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Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies
08:34

Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies

Published on: February 6, 2019

Options for combining altered fractionation with IMRT.

A M Allen1, L Wolfsberger, R B Tishler

  • 1Department of Radiation Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA. aallen@lroc.harvard.edu

Technology in Cancer Research & Treatment
|December 3, 2008
PubMed
Summary
This summary is machine-generated.

Intensity-modulated radiation therapy (IMRT) based concomitant boost strategies are effective for head and neck cancers. Both IMRT and 3D-CRT boost techniques offer comparable target coverage and acceptable dosimetric results.

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Area of Science:

  • Radiation Oncology
  • Medical Physics
  • Head and Neck Cancer Treatment

Background:

  • Stage III/IV squamous cell carcinoma of the head and neck (HNSCC) often requires dose escalation for improved outcomes.
  • Concomitant boost techniques aim to deliver higher doses to the tumor while sparing surrounding tissues.

Purpose of the Study:

  • To compare the dosimetric and planning characteristics of intensity-modulated radiation therapy (IMRT) versus 3-D conformal radiation therapy (3-DCRT) for concomitant boost in HNSCC.
  • To evaluate the feasibility and effectiveness of IMRT-based concomitant boost strategies.

Main Methods:

  • Retrospective review of treatment plans for eight HNSCC patients.
  • Re-planning cases using both IMRT and 3-DCRT for a concomitant boost regimen.
  • Evaluation of target coverage, organ-at-risk sparing, monitor units, integral dose, and planning/QA time.

Main Results:

  • Both IMRT-IMRT and IMRT-3DCRT techniques achieved equivalent target coverage (100% GTV/PTV coverage with 97% prescription dose).
  • Hot spots were observed in both plans, with slightly higher maximums in IMRT-3DCRT.
  • IMRT-IMRT plans required more monitor units for the boost but not significantly different overall; integral dose was slightly higher with IMRT-IMRT.
  • IMRT boost planning was faster than 3-DCRT boost planning, but IMRT-IMRT quality assurance took longer.

Conclusions:

  • IMRT-based concomitant boost strategies are achievable and yield good dosimetric results for HNSCC.
  • Both IMRT and 3-DCRT boost techniques are viable options, with trade-offs in planning time, QA, and specific dose distributions.