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Evaluating the impact of anatomical changes on dose distributions in head and neck cancer

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Warianty tytułu
Języki publikacji
EN
Abstrakty
EN
Introduction: Thanks to modern IGRT procedures, it is possible to track changes in the patient's anatomy and thus calculate the dose distribution for the current anatomical conditions of the patient. This allows the scheduled dose to be compared with the delivered dose. In the case of large discrepancies, it is possible to improve the treatment plan. Radiotherapy, during which the treatment plan is modified, resulting from changes in anatomy, is referred to as adaptive radiotherapy. Material and methods: This study was performed for 30 patients with H&N cancer at the University Hospital in Zielona Góra. All patients were treated with VMAT. The Simultaneous Integrated Technique was used. In each treatment session, set-up verification was performed. Alternating every other day, the CBCT and two orthogonal portal images were made, and position correction prior to each session was performed. For all patients, new planning CT was made after the 11th and 22nd treatment sessions. Dose distributions with the initial plan on CT11 and CT22 were calculated. The initial dose-volume histograms DVH0 were compared with dose-volume histograms DVH11 and DVH22 calculated on CT11 and CT22. Results: We compared the dose distribution in the CTVs and in the most important organs at risk obtained for initial anatomy and dose distributions calculated with the initial plan on the CTs performed after the second and the fourth week of irradiation. The differences between mean doses and V95% to GTV obtained for the initial CT and two other CTs were small. For a few CTs, the values of V95% were smaller by more than 5% points. In most patients, the mean dose in salivary glands increased during treatment. Conclusions: Anatomical changes occurring during radiotherapy in patients with head and neck cancers have little influence on the dose deposited in the Clinical Target Volume. Adaptive therapy may be of particular importance if relapse occurs and re-irradiation.
Rocznik
Strony
156--164
Opis fizyczny
Bibliogr. 17 poz., rys.
Twórcy
  • Medical Physics Department, University Hospital Zielona Góra, Poland
  • Medical Physics Department, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
  • Medical Physics Department, University Hospital Zielona Góra, Poland
Bibliografia
  • 1. Gupta T, Sinha S, Ghosh-Laskar S, et al. Intensity-modulated radiation therapy versus three-dimensional conformal radiotherapy in head and neck squamous cell carcinoma: long-term and mature outcomes of a prospective randomized trial. Radiat Oncol. 2020;15(1):218. https://doi.org/10.1186/s13014-020-01666-5
  • 2. Thorwarth D, Muren L. Imaging science and development in modern high-precision radiotherapy. Phys Imaging Radiat Oncol. 2019;12:63-66. https://doi.org/10.1016/j.phro.2019.11.008
  • 3. van Beek S, Jonker M, Hamming-Vrieze O, et al. Protocolised way to cope with anatomical changes in head & neck cancer during the course of radiotherapy. Tech Innov Patient Support Radiat Oncol. 2019;12:34-40. https://doi.org/10.1016/j.tipsro.2019.11.001
  • 4. Davis AT, Palmer AL, Nisbet A. Can CT scan protocols used for radiotherapy treatment planning be adjusted to optimize image quality and patient dose? A systematic review. Br J Radiol. 2017;90(1076):20160406. https://doi.org/10.1259/bjr.20160406
  • 5. Noble DJ, Yeap PL, Seah SYK, et al. Anatomical change during radiotherapy for head and neck cancer, and its effect on delivered dose to the spinal cord. Radiother Oncol. 2019;130:32-38. https://doi.org/10.1016/j.radonc.2018.07.009
  • 6. Green OL, Henke LE, Hugo GD. Practical Clinical Workflows for Online and Offline Adaptive Radiation Therapy. Semin Radiat Oncol. 2019;29(3):219-227. https://doi.org/10.1016/j.semradonc.2019.02.004
  • 7. Moazzezi M, Rose B, Kisling K, et al. Prospects for daily online adaptive radiotherapy via ethos for prostate cancer patients without nodal involvement using unedited CBCT auto‐segmentation. J App Clin Med Phys. 2021;22(10):82-93. https://doi.org/10.1002/acm2.13399
  • 8. Castelli J, Simon A, Lafond C, et al. Adaptive radiotherapy for head and neck cancer. Acta Oncologica. 2018;57(10):1284-1292. 10.1080/0284186X.2018.1505053
  • 9. Srivastava R, Sharma PK, Das KJM, Manjhi J. A hybrid approach for head and neck cancer using online image guidance and offline adaptive radiotherapy planning. J Radiother Pract. 2019;18(3):271-275. https://doi.org/10.1017/S146039691800078X
  • 10. Beetz I, Schilstra C, van der Schaaf A, et al. NTCP models for patient-rated xerostomia and sticky saliva after treatment with intensity modulated radiotherapy for head and neck cancer: The role of dosimetric and clinical factors. Radiother Oncol. 2012;105(1):101-106. https://doi.org/10.1016/j.radonc.2012.03.004
  • 11. Surucu M, Shah KK, Roeske JC, Choi M, Small W Jr, Emami B. Adaptive Radiotherapy for Head and Neck Cancer. Technol Cancer Res Treat. 2017;16(2):218-223. https://doi.org/10.1177/1533034616662165
  • 12. Zhao L, Wan Q, Zhou Y, Deng X, Xie C, Wu S, et al. The role of replanning in fractionated intensity modulated radiotherapy for nasopharyngeal carcinoma. Radiother Oncol. 2011;98:23-27. https://doi.org/10.1016/j.radonc.2010.10.009
  • 13. Chen AM, Daly ME, Cui J, Mathai M, Benedict S, Purdy JA. Clinical outcomes among head and neck cancer patients treated with intensity-modulated radiotherapy, with and without adaptive replanning. Head Neck. 2013;36(11):1541-1546. https://doi.org/10.1002/hed.23477
  • 14. Castelli J, Simon A, Louvel G, Henry O, Chajon E, Nassef M, et al. Impact of head and neck cancer adaptive radiotherapy to spare the parotid glands and decrease the risk of xerostomia. Radiat Oncol. 2015;10:6. https://doi.org/10.1186/s13014-014-0318-z
  • 15. Lee C, Langen KM, Lu W, Haimerl J, Schnarr E, Ruchala KJ, et al. Assessment of parotid gland dose changes during head and neck cancer radiotherapy using daily megavoltage computed tomography and deformable image registration. Int J Radiat Oncol Biol Phys. 2008;71(5):1563-1571. https://doi.org/10.1016/j.ijrobp.2008.04.013
  • 16. Bhides SA, Davies M, Burke K, et al. Weekly volume and dosimetric changes during chemoradiotherapy with intensity-modulated radiation therapy for head and neck cancer: a prospective observational study. Int J Radiat Oncol Biol Phys. 2010;76(5):1360-1368. https://doi.org/10.1016/j.ijrobp.2009.04.005
  • 17. Avgousti R, Antypas C, Armpilia C, et al. Adaptive radiation therapy: When, how and what are the benefits that literature provides? Cancer Radiother. 2022;26(4):622-636. https://doi.org/10.1016/j.canrad.2021.08.023
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).
Typ dokumentu
Bibliografia
Identyfikator YADDA
bwmeta1.element.baztech-f41e950b-a521-49dc-9047-5603c70dbec5
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