PMID- 23425449
OWN - NLM
STAT- MEDLINE
DCOM- 20130906
LR  - 20231106
IS  - 1748-717X (Electronic)
IS  - 1748-717X (Linking)
VI  - 8
DP  - 2013 Feb 20
TI  - RapidArc, SmartArc and TomoHD compared with classical step and shoot and sliding 
      window intensity modulated radiotherapy in an oropharyngeal cancer treatment plan 
      comparison.
PG  - 37
LID - 10.1186/1748-717X-8-37 [doi]
AB  - BACKGROUND: Radiotherapy techniques have evolved rapidly over the last decade 
      with the introduction of Intensity Modulated RadioTherapy (IMRT) in different 
      forms. It is not clear which of the IMRT techniques is superior in the treatment 
      of head and neck cancer patients in terms of coverage of the planning target 
      volumes (PTVs), sparing the organs at risk (OARs), dose to the normal tissue, 
      number of monitor units needed and delivery time.The present paper aims to 
      compare Step and Shoot (SS) IMRT, Sliding Window (SW) IMRT, RapidArc (RA) planned 
      with Eclipse, Elekta VMAT planned with SmartArc (SA) and helical TomoHD (HT). 
      METHODS: Target volumes and organs at risk (OARs) of five patients with 
      oropharyngeal cancer were delineated on contrast enhanced CT-scans, then 
      treatment plans were generated on five different IMRT systems. In 32 fractions, 
      69.12 Gy and 56 Gy were planned to the therapeutic and prophylactic PTVs, 
      respectively. For the PTVs and 26 OARs ICRU 83 reporting guidelines were 
      followed. Differences in the studied parameters between treatment planning 
      systems were analysed using repeated measures ANOVA. RESULTS: Mean Homogeneity 
      Index of PTV(therapeutic) is better with HT(.06) followed by SA(.08), RA(.10), 
      SW(.10) and SS(.11). PTV(prophylactic) is most homogeneous with RA. Parotid 
      glands prescribed mean doses are only obtained by SA and HT, 20.6 Gy and 21.7 Gy 
      for the contralateral and 25.6 Gy and 24.1 Gy for the ipsilateral, against 25.6 
      Gy and 32.0 Gy for RA, 26.4 Gy and 34.6 Gy for SW, and 28.2 Gy and 34.0 Gy for 
      SS. RA uses the least monitor units, HT the most. Treatment times are 3.05 min 
      for RA, and 5.9 min for SA and HT. CONCLUSIONS: In the treatment of oropharyngeal 
      cancer, we consider rotational IMRT techniques preferable to fixed gantry 
      techniques due to faster fraction delivery and better sparing of OARs without a 
      higher integral dose. TomoHD gives most homogeneous target coverage with more 
      sparing of spinal cord, brainstem, parotids and the lower swallowing apparatus 
      than most of the other systems. Between RA and SA, SA gives a more homogeneous 
      PTV(therapeutic) while sparing the parotids more, but the delivery of RA is twice 
      as fast with less overdose to the PTV(elective).
FAU - Van Gestel, Dirk
AU  - Van Gestel D
AD  - Department of Radiotherapy, University Radiotherapy department Antwerp - UZA / 
      ZNA, Lindendreef 1, 2020 Antwerp, Belgium. dirk.vangestel@zna.be
FAU - van Vliet-Vroegindeweij, Corine
AU  - van Vliet-Vroegindeweij C
FAU - Van den Heuvel, Frank
AU  - Van den Heuvel F
FAU - Crijns, Wouter
AU  - Crijns W
FAU - Coelmont, Ann
AU  - Coelmont A
FAU - De Ost, Bie
AU  - De Ost B
FAU - Holt, Andrea
AU  - Holt A
FAU - Lamers, Emmy
AU  - Lamers E
FAU - Geussens, Yasmyne
AU  - Geussens Y
FAU - Nuyts, Sandra
AU  - Nuyts S
FAU - Van den Weyngaert, Danielle
AU  - Van den Weyngaert D
FAU - Van den Wyngaert, Tim
AU  - Van den Wyngaert T
FAU - Vermorken, Jan B
AU  - Vermorken JB
FAU - Gregoire, Vincent
AU  - Gregoire V
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
DEP - 20130220
PL  - England
TA  - Radiat Oncol
JT  - Radiation oncology (London, England)
JID - 101265111
SB  - IM
MH  - Humans
MH  - Oropharyngeal Neoplasms/pathology/*radiotherapy
MH  - Radiotherapy Dosage
MH  - *Radiotherapy Planning, Computer-Assisted
MH  - Radiotherapy, Intensity-Modulated/*methods
MH  - Tumor Burden
PMC - PMC3599972
EDAT- 2013/02/22 06:00
MHDA- 2013/09/07 06:00
PMCR- 2013/02/20
CRDT- 2013/02/22 06:00
PHST- 2012/08/17 00:00 [received]
PHST- 2013/02/06 00:00 [accepted]
PHST- 2013/02/22 06:00 [entrez]
PHST- 2013/02/22 06:00 [pubmed]
PHST- 2013/09/07 06:00 [medline]
PHST- 2013/02/20 00:00 [pmc-release]
AID - 1748-717X-8-37 [pii]
AID - 10.1186/1748-717X-8-37 [doi]
PST - epublish
SO  - Radiat Oncol. 2013 Feb 20;8:37. doi: 10.1186/1748-717X-8-37.