Optimal organ-sparing intensity-modulated radiation therapy (IMRT) regimen for the treatment of locally advanced anal canal carcinoma: a comparison of conventional and IMRT plans

<p>Abstract</p> <p>Background</p> <p>To compare the dosimetric advantage of three different intensity-modulated radiation therapy (IMRT) plans to a three dimensional (3D) conventional radiation treatment for anal cancer with regards to organs-at-risk (OAR) avoidance, in...

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Main Authors: Lemanski Claire, Gourgou Sophie, Moscardo Carmen, Laliberté Benoit, Azria David, Menkarios Cathy, Dubois Jean-Bernard, Aillères Norbert, Fenoglietto Pascal
Format: Article
Language:English
Published: BMC 2007-11-01
Series:Radiation Oncology
Online Access:http://www.ro-journal.com/content/2/1/41
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author Lemanski Claire
Gourgou Sophie
Moscardo Carmen
Laliberté Benoit
Azria David
Menkarios Cathy
Dubois Jean-Bernard
Aillères Norbert
Fenoglietto Pascal
author_facet Lemanski Claire
Gourgou Sophie
Moscardo Carmen
Laliberté Benoit
Azria David
Menkarios Cathy
Dubois Jean-Bernard
Aillères Norbert
Fenoglietto Pascal
author_sort Lemanski Claire
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>To compare the dosimetric advantage of three different intensity-modulated radiation therapy (IMRT) plans to a three dimensional (3D) conventional radiation treatment for anal cancer with regards to organs-at-risk (OAR) avoidance, including iliac bone marrow.</p> <p>Methods</p> <p>Five patients with T1-3 N0-1 anal cancer and five with T4 and/or N2-3 tumors were selected. Clinical tumor volume (CTV) included tumor, anal canal and inguinal, peri-rectal, and internal/external iliac nodes (plus pre-sacral nodes for T4/N2-3 tumors). Four plans were generated: (A) AP/PA with 3D conformal boost, (B) pelvic IMRT with conformal boost (C) pelvic IMRT with IMRT boost and (D) IMRT with simultaneous integrated boost (SIB). The dose for plans (A) to (C) was 45 Gy/25 followed by a 14.4 Gy/8 boost, and the total dose for plan (D) (SIB) was 59.4 Gy/33. Coverage of both PTV and the volume of OAR (small bowel, genitalia, iliac crest and femoral heads) receiving more than 10, 20, 30, and 40 Gy (V10, V20, V30, V40) were compared using non parametric statistics.</p> <p>Results</p> <p>Compared to plan (A), IMRT plans (B) to (D) significantly reduced the V30 and V40 of small bowel, bladder and genitalia for all patients. The V10 and V20 of iliac crests were similar for the N0-1 group but were significantly reduced with IMRT for the N2-3/T4 group (V20 for A = 50.2% compared to B = 33%, C = 32.8%, D = 34.3%). There was no statistical difference between 2-phase (arm C) and single-phase (SIB, arm D) IMRT plans.</p> <p>Conclusion</p> <p>IMRT is superior to 3D conformal radiation treatment for anal carcinoma with respect to OAR sparing, including bone marrow sparing.</p>
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spelling doaj.art-4f0ad03a70684c2ab2b91e8906f7706c2022-12-21T21:17:48ZengBMCRadiation Oncology1748-717X2007-11-01214110.1186/1748-717X-2-41Optimal organ-sparing intensity-modulated radiation therapy (IMRT) regimen for the treatment of locally advanced anal canal carcinoma: a comparison of conventional and IMRT plansLemanski ClaireGourgou SophieMoscardo CarmenLaliberté BenoitAzria DavidMenkarios CathyDubois Jean-BernardAillères NorbertFenoglietto Pascal<p>Abstract</p> <p>Background</p> <p>To compare the dosimetric advantage of three different intensity-modulated radiation therapy (IMRT) plans to a three dimensional (3D) conventional radiation treatment for anal cancer with regards to organs-at-risk (OAR) avoidance, including iliac bone marrow.</p> <p>Methods</p> <p>Five patients with T1-3 N0-1 anal cancer and five with T4 and/or N2-3 tumors were selected. Clinical tumor volume (CTV) included tumor, anal canal and inguinal, peri-rectal, and internal/external iliac nodes (plus pre-sacral nodes for T4/N2-3 tumors). Four plans were generated: (A) AP/PA with 3D conformal boost, (B) pelvic IMRT with conformal boost (C) pelvic IMRT with IMRT boost and (D) IMRT with simultaneous integrated boost (SIB). The dose for plans (A) to (C) was 45 Gy/25 followed by a 14.4 Gy/8 boost, and the total dose for plan (D) (SIB) was 59.4 Gy/33. Coverage of both PTV and the volume of OAR (small bowel, genitalia, iliac crest and femoral heads) receiving more than 10, 20, 30, and 40 Gy (V10, V20, V30, V40) were compared using non parametric statistics.</p> <p>Results</p> <p>Compared to plan (A), IMRT plans (B) to (D) significantly reduced the V30 and V40 of small bowel, bladder and genitalia for all patients. The V10 and V20 of iliac crests were similar for the N0-1 group but were significantly reduced with IMRT for the N2-3/T4 group (V20 for A = 50.2% compared to B = 33%, C = 32.8%, D = 34.3%). There was no statistical difference between 2-phase (arm C) and single-phase (SIB, arm D) IMRT plans.</p> <p>Conclusion</p> <p>IMRT is superior to 3D conformal radiation treatment for anal carcinoma with respect to OAR sparing, including bone marrow sparing.</p>http://www.ro-journal.com/content/2/1/41
spellingShingle Lemanski Claire
Gourgou Sophie
Moscardo Carmen
Laliberté Benoit
Azria David
Menkarios Cathy
Dubois Jean-Bernard
Aillères Norbert
Fenoglietto Pascal
Optimal organ-sparing intensity-modulated radiation therapy (IMRT) regimen for the treatment of locally advanced anal canal carcinoma: a comparison of conventional and IMRT plans
Radiation Oncology
title Optimal organ-sparing intensity-modulated radiation therapy (IMRT) regimen for the treatment of locally advanced anal canal carcinoma: a comparison of conventional and IMRT plans
title_full Optimal organ-sparing intensity-modulated radiation therapy (IMRT) regimen for the treatment of locally advanced anal canal carcinoma: a comparison of conventional and IMRT plans
title_fullStr Optimal organ-sparing intensity-modulated radiation therapy (IMRT) regimen for the treatment of locally advanced anal canal carcinoma: a comparison of conventional and IMRT plans
title_full_unstemmed Optimal organ-sparing intensity-modulated radiation therapy (IMRT) regimen for the treatment of locally advanced anal canal carcinoma: a comparison of conventional and IMRT plans
title_short Optimal organ-sparing intensity-modulated radiation therapy (IMRT) regimen for the treatment of locally advanced anal canal carcinoma: a comparison of conventional and IMRT plans
title_sort optimal organ sparing intensity modulated radiation therapy imrt regimen for the treatment of locally advanced anal canal carcinoma a comparison of conventional and imrt plans
url http://www.ro-journal.com/content/2/1/41
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