Comparison of target coverage and dose to organs at risk between simultaneous integrated-boost whole-field intensity-modulated radiation therapy and junctioned intensity-modulated radiation therapy with a conventional radiotherapy field in treatment of nasopharyngeal carcinoma

Radiol Phys Technol. 2011 Jul;4(2):180-4. doi: 10.1007/s12194-011-0119-0. Epub 2011 May 10.

Abstract

We have retrospectively investigated 15 nasopharyngeal carcinoma patients treated at our institution between March 2007 and August 2009. We used simultaneous integrated-boost whole field intensity-modulated radiation therapy (SIB WF-IMRT) to treat the entire planning target volume in the head and neck cancer. All of the SIB WF-IMRT plans were replanned by use of the junctioned intensity modulated radiation therapy (J-IMRT) technique for comparison. The effect on target coverage and sparing of organs at risk, including laryngeal sparing in the optimal SIB WF-IMRT plan was compared with that achieved with use of the J-IMRT technique. The mean larynx dose and standard deviation was 25.2 ± 5.8 Gy for SIB WF-IMRT and 19.8 ± 16.8 Gy for J-IMRT. A comparison between SIB WF-IMRT and the J-IMRT technique demonstrated that the larynx dose was increased in SIB WF-IMRT. However, when the strong dose constraint was applied to the larynx and the pseudo-volume was used for a steep dose fall-off immediately outside the target, the SIB WF-IMRT technique would have led to a larynx dose comparable to that achieved with J-IMRT. Therefore, in our current practice we use the SIB WF-IMRT technique, which does not have the problem of setup error at the match line for treatment of nasopharyngeal carcinoma.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Brain Stem / radiation effects
  • Carcinoma
  • Eye / radiation effects
  • Female
  • Humans
  • Larynx / radiation effects*
  • Male
  • Nasopharyngeal Carcinoma
  • Nasopharyngeal Neoplasms / pathology
  • Nasopharyngeal Neoplasms / radiotherapy*
  • Optic Chiasm / radiation effects
  • Optic Nerve / radiation effects
  • Organs at Risk*
  • Parotid Gland / radiation effects
  • Pharynx / radiation effects*
  • Radiotherapy Dosage
  • Radiotherapy, Intensity-Modulated / methods*
  • Radiotherapy, Intensity-Modulated / standards
  • Spinal Cord / radiation effects