Utility of daily image guidance with intensity-modulated radiotherapy for tumors of the base of skull

Head Neck. 2012 Jun;34(6):763-70. doi: 10.1002/hed.21805. Epub 2011 Jul 7.

Abstract

Background: This study was carried out to report our experience using intensity-modulated radiotherapy (IMRT) with daily image-guided radiotherapy (IGRT) for tumors involving the base of skull.

Methods: In all, 100 patients were prospectively treated with IMRT to a median dose of 64 Gy (range, 45-70 Gy). Daily helical megavoltage computed tomography (MVCT) scans were obtained as part of an IGRT registration protocol for patient alignment.

Results: The 2-year local-regional control was 91%. A total of 3295 daily MVCT scans were obtained. The mean shift to account for interfraction motion was 1.18 ± 1.75 mm, 1.81 ± 1.34 mm, and 1.33 ± 1.19 mm for the medial-lateral (ML), superior-inferior (SI), and anterior-posterior (AP) directions, respectively. Pretreatment shifts of >3 mm occurred in 10%, 26%, and 18%, in the ML, SI, and AP directions, respectively.

Conclusions: The feasibility and efficacy of daily IGRT as a complement to IMRT for skull base were demonstrated.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Feasibility Studies
  • Humans
  • Middle Aged
  • Patient Positioning
  • Prospective Studies
  • Radiography, Interventional*
  • Radiotherapy Dosage
  • Radiotherapy Planning, Computer-Assisted
  • Radiotherapy, Intensity-Modulated*
  • Skull Base Neoplasms / diagnostic imaging*
  • Skull Base Neoplasms / mortality
  • Skull Base Neoplasms / radiotherapy*
  • Tomography, Spiral Computed*