Evaluation and risk factors of volume and dose differences of selected structures in patients with head and neck cancer treated on Helical TomoTherapy by using Deformable Image Registration tool

• Autorzy: Bąk Bartosz , Skrobała Agnieszka , Adamska Anna , Józefacka Natalia , Styś Sara , Malicki Julian

Identyfikatory

DOI

10.2478/pjmpe-2022-0007

• Języki publikacji: EN

Abstrakty

EN

Introduction: The aim of this study was the evaluation of volume and dose differences in selected structures in patients with head and neck cancer during treatment on Helical TomoTherapy (HT) using a commercially available deformable image registration (DIR) tool. We attempted to identify anatomical and clinical predictive factors for significant volume changes probability. Material and methods: According to our institutional protocol, we retrospectively evaluated the group of 20 H&N cancer patients treated with HT who received Adaptive Radiotherapy (ART) due to soft tissue alterations spotted on daily MVCT. We compared volumes on initial computed tomography (iCT) and replanning computed tomography (rCT) for clinical target volumes (CTV) – CTV1 (the primary tumor) and CTV2 (metastatic lymph nodes), parotid glands (PG) and body contour (B-body). To estimate the planned and delivered dose discrepancy, the dose from the original plan was registered and deformed to create a simulation of dose distribution on rCT (DIR-rCT). Results: The decision to replan was made at the 4th week of RT (N = 6; 30%). The average volume reduction in parotid right PG[R] and left PG[L] was 4.37 cc (18.9%) (p < 0.001) and 3.77 cc (16.8%) (p = 0.004), respectively. In N = 13/20 cases, the delivered dose was greater than the planned dose for PG[R] of mean 3 Gy (p < 0.001), and in N = 6/20 patients for PG[L] the mean of 3.6 Gy (p = 0.031). Multivariate regression analysis showed a very strong predictor explaining 88% (R2 = 0.88) and 83% (R2 = 0.83) of the variance based on the mean dose of iPG[R] and iPG[L] (p < 0.001), respectively. No statistically significant correlation between volume changes and risk factors was found. Conclusions: Dosimetric changes to the target demonstrated the validity of replanning. A DIR tool can be successfully used for dose deformation and ART qualification, significantly reducing the workload of radiotherapy centers. In addition, the mean dose for PG was a significant predictor that may indicate the need for a replan.

Słowa kluczowe

EN

replanning; adaptive radiotherapy; head and neck cancer; Deformable Image Registration; TomoTherapy

• Wydawca: Polskie Towarzystwo Fizyki Medycznej ; De Gruyter
• Czasopismo: Polish Journal of Medical Physics and Engineering
• Rocznik: 2022
• Tom: Vol. 28, Iss. 2
• Strony: 60--68
• Opis fizyczny: Bibliogr. 46 poz., rys., tab.

Twórcy

autor

Bąk Bartosz

• Radiotherapy Department II, Greater Poland Cancer Center, Poland
• Department of Electroradiology, Poznań University of Medical Sciences, Poznań, Poland

• https://orcid.org/0000-0003-4567-4917

autor

Skrobała Agnieszka

• Department of Electroradiology, Poznań University of Medical Sciences, Poznań, Poland
• Department of Medical Physics, Greater Poland Cancer Center, Poland

• https://orcid.org/0000-0003-0539-9041

autor

Adamska Anna

• Radiotherapy Ward I and Department I, Greater Poland Cancer Center, Poland

autor

Józefacka Natalia

• Institute of Psychology, Pedagogical University in Krakow, Poland

• https://orcid.org/0000-0002-1674-3760

autor

Styś Sara

• Department of Medical Physics, Greater Poland Cancer Center, Poland

autor

Malicki Julian

• Department of Electroradiology, Poznań University of Medical Sciences, Poznań, Poland

• https://orcid.org/0000-0002-5558-5558

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Uwagi

Opracowanie rekordu ze środków MEiN, umowa nr SONP/SP/546092/2022 w ramach programu "Społeczna odpowiedzialność nauki" - moduł: Popularyzacja nauki i promocja sportu (2022-2023).