3D-conformal-intensity modulated radiotherapy with compensators for head and neck cancer: clinical results of normal tissue sparing
<p>Abstract</p> <p>Background</p> <p>To investigate the potential of parotic gland sparing of intensity modulated radiotherapy (3D-c-IMRT) performed with metallic compensators for head and neck cancer in a clinical series by analysis of dose distributions and clinical m...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2006-06-01
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| Series: | Radiation Oncology |
| Online Access: | http://www.ro-journal.com/content/1/1/18 |
| _version_ | 1818358279130054656 |
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| author | Koscielny Sven Pinquart Ines Salz Henning Abbasi-Senger Nasrin Wendt Thomas G Przetak Susi-Marie Wiezorek Tilo |
| author_facet | Koscielny Sven Pinquart Ines Salz Henning Abbasi-Senger Nasrin Wendt Thomas G Przetak Susi-Marie Wiezorek Tilo |
| author_sort | Koscielny Sven |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>To investigate the potential of parotic gland sparing of intensity modulated radiotherapy (3D-c-IMRT) performed with metallic compensators for head and neck cancer in a clinical series by analysis of dose distributions and clinical measures.</p> <p>Materials and methods</p> <p>39 patients with squamous cell cancer of the head and neck irradiated using 3D-c-IMRT were evaluable for dose distribution within PTVs and at one parotid gland and 38 patients for toxicity analysis. 10 patients were treated primarily, 29 postoperatively, 19 received concomittant cis-platin based chemotherapy, 20 3D-c-IMRT alone. Initially the dose distribution was calculated with Helax <sup>® </sup>and photon fluence was modulated using metallic compensators made of tin-granulate (n = 22). Later the dose distribution was calculated with KonRad <sup>® </sup>and fluence was modified by MCP 96 alloy compensators (n = 17). Gross tumor/tumor bed (PTV 1) was irradiated up to 60–70 Gy, [5 fractions/week, single fraction dose: 2.0–2.2 (simultaneously integrated boost)], adjuvantly irradiated bilateral cervical lymph nodes (PTV 2) with 48–54 Gy [single dose: 1.5–1.8]). Toxicity was scored according the RTOG scale and patient-reported xerostomia questionnaire (XQ).</p> <p>Results</p> <p>Mean of the median doses at the parotid glands to be spared was 25.9 (16.3–46.8) Gy, for tin graulate 26 Gy, for MCP alloy 24.2 Gy. Tin-granulate compensators resulted in a median parotid dose above 26 Gy in 10/22, MCP 96 alloy in 0/17 patients. Following acute toxicities were seen (°0–2/3): xerostomia: 87%/13%, dysphagia: 84%/16%, mucositis: 89%/11%, dermatitis: 100%/0%. No grade 4 reaction was encountered. During therapy the XQ forms showed °0–2/3): 88%/12%. 6 months postRT chronic xerostomia °0–2/3 was observed in 85%/15% of patients, none with °4 xerostomia.</p> <p>Conclusion</p> <p>3D-c-IMRT using metallic compensators along with inverse calculation algorithm achieves sufficient parotid gland sparing in virtually all advanced head and neck cancers. Since the concept of lower single (and total) doses in the adjuvantly treated volumes reduces acute morbidity 3D-c-IMRT nicely meets demands of concurrent chemotherapy protocols.</p> |
| first_indexed | 2024-12-13T20:26:28Z |
| format | Article |
| id | doaj.art-84b87071fce9418bbc0251c2a352f3f8 |
| institution | Directory Open Access Journal |
| issn | 1748-717X |
| language | English |
| last_indexed | 2024-12-13T20:26:28Z |
| publishDate | 2006-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Radiation Oncology |
| spelling | doaj.art-84b87071fce9418bbc0251c2a352f3f82022-12-21T23:32:33ZengBMCRadiation Oncology1748-717X2006-06-01111810.1186/1748-717X-1-183D-conformal-intensity modulated radiotherapy with compensators for head and neck cancer: clinical results of normal tissue sparingKoscielny SvenPinquart InesSalz HenningAbbasi-Senger NasrinWendt Thomas GPrzetak Susi-MarieWiezorek Tilo<p>Abstract</p> <p>Background</p> <p>To investigate the potential of parotic gland sparing of intensity modulated radiotherapy (3D-c-IMRT) performed with metallic compensators for head and neck cancer in a clinical series by analysis of dose distributions and clinical measures.</p> <p>Materials and methods</p> <p>39 patients with squamous cell cancer of the head and neck irradiated using 3D-c-IMRT were evaluable for dose distribution within PTVs and at one parotid gland and 38 patients for toxicity analysis. 10 patients were treated primarily, 29 postoperatively, 19 received concomittant cis-platin based chemotherapy, 20 3D-c-IMRT alone. Initially the dose distribution was calculated with Helax <sup>® </sup>and photon fluence was modulated using metallic compensators made of tin-granulate (n = 22). Later the dose distribution was calculated with KonRad <sup>® </sup>and fluence was modified by MCP 96 alloy compensators (n = 17). Gross tumor/tumor bed (PTV 1) was irradiated up to 60–70 Gy, [5 fractions/week, single fraction dose: 2.0–2.2 (simultaneously integrated boost)], adjuvantly irradiated bilateral cervical lymph nodes (PTV 2) with 48–54 Gy [single dose: 1.5–1.8]). Toxicity was scored according the RTOG scale and patient-reported xerostomia questionnaire (XQ).</p> <p>Results</p> <p>Mean of the median doses at the parotid glands to be spared was 25.9 (16.3–46.8) Gy, for tin graulate 26 Gy, for MCP alloy 24.2 Gy. Tin-granulate compensators resulted in a median parotid dose above 26 Gy in 10/22, MCP 96 alloy in 0/17 patients. Following acute toxicities were seen (°0–2/3): xerostomia: 87%/13%, dysphagia: 84%/16%, mucositis: 89%/11%, dermatitis: 100%/0%. No grade 4 reaction was encountered. During therapy the XQ forms showed °0–2/3): 88%/12%. 6 months postRT chronic xerostomia °0–2/3 was observed in 85%/15% of patients, none with °4 xerostomia.</p> <p>Conclusion</p> <p>3D-c-IMRT using metallic compensators along with inverse calculation algorithm achieves sufficient parotid gland sparing in virtually all advanced head and neck cancers. Since the concept of lower single (and total) doses in the adjuvantly treated volumes reduces acute morbidity 3D-c-IMRT nicely meets demands of concurrent chemotherapy protocols.</p>http://www.ro-journal.com/content/1/1/18 |
| spellingShingle | Koscielny Sven Pinquart Ines Salz Henning Abbasi-Senger Nasrin Wendt Thomas G Przetak Susi-Marie Wiezorek Tilo 3D-conformal-intensity modulated radiotherapy with compensators for head and neck cancer: clinical results of normal tissue sparing Radiation Oncology |
| title | 3D-conformal-intensity modulated radiotherapy with compensators for head and neck cancer: clinical results of normal tissue sparing |
| title_full | 3D-conformal-intensity modulated radiotherapy with compensators for head and neck cancer: clinical results of normal tissue sparing |
| title_fullStr | 3D-conformal-intensity modulated radiotherapy with compensators for head and neck cancer: clinical results of normal tissue sparing |
| title_full_unstemmed | 3D-conformal-intensity modulated radiotherapy with compensators for head and neck cancer: clinical results of normal tissue sparing |
| title_short | 3D-conformal-intensity modulated radiotherapy with compensators for head and neck cancer: clinical results of normal tissue sparing |
| title_sort | 3d conformal intensity modulated radiotherapy with compensators for head and neck cancer clinical results of normal tissue sparing |
| url | http://www.ro-journal.com/content/1/1/18 |
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