Dosimetric and radiobiological comparison in head-and-neck radiotherapy using JO-IMRT and 3D-CRT

Duong Thanh Tai; Luong Thi Oanh; Pham Hoai Phuong; Abdelmoneim Sulieman; Fouad A Abolaban; Hiba Omer; James C L Chow

doi:10.1016/j.sjbs.2022.103336

Dosimetric and radiobiological comparison in head-and-neck radiotherapy using JO-IMRT and 3D-CRT

Saudi J Biol Sci. 2022 Aug;29(8):103336. doi: 10.1016/j.sjbs.2022.103336. Epub 2022 Jun 2.

Authors

Duong Thanh Tai^{1

2}, Luong Thi Oanh³, Pham Hoai Phuong⁴, Abdelmoneim Sulieman⁵, Fouad A Abolaban^{6

7}, Hiba Omer⁸, James C L Chow^{9

10}

Affiliations

¹ Department of Medical Physics, Faculty of Medicine, Nguyen Tat Thanh University, 298-300A Nguyen Tat Thanh Street, Ward 13, District 4, Ho Chi Minh City, Viet Nam.
² Robarts Research Institute, London, Ontario, N6A 5K8, Canada.
³ Department of Radiation Technology, Ho Chi Minh City Oncology Hospital, Ho Chi Minh City 702000, Viet Nam.
⁴ VKTECH Research Center, Nguyen Tat Thanh University, 298-300A Nguyen Tat Thanh Street, Ward 13, District 4, Ho Chi Minh City, Viet Nam.
⁵ Prince Sattam Bin Abdulaziz University, College of Applied Medical Sciences, Radiology and Medical Imaging Department, Alkharj, Saudi Arabia.
⁶ Department of Nuclear Engineering , Faculty of Engineering, King Abdulaziz University P. O. Box 80204, Jeddah 21589, Saudi Arabia.
⁷ K. A. CARE Energy Research and Innovation Center, King Abdulaziz University, Jeddah 21589, Saudi Arabia.
⁸ Department of Basic Sciences, Deanship of Preparatory Year and Supporting Studies, Imam Abdulrahman Bin Faisal University, P.O.Box 1982, Dammam 34212, Saudi Arabia.
⁹ Department of Radiation Oncology, University of Toronto, Toronto, ON, M5S 1A1, Canada.
¹⁰ Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, M5G 1X6, Canada.

Abstract

Introduction: Dosimetric and radiobiological evaluations for the Jaws-only Intensity-modulated radiotherapy (JO-IMRT) technique for head and neck jaws-only intensity-modulated radiation therapy (JO-IMRT) and 3D conformal radiation therapy (3D-CRT). To compare the head-and-neck therapeutic approaches utilizing JO-IMRT and 3D-CRT techniques, different radiation dose indices were calculated, including: conformity index (CI), homogeneity index (HI), and radiobiological variables like Niemierko's equivalent uniform dose based tumor control probability (TCP) of planning target volume (PTV), normal tissue complication probability (NTCP) of organs at risk (OAR) (brainstem, spinal cord, and parotid grand).

Materials and methods: Twenty-five nasopharynx patients were studied using the Prowess Panther Treatment Planning System (Prowess Inc). The results were compared with the dose distribution obtained using 3D-CRT.

Results: Regarding tumor coverage and CI, JO-IMRT showed better results than 3D-CRT. The average doses received by the PTVs were quite similar: 72.1 ± 0.8 Gy by 3D-CRT and 72.5 ± 0.6 Gy by JO-IMRT plans (p > 0.05). The mean doses received by the parotid gland were 56.7 ± 0.7 Gy by 3D-CRT and 26.8 ± 0.3 Gy by JO-IMRT (p > 0.05). The HI and CI were 0.13 ± 0.01 and 0.14 ± 0.05 and (p > 0.05) by 3D-CRT and 0.83 ± 0.05 and 0.73 ± 0.10 by JO-IMRT (p < 0.05). The average TCP of PTV was 0.82 ± 0.08 by 3D-CRT and 0.92 ± 0.02 by JO-IMRT. Moreover, the NTCP of the parotid glands, brain stem, and spinal cord were lower using the JO-IMRT than 3D-CRT plans. In comparison to the 3D-CRT approach, the JO-IMRT technique was able to boost dose coverage to the PTV, improve the target's CI and HI, and spare the parotid glands. This suggests the power of the JO-IMRT over 3D-CRT in head-and-neck radiotherapy.

Keywords: 3D-CRT technique; 3D-CRT, 3D conformal radiation therapy; CI, Conformity index; Dosimetric and radiobiological evaluation; EUD, Equivalent uniform dose; Equivalent Uniform Dose (EUD); HI, Homogeneity index; JO-IMRT technique; JO-IMRT, Jaws-only Intensity-modulated radiotherapy; NTCP, Normal tissue complication probability; PTV, Planning target volume; Plan evaluation; TCP, Tumor control probability.