Extended-field bone marrow sparing radiotherapy for primary chemoradiotherapy in cervical cancer patients with para-aortic lymphadenopathy: Volumetric-modulated arc therapy versus helical tomotherapy.
J Xray Sci Technol
; 28(1): 111-124, 2020.
Article
in En
| MEDLINE
| ID: mdl-31904003
ABSTRACT
BACKGROUND:
Extended-field (EF) bone marrow-sparing (BMS) radiotherapy is attracting interest for cervical cancer patients with para-aortic lymphadenopathy.OBJECTIVE:
To compare dosimetric quality of volumetric-modulated arc therapy (VMAT) vs. helical tomotherapy (HT) during EF BMS radiotherapy.METHODS:
HT dose-volume histogram parameters including (1) coverage, homogeneity, and conformity of target volumes, (2) sparing of organs-at-risk, (3) monitor units, and (4) estimated treatment time were compared with those of VMAT in 20 cervical cancer patients who underwent EF BMS radiotherapy. The pelvic and para-aortic regions received 45-Gy dose (25 fractions), with simultaneous integrated boost of 55âGy (25 fractions) for pelvic and para-aortic lymphadenopathy, followed by a parametrial boost of 9âGy (5 fractions).RESULTS:
The HT-based and VMAT techniques achieved adequate and similar target volume coverage with good dose homogeneity and conformity, while sparing all organs-at-risk, including the rectum, bladder, bowel, bone marrow, femoral head, kidney, and spinal cord. The HT treatment plan had significantly higher monitor units (pâ<â0.001) and longer estimated treatment times (pâ<â0.001).CONCLUSIONS:
VMAT and HT plans are suitable for EF BMS radiotherapy, which can achieve adequate target volume coverage while sufficiently sparing normal tissue. In addition, VMAT, compared to HT planning, yielded shorter estimated treatment times.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Bone Marrow
/
Radiotherapy Planning, Computer-Assisted
/
Uterine Cervical Neoplasms
/
Radiotherapy, Intensity-Modulated
/
Chemoradiotherapy
/
Lymphadenopathy
Type of study:
Etiology_studies
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Middle aged
Language:
En
Year:
2020
Type:
Article