Dosimetric Evaluation of Hippocampus Sparing Intensity Modulated Radiation Therapy in Patients With Stage T1-T2 and Stage T3-T4 Nasopharyngeal Carcinoma
Xiaofeng Zhou MD , Kui Wu MPhys , Niharika Prasad BDS , Sanjay Jaiswal PhD , Biao Jiang , Xia Li MPhys , Wenzheng Sun PhD , Lingli Mao PhD , Kanghua Huang PhD , Minghan Shi PhD , Shen Li , Qichun Wei MD, PhD
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引用次数: 0
Abstract
Purpose
To compare the hippocampus (HPC) dose reduced by HPC-sparing intensity modulated radiation therapy (IMRT) plans between nasopharyngeal carcinoma (NPC) patients of stages T1-T2 and T3-T4, and to investigate the correlation between the dose of the HPC and the volume of PTVnx70 (the planning target volume of the primary tumor in the nasopharynx that received 70 Gy).
Methods and Materials
Fifty-eight NPC patients were retrospectively evaluated. HPC-nonsparing IMRT or sparing IMRT for each patient was designed according to the protocol for NPC. Dose-volume histogram was used to evaluate the IMRT plans for each patient. The difference in values of HPC parameters (eg, Dmin[NS] – Dmin[S]) between HPC-sparing and nonsparing plans in the stage T1-T2 group and stage T3-T4 group were compared. The correlations between the dose of the HPC and the volume of PTVnx70 were analyzed.
Results
There was no significance between HPC-sparing and nonsparing IMRT plans. Compared with the HPC-nonsparing plans, the HPC-sparing plans significantly decreased both dosimetric and volumetric parameters for the HPC (P < .05), except for Dmin, D98%, and V5. The medians of Dmedian[NS] – Dmedian[S], Dmean[NS] – Dmean[S], D40%[NS] – D40%[S], V30[NS] – V30[S], V40[NS] – V40[S] and V50[NS] – V50[S] in the T1-T2 group were significantly lower than in the T3-T4 group (P < .05), respectively. Both dosimetric and volumetric parameters for the HPC were positively correlated with the volume of PTVnx70 in HPC-sparing and HPC-nonsparing plans (P < .05). The volume of PTVnx70 was positively correlated with Dmedian[NS] – Dmedian[S], Dmean[NS] – Dmean[S], D40%[NS] – D40%[S], V40[NS] – V40[S] and V50[NS] – V50[S] (P < .05).
Conclusions
HPC-sparing IMRT plans may play a more significant role in decreasing Dmedian, Dmean, D40%, and V30-V50 of HPC in NPC patients with stages T3-T4 than those in stages T1-T2. PTVnx70 volume of NPC patients is positively correlated with all dosimetric and volumetric parameters of HPC and the reduction of specific dosage parameters by HPC-sparing IMRT plans.
期刊介绍：
The purpose of Advances is to provide information for clinicians who use radiation therapy by publishing: Clinical trial reports and reanalyses. Basic science original reports. Manuscripts examining health services research, comparative and cost effectiveness research, and systematic reviews. Case reports documenting unusual problems and solutions. High quality multi and single institutional series, as well as other novel retrospective hypothesis generating series. Timely critical reviews on important topics in radiation oncology, such as side effects. Articles reporting the natural history of disease and patterns of failure, particularly as they relate to treatment volume delineation. Articles on safety and quality in radiation therapy. Essays on clinical experience. Articles on practice transformation in radiation oncology, in particular: Aspects of health policy that may impact the future practice of radiation oncology. How information technology, such as data analytics and systems innovations, will change radiation oncology practice. Articles on imaging as they relate to radiation therapy treatment.
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