Improvement of treatment plans developed with intensity-modulated radiation therapy for concave-shaped head and neck tumors

Radiology
Nesrin DoganBahman Emami

Abstract

To improve dose conformity and normal tissue sparing in patients with concave-shaped head and neck cancers by using tomotherapy and static step-and-shoot intensity-modulated radiation therapy (IMRT) and by comparing results with those of three-dimensional (3D) conformal radiation therapy (CRT) and two-dimensional (2D) radiation therapy. Treatment planning in 10 patients with concave-shaped head and neck tumors was performed by using tomotherapy and step-and-shoot IMRT, 3D CRT, and 2D techniques. IMRT plans were modified by placing "virtual critical structures" in regions outside the target where hot spots occurred. These modified plans were used for comparison because they provided better dose conformity. Critical structures were the spinal cord, the parotid glands, and the mandible. Comparisons were performed by means of dose-volume histograms, clinical target volume (CTV), target covered by 95% isodose (D(95%)), dose received by 5% of the critical structure volume (D(5%)), maximum dose, mean dose, and normal tissue complication probability for critical structures. Original IMRT plans showed more conformal dose distributions than those in 3D CRT and 2D plans. However, hot spots developed in the posterior and anterior neck. Int...Continue Reading

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