Intensity-modulated radiotherapy increases dose to the brachial plexus compared with conventional radiotherapy for head and neck cancer.
Br J Radiol
; 84(997): 58-63, 2011 Jan.
Article
in En
| MEDLINE
| ID: mdl-20858665
ABSTRACT
OBJECTIVE:
The preferential use of intensity-modulated radiotherapy (IMRT) over conventional radiotherapy (CRT) in the treatment of head and neck cancer has raised concerns regarding dose to non-target tissue. The purpose of this study was to compare dose-volume characteristics with the brachial plexus between treatment plans generated by IMRT and CRT using several common treatment scenarios.METHOD:
The brachial plexus was delineated on radiation treatment planning CT scans from 10 patients undergoing IMRT for locally advanced head and neck cancer using a Radiation Therapy Oncology Group-endorsed atlas. No brachial plexus constraint was used. For each patient, a conventional three-field shrinking-field plan was generated and the dose-volume histogram (DVH) for the brachial plexus was compared with that of the IMRT plan.RESULTS:
The mean irradiated volumes of the brachial plexus using the IMRT vs the CRT plan, respectively, were as follows V50 (18±5 ml) vs (11±6 ml), p = 0.01; V60 (6±4 ml) vs (3±3 ml), p = 0.02; V66 (3±1 ml) vs (1±1 ml), p = 0.04, V70 (0±1 ml) vs (0±1 ml), p = 0.68. The maximum point dose to the brachial plexus was 68.9 Gy (range 62.3-78.7 Gy) and 66.1 Gy (range 60.2-75.6 Gy) for the IMRT and CRT plans, respectively (p = 0.01).CONCLUSION:
Dose to the brachial plexus is significantly increased among patients undergoing IMRT compared with CRT for head and neck cancer. Preliminary studies on brachial plexus-sparing IMRT are in progress.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Brachial Plexus
/
Radiotherapy, Intensity-Modulated
/
Head and Neck Neoplasms
Limits:
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Br J Radiol
Year:
2011
Document type:
Article
Affiliation country:
United States