A Dosimetric Comparison of Volumetric-modulated Arc Therapy and IMRT for Cochlea-sparing Radiation Therapy in Locally Advanced Nasopharyngeal Cancer.

IF 0.7 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Journal of Medical Physics Pub Date : 2023-07-01 Epub Date: 2023-09-18 DOI:10.4103/jmp.jmp_21_23
Siddhartha Nanda, Sourajit Parida, Manish Kumar Ahirwar
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引用次数: 0

Abstract

Background: Head-and-neck cancer treatment includes radiotherapy as a crucial component. However, radiotherapy, like other treatment modalities, has its own side effects, some of which can be avoided using the latest medical technology and understanding the illness. Despite being a relatively uncommon subtype of head-and-neck cancer, radiation is essential in the treatment of nasopharyngeal carcinoma (NPC). Because of the complex anatomy of the nasopharyngeal region, it is difficult to plan radiotherapy without sparing the cochlea, an important part of the auditory system, and the radiotherapy dosage to it may cause sensorineural hearing loss. In the modern era, volumetric-modulated arc therapy (VMAT) and intensity-modulated radiotherapy (IMRT) have become the gold standard in radiotherapy. With the advancement of these techniques, cochlear sparing is now possible without compromising the tumor dose.

Materials and methods: We reviewed 14 plans for patients with locally advanced NPC who had received radiation in our department. VMAT plans were created for patients who had IMRT radiotherapy and vice versa. Both approaches were evaluated in terms of cochlea sparing while maintaining the coverage of the planned target volume (PTV).

Results: Our study compared the results of two different radiation techniques for locally advanced NPC, IMRT, and VMAT in 14 cases, and we found that VMAT was associated with a lower maximum dose to the cochlea, a lower mean dose to the cochlea, a higher PTV D98% (Gy), a lower PTV D2% (Gy), a higher PTV V95% (%), a lower heterogeneity index, and a higher conformity index. The P value for each comparison was <0.05, which indicates that the difference is statistically significant. These results suggest that VMAT is a better radiation technique than IMRT for locally advanced NPC. VMAT is associated with a lower dose to the cochlea and other organs at risk, which can improve the quality of life and survival of patients.

Conclusion: These results suggest that VMAT is a better radiation technique than IMRT for locally advanced NPC. VMAT is associated with a lower dose to the cochlea and other organs at risk, which can improve the quality of life and survival of patients.

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局部晚期鼻咽癌保留耳蜗放射治疗中体积调节弧线治疗与IMRT的剂量学比较。
背景:头颈癌的治疗包括放疗作为一个重要组成部分。然而,放射治疗和其他治疗方式一样,有其自身的副作用,其中一些可以通过最新的医疗技术和对疾病的了解来避免。尽管鼻咽癌是一种相对罕见的头颈癌亚型,但放射治疗在鼻咽癌(NPC)的治疗中是必不可少的。由于鼻咽区解剖结构复杂,放疗很难不保留耳蜗这一听觉系统的重要组成部分,对其放疗剂量可能导致感音神经性听力损失。在现代,体积调制电弧治疗(VMAT)和调强放疗(IMRT)已成为放疗的金标准。随着这些技术的进步,在不影响肿瘤剂量的情况下保留耳蜗现在是可能的。材料与方法:回顾了14例局部晚期鼻咽癌患者在我科接受放射治疗的方案。VMAT计划是为接受IMRT放疗的患者制定的,反之亦然。两种方法在保持计划目标体积(PTV)覆盖范围的情况下评估耳蜗保留。结果:我们的研究比较了14例局部晚期鼻咽癌、IMRT和VMAT两种不同放射技术的结果,我们发现VMAT与较低的耳蜗最大剂量、较低的耳蜗平均剂量、较高的PTV D98% (Gy)、较低的PTV D2% (Gy)、较高的PTV V95%(%)、较低的异质性指数和较高的符合性指数相关。结论:对于局部晚期鼻咽癌,VMAT放疗优于IMRT。VMAT与对耳蜗和其他危险器官的较低剂量有关,这可以改善患者的生活质量和生存率。
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来源期刊
Journal of Medical Physics
Journal of Medical Physics RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
1.10
自引率
11.10%
发文量
55
审稿时长
30 weeks
期刊介绍: JOURNAL OF MEDICAL PHYSICS is the official journal of Association of Medical Physicists of India (AMPI). The association has been bringing out a quarterly publication since 1976. Till the end of 1993, it was known as Medical Physics Bulletin, which then became Journal of Medical Physics. The main objective of the Journal is to serve as a vehicle of communication to highlight all aspects of the practice of medical radiation physics. The areas covered include all aspects of the application of radiation physics to biological sciences, radiotherapy, radiodiagnosis, nuclear medicine, dosimetry and radiation protection. Papers / manuscripts dealing with the aspects of physics related to cancer therapy / radiobiology also fall within the scope of the journal.
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