PMID- 34646757
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220427
IS  - 2234-943X (Print)
IS  - 2234-943X (Electronic)
IS  - 2234-943X (Linking)
VI  - 11
DP  - 2021
TI  - Comparison of Dosimetric Benefits of Three Precise Radiotherapy Techniques in 
      Nasopharyngeal Carcinoma Patients Using a Priority-Classified Plan Optimization 
      Model.
PG  - 646584
LID - 10.3389/fonc.2021.646584 [doi]
LID - 646584
AB  - INTRODUCTION: Although intensity-modulated radiotherapy (IMRT), 
      volumetric-modulated arc therapy (VMAT) and tomotherapy (TOMO) are broadly 
      applied for nasopharyngeal carcinoma (NPC), the best technique remains unclear. 
      Therefore, this study was conducted to address this issue. METHODS: The 
      priority-classified plan optimization model was applied to IMRT, VMAT and TOMO 
      plans in forty NPC patients according to the latest international guidelines. And 
      the dosimetric parameters of planning target volumes (PTVs) and organs at risk 
      (OARs) were compared among these three techniques. The Friedman M test in SPSS 
      software was applied to assess significant differences. RESULTS: The median 
      PGTVnx coverage of IMRT was the lowest (93.5%, P < 0.001) for all T categories. 
      VMAT was comparable to TOMO in OARs clarified as priority I and II, and both 
      satisfied the prescribed requirement. IMRT resulted in a relatively high dose for 
      V25 and V30. Interestingly, subgroup analysis showed that the median PTV coverage 
      of the three techniques was no less than 95% in the early T stage. The 
      heterogeneity index (HI) of PGTVnx in VMAT was better than that in IMRT (P = 
      0.028). Compared to TOMO, VMAT showed a strong ability to protect eyesight and 
      decrease low-dose radiation volumes. In the advanced T stage subgroup, TOMO 
      numerically achieved the highest median PGTVnx coverage volume compared with VMAT 
      and IMRT (93.61%, 91% and 90%, respectively). The best CI and HI of PCTV-1 were 
      observed in TOMO. Furthermore, TOMO was better than VMAT for sparing the brain 
      stem, spinal cord and temporal lobes (all P < 0.05). However, the median V5, V10, 
      V15, V20 and V25 were significantly higher with TOMO than with VMAT (all P < 
      0.05). CONCLUSION: In the early T stage, VMAT provides a similar dose coverage 
      and protection of OARs to IMRT, and there are no obvious advantages to choosing 
      TOMO for NPC patients in the early T stage. TOMO may be recommended for patients 
      in the advanced T stage due as it provides the largest dose coverage of PGTVnx 
      and the best protection of the brain stem, spinal cord and temporal lobes. 
      Additionally, more randomized clinical trials are needed for further 
      clarification.
CI  - Copyright (c) 2021 Wang, Qin, Cao, Xu, Yan, Zhu, Wu, Xu, Zhu, Jiang, Li and Xiong.
FAU - Wang, Qiaoli
AU  - Wang Q
AD  - Department of Radiotherapy, Yunnan Cancer Hospital, the Third Affiliated Hospital 
      of Kunming Medical University, Kunming, China.
FAU - Qin, Jiyong
AU  - Qin J
AD  - Department of Radiotherapy, Yunnan Cancer Hospital, the Third Affiliated Hospital 
      of Kunming Medical University, Kunming, China.
FAU - Cao, Ruixue
AU  - Cao R
AD  - Department of Radiotherapy, Yunnan Cancer Hospital, the Third Affiliated Hospital 
      of Kunming Medical University, Kunming, China.
FAU - Xu, Tianrui
AU  - Xu T
AD  - Department of Radiotherapy, Yunnan Cancer Hospital, the Third Affiliated Hospital 
      of Kunming Medical University, Kunming, China.
FAU - Yan, Jiawen
AU  - Yan J
AD  - Department of Radiotherapy, Yunnan Cancer Hospital, the Third Affiliated Hospital 
      of Kunming Medical University, Kunming, China.
FAU - Zhu, Sijin
AU  - Zhu S
AD  - Department of Radiotherapy, Yunnan Cancer Hospital, the Third Affiliated Hospital 
      of Kunming Medical University, Kunming, China.
FAU - Wu, Jiang
AU  - Wu J
AD  - Department of Radiotherapy, Yunnan Cancer Hospital, the Third Affiliated Hospital 
      of Kunming Medical University, Kunming, China.
FAU - Xu, Guoqiang
AU  - Xu G
AD  - Department of Radiotherapy, Yunnan Cancer Hospital, the Third Affiliated Hospital 
      of Kunming Medical University, Kunming, China.
FAU - Zhu, Lixiu
AU  - Zhu L
AD  - Department of Radiotherapy, Yunnan Cancer Hospital, the Third Affiliated Hospital 
      of Kunming Medical University, Kunming, China.
FAU - Jiang, Wei
AU  - Jiang W
AD  - Cancer Hospital Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking 
      Union Medical College, Shenzhen, China.
FAU - Li, Wenhui
AU  - Li W
AD  - Department of Radiotherapy, Yunnan Cancer Hospital, the Third Affiliated Hospital 
      of Kunming Medical University, Kunming, China.
FAU - Xiong, Wei
AU  - Xiong W
AD  - Department of Radiotherapy, Yunnan Cancer Hospital, the Third Affiliated Hospital 
      of Kunming Medical University, Kunming, China.
LA  - eng
PT  - Journal Article
DEP - 20210927
PL  - Switzerland
TA  - Front Oncol
JT  - Frontiers in oncology
JID - 101568867
PMC - PMC8504456
OTO - NOTNLM
OT  - dosimetry
OT  - intensity-modulated radiotherapy
OT  - nasopharyngeal carcinoma
OT  - tomotherapy
OT  - volumetric-modulated arc therapy
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest. The reviewer [YT] declared a shared affiliation with one of 
      the authors [WJ] to the handling editor at the time of review.
EDAT- 2021/10/15 06:00
MHDA- 2021/10/15 06:01
PMCR- 2021/01/01
CRDT- 2021/10/14 06:38
PHST- 2020/12/27 00:00 [received]
PHST- 2021/09/06 00:00 [accepted]
PHST- 2021/10/14 06:38 [entrez]
PHST- 2021/10/15 06:00 [pubmed]
PHST- 2021/10/15 06:01 [medline]
PHST- 2021/01/01 00:00 [pmc-release]
AID - 10.3389/fonc.2021.646584 [doi]
PST - epublish
SO  - Front Oncol. 2021 Sep 27;11:646584. doi: 10.3389/fonc.2021.646584. eCollection 
      2021.