Hostname: page-component-78c5997874-lj6df Total loading time: 0 Render date: 2024-11-08T16:23:33.408Z Has data issue: false hasContentIssue false
  • English
  • Français

Radiobiological assessment of nasopharyngeal cancer IMRT using various collimator angles and non-coplanar fields

Published online by Cambridge University Press:  12 February 2020

G. Sharbo ,
B. Hashemi Open the ORCID record for B. Hashemi [Opens in a new window] ,
M. Bakhshandeh Open the ORCID record for M. Bakhshandeh [Opens in a new window]  and
A. Rakhsha Open the ORCID record for A. Rakhsha [Opens in a new window]
G. Sharbo
Affiliation:
Department of Medical Physics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
B. Hashemi*
Affiliation:
Department of Medical Physics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
M. Bakhshandeh
Affiliation:
Department of Radiology Technology, Faculty of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
A. Rakhsha
Affiliation:
Department of Radiation Oncology, Faculty of Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
*
Author for correspondence: Bijan Hashemi, Department of Medical Physics, Faculty of Medical Sciences, Tarbiat Modares University, Al-Ahmad and Chamran Cross, Tehran1411713116, Iran. Tel: +98-21-82883892. Fax: +98-21-88006544. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Aim:

The aim of this study was to evaluate clinical efficacy and radiobiological outcome of intensity-modulated radiation therapy (IMRT) modalities using various collimator angles and non-coplanar fields for nasopharyngeal cancer (NPC).

Materials and methods:

A 70-Gy planning target volume dose was administered for 30 NPC patients referred for IMRT. Standard IMRT plans were constructed based on the target and organs at risk (OARs) volume; and dose constraints recommended by Radiation Therapy Oncology Group (RTOG). Using various collimator angles and non-coplanar fields, 11 different additional IMRT protocols were investigated. Homogeneity indexes (HIs) and conformation numbers (CNs) were calculated. Poisson and relative seriality models were utilised for estimating tumour control probability (TCP) and normal tissue complication probabilities (NTCPs), respectively.

Results:

Various collimator angles and non-coplanar fields had no significant effect on HI, CN and TCP, while significant effects were noted for some OARs, with a maximum mean dose (Dmax). No significant differences were observed among the calculated NTCPs of all the IMRT protocols. However, the protocol with 10° collimator angle (for five fields out of seven) and 8° couch angle had the lowest NTCP. Furthermore, the standard and some of non-coplanar IMRT protocols led to the reduction in OARs Dmax.

Conclusions:

Using appropriate standard/non-coplanar IMRT protocols for NPC treatment could potentially reduce the dose to the OARs and the probability of inducing secondary cancer in patients.

Keywords

angle of collimatorIMRTnasopharyngeal carcinomanon-coplanar fieldtreatment planning
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 20 , Issue 2 , June 2021 , pp. 168 - 175
Check for updates
Copyright
© The Authors, 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Narayanasamy, G, Pyakuryal, AP, Pandit, S et al. Radiobiological evaluation of intensity modulated radiation therapy treatments of patients with head and neck cancer: a dual-institutional study. J Med Phys 2015; 40 (3): 165–169.CrossRefGoogle ScholarPubMed
Wu, PM, Chua, DT, Sham, JS et al. Tumor control probability of nasopharyngeal carcinoma: a comparison of different mathematical models. Int J Radiat Oncol Biol Phys 1997; 37 (4): 913–320.CrossRefGoogle ScholarPubMed
NCI. The national cancer institute guidelines for the use of IMRT in clinical trials. http://rpc.mdanderson.org/RPC/services/Anthropomorphic_%20Phantoms/IMRT_NCI_Guidelines_v4.0.pdf. Accessed on 26th November 2019.Google Scholar
Tao, Y, Lefkopoulos, D, Ibrahima, D et al. Comparison of dose contribution to normal pelvic tissues among conventional, conformal and intensity-modulated radiotherapy techniques in prostate cancer. Acta Oncol 2008; 47 (3): 442–450.CrossRefGoogle ScholarPubMed
Fiandra, C, Filippi, AR, Catuzzo, P et al. Different IMRT solutions vs. 3D-conformal radiotherapy in early stage Hodgkin’s Lymphoma: dosimetric comparison and clinical considerations. Radiation Oncol 2012; 7 (1): 186.CrossRefGoogle ScholarPubMed
Hall, EJ, Wuu, CS. Radiation-induced second cancers: the impact of 3D-CRT and IMRT. Int J Radiat Oncol Biol Phys 2003; 56 (1): 83–88.CrossRefGoogle ScholarPubMed
Brenner, DJ, Curtis, RE, Hall, EJ, Ron, E. Second malignancies in prostate carcinoma patients after radiotherapy compared with surgery. Cancer 2000; 88 (2): 398–406.3.0.CO;2-V>CrossRefGoogle ScholarPubMed
Sigurdson, AJ, Jones, IM. Second cancers after radiotherapy: any evidence for radiation-induced genomic instability? Oncogene 2003; 22 (45): 7018–7027.CrossRefGoogle ScholarPubMed
Dores, GM, Metayer, C, Curtis, RE et al. Second malignant neoplasms among long-term survivors of Hodgkin’s disease: a population-based evaluation over 25 years. Int J Clin 2002; 20 (16): 3484–3494.Google ScholarPubMed
Travis, LB, Andersson, M, Gospodarowicz, M et al. Treatment-associated leukemia following testicular cancer. J Natl Cancer Inst 2000; 92 (14): 1165–1171.CrossRefGoogle ScholarPubMed
Travis, LB, Gospodarowicz, M, Curtis, RE et al. Lung cancer following chemotherapy and radiotherapy for Hodgkin’s disease. J Natl Cancer Inst 2002; 94 (3): 182–192.CrossRefGoogle ScholarPubMed
Richie, JP, Travis, LB, Fossa, SD et al. Second cancers among 40,576 testicular cancer patients: focus on long-term survivors. Urol Oncol 2006; 24 (2): 171–171.CrossRefGoogle Scholar
Boughalia, A, Marcie, S, Fellah, M, Chami, S, Mekki, F. Assessment and quantification of patient set-up errors in nasopharyngeal cancer patients and their biological and dosimetric impact in terms of generalized equivalent uniform dose (gEUD), tumour control probability (TCP) and normal tissue complication probability (NTCP). Br J Radiol 2015; 88 (1050): 20140839.CrossRefGoogle Scholar
Monica, W. K. Kan, Lucullus, H. T. Leung, Peter, K. N. Yu. The use of biologically related model (Eclipse) for the intensity-modulated radiation therapy planning of nasopharyngeal carcinomas. PLoS ONE 2014; 9 (11): e112229.Google Scholar
Mesbahi, A, Dadgar, H. Dose calculations accuracy of TiGRT treatment planning system for small IMRT beamlets in heterogeneous lung phantom. Int J Radiat Res 2015; 13 (4): 345–354.Google Scholar
Mesbahi, A, Zergoug, I. Dose calculations for lung inhomogeneity in high-energy photon beams and small beamlets: a comparison between XiO and TiGRT treatment planning systems and MCNPX Monte Carlo code. Iran J Med Phys 2015; 12 (3): 167–177.Google Scholar
Radiation Therapy Oncology Group. RTOG 0615: a phase II study of concurrent chemoradiotherapy using three – dimensional conformal radiotherapy (3D-CRT) or Intensity – Modulated Radiation Therapy (IMRT) + Bevacizumab (BV) for locally or regionally advanced Nasopharygeal Cancer. https://www.nrgoncology.org/Clinical-Trials/Protocol/rtog-0615?filter=rtog-0615%22. Accessed on 1st February 2020.Google Scholar
Van’t Riet, A, Mak, AC, Moerland, MA, Elders, LH, Van Der Zee, W. A conformation number to quantify the degree of conformality in brachytherapy and external beam irradiation: application to the prostate. Int J Radiat Oncol Biol Phys 1997; 37 (3): 731–736.CrossRefGoogle ScholarPubMed
Landberg, T, Chavaudra, J, Dobbs, J et al. ICRU report 62: prescribing, recording and reporting photon beam therapy (supplement to ICRU report 50). Bethesda MD: ICRU, 1999.Google Scholar
Komisopoulos, G, Mavroidis, P, Rodriguez, S et al.. Radiobiologic comparison of helical tomotherapy, intensity modulated radiotherapy, and conformal radiotherapy in treating lung cancer accounting for secondary malignancy risks. Med Dosim 2014; 39 (4): 337–347.CrossRefGoogle ScholarPubMed
Ågren, A, Brahme, A, Turesson, I. Optimization of uncomplicated control for head and neck tumors. Int J Radiat Oncol Biol Phys 1990; 19 (4): 1077–1085.CrossRefGoogle ScholarPubMed
Källman, P, Ågren, A, Brahme, A. Tumour and normal tissue responses to fractionated non-uniform dose delivery. Int J Radiat Biol 1992; 62 (2): 249–262.CrossRefGoogle ScholarPubMed
Lind, BK, Mavroidis, P, Hyödynmaa, S, Kappas, C. Optimization of the dose level for a given treatment plan to maximize the complication-free tumor cure. Acta Oncol 1999; 38 (6): 787–798.Google ScholarPubMed
Kallman, P, Lind, BK, Brahme, A. An algorithm for maximizing the probability of complication-free tumour control in radiation therapy. Phys Med Biol 1992; 37 (4): 871–890.CrossRefGoogle ScholarPubMed
Mavroidis, P, Lind, BK, Brahme, A. Biologically effective uniform dose (D) for specification, report and comparison of dose response relations and treatment plans. Phys Med Biol 2001; 46 (10): 2607–2630.CrossRefGoogle ScholarPubMed
Uzan, J, Nahum, AE. Radiobiologically guided optimisation of the prescription dose and fractionation scheme in radiotherapy using BioSuite. Br J Radiol. 2012; 85 (1017): 1279–1286.CrossRefGoogle ScholarPubMed
Mesbahi, A, Oladghaffari, M. An overview on the clinical application of radiobiological modeling in radiation therapy of cancer. Int J Radiol Radiat Therapy 2017; 2 (1): 9–14.CrossRefGoogle Scholar