PMID- 33272744
OWN - NLM
STAT- MEDLINE
DCOM- 20211124
LR  - 20211124
IS  - 1873-4022 (Electronic)
IS  - 1873-4022 (Linking)
VI  - 46
IP  - 2
DP  - 2021 Summer
TI  - Comparative evaluation of treatment plan quality for a prototype biology-guided 
      radiotherapy system in the treatment of nasopharyngeal carcinoma.
PG  - 171-178
LID - S0958-3947(20)30157-6 [pii]
LID - 10.1016/j.meddos.2020.11.002 [doi]
AB  - We aimed to compare prototype treatment plans for a new biology-guided 
      radiotherapy (BgRT) machine in its intensity-modulated radiation therapy (IMRT) 
      mode with those using existing IMRT delivery techniques in treatment of 
      nasopharyngeal carcinoma (NPC). We retrospectively selected ten previous NPC 
      patients treated in 33 fractions according to the NRG-HN001 treatment protocol. 
      Three treatment plans were generated for each patient: a helical tomotherapy (HT) 
      plan with a 2.5-cm jaw, a volumetric modulated arc therapy (VMAT) plan using 2 to 
      4 6-MV arc fields, and a prototype IMRT plan for a new BgRT system which uses a 
      6-MV photon beam on a ring gantry that rotates at 60 rotations per minute with a 
      couch that moves in small incremental steps. Treatment plans were compared using 
      dosimetric parameters to planning target volumes (PTVs) and organs at risk (OARs) 
      as specified by the NRG-HN001 protocol. Plans for the three modalities had 
      comparable dose coverage, mean dose, and dose heterogeneity to the primary PTV, 
      while the prototype IMRT plans had greater dose heterogeneity to the non-primary 
      PTVs, with the average homogeneity index ranging from 1.28 to 1.50 in the 
      prototype plans. Six of all the 7 OAR mean dose parameters were lower with 
      statistical significance in the prototype plans compared to the HT and VMAT plans 
      with the other mean dose parameter being comparable, and all the 18 OAR maximum 
      dose parameters were comparable or lower with statistical significance in the 
      prototype plans. The average left and right parotid mean doses in the prototype 
      plans were 10.5 Gy and 10.4 Gy lower than those in the HT plans, respectively, 
      and were 5.1 Gy and 5.2 Gy lower than those in the VMAT plans, respectively. 
      Compared to that with the HT and VMAT plans, the treatment time was longer with 
      statistical significance with the prototype IMRT plans. Based on dosimetric 
      comparison of ten NPC cases, the prototype IMRT plans achieved comparable or 
      better critical organ sparing compared to the HT and VMAT plans for definitive 
      NPC radiotherapy. However, there was higher dose heterogeneity to non-primary 
      targets and longer estimated treatment time with the prototype plans.
CI  - Copyright (c) 2020 American Association of Medical Dosimetrists. Published by 
      Elsevier Inc. All rights reserved.
FAU - Han, Chunhui
AU  - Han C
AD  - Department of Radiation Oncology, City of Hope National Medical Center, Duarte, 
      CA, USA. Electronic address: chan@coh.org.
FAU - Da Silva, Angela J
AU  - Da Silva AJ
AD  - RefleXion Medical, Inc., Hayward, CA, USA.
FAU - Liang, Jieming
AU  - Liang J
AD  - Department of Radiation Oncology, City of Hope National Medical Center, Duarte, 
      CA, USA.
FAU - Wohlers, Christopher
AU  - Wohlers C
AD  - Department of Radiation Oncology, City of Hope National Medical Center, Duarte, 
      CA, USA.
FAU - Huntzinger, Cal
AU  - Huntzinger C
AD  - RefleXion Medical, Inc., Hayward, CA, USA.
FAU - Neylon, John P
AU  - Neylon JP
AD  - Department of Radiation Oncology, City of Hope National Medical Center, Duarte, 
      CA, USA.
FAU - Du, Dongsu
AU  - Du D
AD  - Department of Radiation Oncology, City of Hope National Medical Center, Duarte, 
      CA, USA.
FAU - Wong, Jeffrey Y C
AU  - Wong JYC
AD  - Department of Radiation Oncology, City of Hope National Medical Center, Duarte, 
      CA, USA.
FAU - Liu, An
AU  - Liu A
AD  - Department of Radiation Oncology, City of Hope National Medical Center, Duarte, 
      CA, USA.
LA  - eng
PT  - Journal Article
DEP - 20201130
PL  - United States
TA  - Med Dosim
JT  - Medical dosimetry : official journal of the American Association of Medical 
      Dosimetrists
JID - 8908862
SB  - IM
MH  - Biology
MH  - Humans
MH  - Nasopharyngeal Carcinoma/radiotherapy
MH  - *Nasopharyngeal Neoplasms/radiotherapy
MH  - Radiotherapy Dosage
MH  - Radiotherapy Planning, Computer-Assisted
MH  - *Radiotherapy, Intensity-Modulated
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Head and neck cancer
OT  - biology-guided radiotherapy
COIS- Declaration of Competing Interest None.
EDAT- 2020/12/05 06:00
MHDA- 2021/11/25 06:00
CRDT- 2020/12/04 05:36
PHST- 2020/07/07 00:00 [received]
PHST- 2020/10/08 00:00 [revised]
PHST- 2020/11/07 00:00 [accepted]
PHST- 2020/12/05 06:00 [pubmed]
PHST- 2021/11/25 06:00 [medline]
PHST- 2020/12/04 05:36 [entrez]
AID - S0958-3947(20)30157-6 [pii]
AID - 10.1016/j.meddos.2020.11.002 [doi]
PST - ppublish
SO  - Med Dosim. 2021 Summer;46(2):171-178. doi: 10.1016/j.meddos.2020.11.002. Epub 
      2020 Nov 30.