of this paper was to utilise data collected in the Assessment of New Radiation Oncology Treatments and Technologies (ANROTAT) project to evaluate the feasibility of ACC IMRT dose planning objectives employed in the Australian situation. Ten Australian centres were randomly allocated three data sets from 15 non-identifiable computed tomography data sets representing a range of disease stages and gender. Each data set was planned by two different centres, producing 30 plans. All tumour and organ at risk (OAR) contours, prescription and dose constraint details were provided. Dose–volume histograms (DVHs) for each plan were analysed to evaluate the feasibility of dose planning objectives provided. All dose planning objectives for the bone marrow (BM) and femoral heads were achieved. Median planned doses exceeded one or more objectives for bowel, external genitalia and bladder. This reached statistical significance for bowel V30 (P = 0.04), V45 (P < 0.001), V50 (P < 0.001), external genitalia V20 (P < 0.001) and bladder V35 (P < 0.001), V40 (P = 0.01). Gendermore » was found to be the only significant factor in the likelihood of achieving the bowel V50 (P = 0.03) and BM V30 constraints (P = 0.04). The dose planning objectives used in the ANROTAT project provide a good starting point for ACC IMRT planning. To facilitate clinical implementation, it is important to prioritise OAR objectives and recognise factors that affect the achievability of these objectives.« less
Authors:
 [1] ;  [2] ;  [2] ;  [3] ;  [2] ;  [4] ; ;  [5] ;  [3]
  1. Princess Alexandra Hospital, Brisbane, Queensland (Australia)
  2. Peter MacCallum Cancer Cancer Centre, Box Hill, Victoria (Australia)
  3. (Australia)
  4. Medica Oncology, Hurstville, New South Wales (Australia)
  5. Radiation Oncology Victoria, Melbourne, Victoria (Australia)
Publication Date:
OSTI Identifier:
22402370
Resource Type:
Journal Article
Resource Relation:
Journal Name: Journal of Medical Radiation Sciences (Print); Journal Volume: 62; Journal Issue: 2; Other Information: PMCID: PMC4462981; PMID: 26229674; OAI: oai:pubmedcentral.nih.gov:4462981; Copyright (c) 2015 The Authors. Journal of Medical Radiation Sciences published by Wiley Publishing Asia Pty Ltd on behalf of Australian Institute of Radiography and New Zealand Institute of Medical Radiation Technology.; This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
Australia
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BLADDER; BONE MARROW; CHARGES; COMPUTERIZED TOMOGRAPHY; DOSES; HAZARDS; HEAD; IMPLEMENTATION; NEOPLASMS; PLANNING; RADIOTHERAPY