Assessment of nodal target definition and dosimetry using three different techniques: implications for re-defining the optimal pelvic field in endometrial cancer
<p>Abstract</p> <p>Purposes</p> <p>1. To determine the optimal pelvic nodal clinical target volume for post-operative treatment of endometrial cancer. 2. To compare the DVH of different treatment planning techniques applied to this new CTV and the surrounding tissues.&l...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2010-06-01
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| Series: | Radiation Oncology |
| Online Access: | http://www.ro-journal.com/content/5/1/59 |
| _version_ | 1811249880571576320 |
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| author | Bashist Benjamin Trichter Frieda Bhatia Stephen Ennis Ronald D Guo Susan Shah Jinesh Chadha Manjeet |
| author_facet | Bashist Benjamin Trichter Frieda Bhatia Stephen Ennis Ronald D Guo Susan Shah Jinesh Chadha Manjeet |
| author_sort | Bashist Benjamin |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Purposes</p> <p>1. To determine the optimal pelvic nodal clinical target volume for post-operative treatment of endometrial cancer. 2. To compare the DVH of different treatment planning techniques applied to this new CTV and the surrounding tissues.</p> <p>Methods and Materials</p> <p>Based on the literature, we selected a methodology to delineate nodal target volume to define a NEW-CTV and NEW-PTV. Conventional 2D fields, 3D fields based on anatomic guidelines per RTOG 0418, 3D fields based on our guidelines, and IMRT based on our guidelines were assessed for coverage of NEW-CTV, NEW-PTV, and surrounding structures. CT scans of 10 patients with gynecologic malignancies after TAH/BSO were used. DVHs were compared.</p> <p>Results</p> <p>For NEW-PTV, mean V45Gy were 50% and 69% for 2D and RTOG 0418-3DCRT vs. 98% and 97% for NEW-3DCRT and NEW-IMRT (p < 0.0009). Mean V45Gy small bowel were 24% and 20% for 2D and RTOG 0418-3DCRT, increased to 32% with NEW-3DCRT, and decreased to 14% with IMRT (p = 0.005, 0.138, 0.002). Mean V45Gy rectum were 26%, 35%, and 52% for 2D, RTOG 0418-3DCRT, and NEW-3DCRT, and decreased to 26% with NEW-IMRT (p < 0.05). Mean V45Gy bladder were 83%, 51%, and 73% for 2D, RTOG 0418-3DCRT, and NEW-3DCRT, and decreased to 30% with NEW-IMRT (p < 0.002).</p> <p>Conclusions</p> <p>Conventional 2D and RTOG 0418-based 3DCRT plans cover only a fraction of our comprehensive PTV. A 3DCRT plan covers this PTV with high doses to normal tissues, whereas IMRT covers the PTV while delivering lower normal tissue doses. Re-consideration of what <it>specifically </it>the pelvic target encompasses is warranted.</p> |
| first_indexed | 2024-04-12T15:55:13Z |
| format | Article |
| id | doaj.art-8e9300943a204818a1345ab178843571 |
| institution | Directory Open Access Journal |
| issn | 1748-717X |
| language | English |
| last_indexed | 2024-04-12T15:55:13Z |
| publishDate | 2010-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Radiation Oncology |
| spelling | doaj.art-8e9300943a204818a1345ab1788435712022-12-22T03:26:23ZengBMCRadiation Oncology1748-717X2010-06-01515910.1186/1748-717X-5-59Assessment of nodal target definition and dosimetry using three different techniques: implications for re-defining the optimal pelvic field in endometrial cancerBashist BenjaminTrichter FriedaBhatia StephenEnnis Ronald DGuo SusanShah JineshChadha Manjeet<p>Abstract</p> <p>Purposes</p> <p>1. To determine the optimal pelvic nodal clinical target volume for post-operative treatment of endometrial cancer. 2. To compare the DVH of different treatment planning techniques applied to this new CTV and the surrounding tissues.</p> <p>Methods and Materials</p> <p>Based on the literature, we selected a methodology to delineate nodal target volume to define a NEW-CTV and NEW-PTV. Conventional 2D fields, 3D fields based on anatomic guidelines per RTOG 0418, 3D fields based on our guidelines, and IMRT based on our guidelines were assessed for coverage of NEW-CTV, NEW-PTV, and surrounding structures. CT scans of 10 patients with gynecologic malignancies after TAH/BSO were used. DVHs were compared.</p> <p>Results</p> <p>For NEW-PTV, mean V45Gy were 50% and 69% for 2D and RTOG 0418-3DCRT vs. 98% and 97% for NEW-3DCRT and NEW-IMRT (p < 0.0009). Mean V45Gy small bowel were 24% and 20% for 2D and RTOG 0418-3DCRT, increased to 32% with NEW-3DCRT, and decreased to 14% with IMRT (p = 0.005, 0.138, 0.002). Mean V45Gy rectum were 26%, 35%, and 52% for 2D, RTOG 0418-3DCRT, and NEW-3DCRT, and decreased to 26% with NEW-IMRT (p < 0.05). Mean V45Gy bladder were 83%, 51%, and 73% for 2D, RTOG 0418-3DCRT, and NEW-3DCRT, and decreased to 30% with NEW-IMRT (p < 0.002).</p> <p>Conclusions</p> <p>Conventional 2D and RTOG 0418-based 3DCRT plans cover only a fraction of our comprehensive PTV. A 3DCRT plan covers this PTV with high doses to normal tissues, whereas IMRT covers the PTV while delivering lower normal tissue doses. Re-consideration of what <it>specifically </it>the pelvic target encompasses is warranted.</p>http://www.ro-journal.com/content/5/1/59 |
| spellingShingle | Bashist Benjamin Trichter Frieda Bhatia Stephen Ennis Ronald D Guo Susan Shah Jinesh Chadha Manjeet Assessment of nodal target definition and dosimetry using three different techniques: implications for re-defining the optimal pelvic field in endometrial cancer Radiation Oncology |
| title | Assessment of nodal target definition and dosimetry using three different techniques: implications for re-defining the optimal pelvic field in endometrial cancer |
| title_full | Assessment of nodal target definition and dosimetry using three different techniques: implications for re-defining the optimal pelvic field in endometrial cancer |
| title_fullStr | Assessment of nodal target definition and dosimetry using three different techniques: implications for re-defining the optimal pelvic field in endometrial cancer |
| title_full_unstemmed | Assessment of nodal target definition and dosimetry using three different techniques: implications for re-defining the optimal pelvic field in endometrial cancer |
| title_short | Assessment of nodal target definition and dosimetry using three different techniques: implications for re-defining the optimal pelvic field in endometrial cancer |
| title_sort | assessment of nodal target definition and dosimetry using three different techniques implications for re defining the optimal pelvic field in endometrial cancer |
| url | http://www.ro-journal.com/content/5/1/59 |
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