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To compare helical tomotherapy (HT) and conventional intensity-modulated radiotherapy (IMRT) using a variety of dosimetric and radiobiologic indexes in patients with locally advanced non-small cell lung cancer (LA-NSCLC). PATIENTS AND
A total of 20 patients with LA-NSCLC were enrolled. IMRT plans with 4-6 coplanar beams and HT plans were generated for each patient. Dose distributions and dosimetric indexes for the tumors and critical structures were computed for both plans and compared.
Both modalities created highly conformal plans. They did not differ in the volumes of lung exposed to > 20 Gy of radiation. The average mean lung dose, volume receiving ≥ 30 Gy, and volume receiving ≥ 10 Gy in HT planning were 18.3 Gy, 18.5%, and 57.1%, respectively, compared to 19.4 Gy, 25.4%, and 48.9%, respectively, with IMRT (p = 0.004, p < 0.001, and p < 0.001). The differences between HT and IMRT in lung volume receiving ≥ 10-20 Gy increased significantly as the planning target volume (PTV) increased. For 6 patients who had PTV greater than 700 cm(3), IMRT was superior to HT for 5 patients in terms of lung volume receiving ≥ 5-20 Gy. The integral dose to the entire thorax in HT plans was significantly higher than in IMRT plans.
HT gave significantly better control of mean lung dose and volume receiving ≥ 30-40 Gy, whereas IMRT provided better control of the lung volume receiving ≥ 5-15 Gy and the integral dose to entire thorax. In most patients with PTV greater than 700 cm(3), IMRT was superior to HT in terms of lung volume receiving ≥ 5-20 Gy. It is therefore advised that caution should be exercised when planning LA-NSCLC using HT.
Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
This article was published in the following journal.
Name: Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]
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CONFORMAL RADIOTHERAPY that combines several intensity-modulated beams to provide improved dose homogeneity and highly conformal dose distributions.
The functional superiority and preferential use of one eye over the other. The term is usually applied to superiority in sighting (VISUAL PERCEPTION) or motor task but not difference in VISUAL ACUITY or dysfunction of one of the eyes. Ocular dominance can be modified by visual input and NEUROTROPHIC FACTORS.
Radiotherapy given to augment some other form of treatment such as surgery or chemotherapy. Adjuvant radiotherapy is commonly used in the therapy of cancer and can be administered before or after the primary treatment.
The total amount of radiation absorbed by tissues as a result of radiotherapy.
Computed tomography where there is continuous X-ray exposure to the patient while being transported in a spiral or helical pattern through the beam of irradiation. This provides improved three-dimensional contrast and spatial resolution compared to conventional computed tomography, where data is obtained and computed from individual sequential exposures.
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