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Comparative Dosimetric Analysis and Normal Tissue Complication Probability Modelling of Four-Dimensional Computed
O Nicholas1, C Bowden2, A Selby3
1South West Wales Cancer Centre, Swansea, UK; Swansea University Medical School, Swansea, UK; National RTTQA Group, Velindre Cancer Centre, Cardiff, UK.
Aims:
NeoSCOPE is a trial of two different neoadjuvant chemoradiotherapy regimens for resectable oesophageal cancer and was the first multicentre trial in the UK to incorporate four-dimensional computed tomography (4D-CT) into radiotherapy planning. Despite 4D-CT being increasingly accepted as a standard of care for lower third and junctional oesophageal tumours, there is limited evidence of its benefit over standard three-dimensional computed tomography (3D-CT).
Materials:
Using NeoSCOPE 4D-CT cases, we undertook a dosimetric comparison study of 3D-CT versus 4D-CT plans comparing target volume coverage and dose to organs at risk. We used established normal tissue complication probability models to evaluate the potential toxicity reduction of using 4D-CT plans in oesophageal cancer.
Results:
4D-CT resulted in a smaller median absolute PTV volume and lower dose levels for all reported constraints with comparable target volume coverage. NTCP modelling suggests a significant relative risk reduction of cardiac and pulmonary toxicity endpoints with 4D-CT.
Conclusion:
Our work shows that incorporating 4D-CT into treatment planning may significantly reduce the toxicity burden from this treatment.
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