TY - JOUR
T1 - Adjuvant radiotherapy for gastric cancer
T2 - A dosimetric comparison of 3-dimensional conformal radiotherapy, tomotherapy® and conventional intensity modulated radiotherapy treatment plans
AU - Dahele, Max
AU - Skinner, Matthew
AU - Schultz, Brenda
AU - Cardoso, Marlene
AU - Bell, Chris
AU - Ung, Yee C.
PY - 2010
Y1 - 2010
N2 - Some patients with gastric cancer benefit from post-operative chemo-radiotherapy, but adequately irradiating the planning target volume (PTV) whilst avoiding organs at risk (OAR) can be difficult. We evaluate 3-dimensional conformal radiotherapy (CRT), conventional intensity-modulated radiotherapy (IMRT) and helical tomotherapy (TT). TT, 2 and 5-field (F) CRT and IMRT treatment plans with the same PTV coverage were generated for 5 patients and compared. Median values are reported. The volume of left/right kidney receiving at least 20Gy (V20) was 57/51% and 51/60% for 2 and 5F-CRT, and 28/14% for TT and 27/19% for IMRT. The volume of liver receiving at least 30Gy (V30) was 45% and 62% for 2 and 5F-CRT, and 37% for TT and 35% for IMRT. With TT, 98% of the PTV received 95-105% of the prescribed dose, compared with 45%, 34% and 28% for 2F-CRT, 5F-CRT and IMRT respectively. Using conventional metrics, conventional IMRT can achieve comparable PTV coverage and OAR sparing to TT, but at the expense of PTV dose heterogeneity. Both irradiate large volumes of normal tissue to low doses. Additional studies are needed to demonstrate the clinical impact of these technologies.
AB - Some patients with gastric cancer benefit from post-operative chemo-radiotherapy, but adequately irradiating the planning target volume (PTV) whilst avoiding organs at risk (OAR) can be difficult. We evaluate 3-dimensional conformal radiotherapy (CRT), conventional intensity-modulated radiotherapy (IMRT) and helical tomotherapy (TT). TT, 2 and 5-field (F) CRT and IMRT treatment plans with the same PTV coverage were generated for 5 patients and compared. Median values are reported. The volume of left/right kidney receiving at least 20Gy (V20) was 57/51% and 51/60% for 2 and 5F-CRT, and 28/14% for TT and 27/19% for IMRT. The volume of liver receiving at least 30Gy (V30) was 45% and 62% for 2 and 5F-CRT, and 37% for TT and 35% for IMRT. With TT, 98% of the PTV received 95-105% of the prescribed dose, compared with 45%, 34% and 28% for 2F-CRT, 5F-CRT and IMRT respectively. Using conventional metrics, conventional IMRT can achieve comparable PTV coverage and OAR sparing to TT, but at the expense of PTV dose heterogeneity. Both irradiate large volumes of normal tissue to low doses. Additional studies are needed to demonstrate the clinical impact of these technologies.
KW - Adjuvant radiotherapy
KW - Gastric cancer
KW - Intensity-modulated radiotherapy
KW - TomoTherapy
UR - http://www.scopus.com/inward/record.url?scp=77952466994&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.meddos.2009.03.003
DO - https://doi.org/10.1016/j.meddos.2009.03.003
M3 - Article
C2 - 19931023
SN - 0958-3947
VL - 35
SP - 115
EP - 121
JO - Medical Dosimetry
JF - Medical Dosimetry
IS - 2
ER -