PMID- 22417803
OWN - NLM
STAT- MEDLINE
DCOM- 20121026
LR  - 20181201
IS  - 1879-355X (Electronic)
IS  - 0360-3016 (Linking)
VI  - 84
IP  - 1
DP  - 2012 Sep 1
TI  - Do we need daily image-guided radiotherapy by megavoltage computed tomography in 
      head and neck helical tomotherapy? The actual delivered dose to the spinal cord.
PG  - 283-8
LID - 10.1016/j.ijrobp.2011.10.073 [doi]
AB  - PURPOSE: To quantify the actual delivered dose to the cervical spinal cord with 
      different image-guided radiotherapy (IGRT) approaches during head and neck (HN) 
      cancer helical tomotherapy. METHODS AND MATERIALS: Twenty HN patients (HNpts) 
      treated with bilateral nodal irradiation were analyzed. Daily megavoltage 
      computed tomography MVCT) scans were performed for setup purposes. The maximum 
      dose on the planning CT scan (plan-Dmax) and the magnitude and localization of 
      the actual delivered Dmax (a-Dmax) were analyzed for four scenarios: daily 
      image-guided radiotherapy (dIGRT), twice weekly IGRT (2xWkIGRT), once weekly IGRT 
      (1xWkIGRT), and no IGRT at all (non-IGRT). The spinal cord was recontoured on 236 
      MVCTs for each scenario (total, 944 fractions), and the delivered dose was 
      recalculated for each fraction (fx) separately. RESULTS: Fifty-one percent of the 
      analyzed fx for dIGRT, 56% of the analyzed fx for the 2xWkIGRT, 62% of the 
      analyzed fx for the 1xWkIGRT, and 63% of the analyzed fx for the non-IGRT 
      scenarios received a higher a-Dmax than the plan-Dmax. The median increase of 
      dose in these fx was 3.3% more for dIGRT, 5.8% more for 2xWkIGRT, 10.0% more for 
      1xWkIGRT, and 9.5% more for non-IGRT than the plan-Dmax. The median spinal cord 
      volumes receiving a higher dose than the plan-Dmax were 0.02 cm(3) for dIGRT, 0.11 
      cm(3) for 2xWkIGRT, 0.31 cm(3) for 1xWkIGRT, and 0.22 cm(3) for non-IGRT. Differences 
      between the dIGRT and all other scenarios were statistically significant (p < 
      0.05). CONCLUSIONS: Compared to the Dmax of the initial plan, daily IGRT had the 
      smallest increase in dose. Furthermore, daily IGRT had the lowest proportion of 
      fractions and the smallest volumes affected by a dose that was higher than the 
      planned dose. For patients treated with doses close to the tolerance dose of the 
      spinal cord, we recommend daily IGRT. For all other cases, twice weekly IGRT is 
      sufficient.
CI  - Copyright (c) 2012 Elsevier Inc. All rights reserved.
FAU - Duma, Marciana Nona
AU  - Duma MN
AD  - Department of Radiation Oncology, Technische Universitat Munchen, Klinikum rechts 
      der Isar, Munchen, Germany. Marciana.Duma@lrz.tumuenchen.de
FAU - Kampfer, Severin
AU  - Kampfer S
FAU - Schuster, Tibor
AU  - Schuster T
FAU - Aswathanarayana, Nandana
AU  - Aswathanarayana N
FAU - Fromm, Laura-Sophie
AU  - Fromm LS
FAU - Molls, Michael
AU  - Molls M
FAU - Andratschke, Nicolaus
AU  - Andratschke N
FAU - Geinitz, Hans
AU  - Geinitz H
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20120313
PL  - United States
TA  - Int J Radiat Oncol Biol Phys
JT  - International journal of radiation oncology, biology, physics
JID - 7603616
SB  - IM
MH  - Dose Fractionation, Radiation
MH  - Female
MH  - Humans
MH  - Lymphatic Irradiation/*methods
MH  - Male
MH  - Middle Aged
MH  - Nasopharyngeal Neoplasms/*radiotherapy
MH  - Neck
MH  - Radiotherapy Planning, Computer-Assisted
MH  - Radiotherapy Setup Errors
MH  - Radiotherapy, Image-Guided/*methods
MH  - Radiotherapy, Intensity-Modulated/*methods
MH  - Spinal Cord/diagnostic imaging/*radiation effects
MH  - Time Factors
MH  - Tomography, X-Ray Computed/*methods
MH  - Tonsillar Neoplasms/*radiotherapy
MH  - Uncertainty
EDAT- 2012/03/16 06:00
MHDA- 2012/10/27 06:00
CRDT- 2012/03/16 06:00
PHST- 2011/07/15 00:00 [received]
PHST- 2011/10/27 00:00 [revised]
PHST- 2011/10/28 00:00 [accepted]
PHST- 2012/03/16 06:00 [entrez]
PHST- 2012/03/16 06:00 [pubmed]
PHST- 2012/10/27 06:00 [medline]
AID - S0360-3016(11)03481-X [pii]
AID - 10.1016/j.ijrobp.2011.10.073 [doi]
PST - ppublish
SO  - Int J Radiat Oncol Biol Phys. 2012 Sep 1;84(1):283-8. doi: 
      10.1016/j.ijrobp.2011.10.073. Epub 2012 Mar 13.