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A retrospective comparison of intensity-modulated arc therapy and 3-dimensional conformal approaches in the planning of grade 3 gliomas

Published online by Cambridge University Press:  28 May 2018

Lubna Sheazadi ,
Robert Appleyard ,
Natalie Foley  and
Bernadette Foran
Lubna Sheazadi*
Affiliation:
Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield, UK
Robert Appleyard
Affiliation:
Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield, UK
Natalie Foley
Affiliation:
Sheffield Teaching Hospitals NHS Trust, Weston Park Hospital, Sheffield, UK
Bernadette Foran
Affiliation:
Sheffield Teaching Hospitals NHS Trust, Weston Park Hospital, Sheffield, UK
*
Author for correspondence: Lubna Sheazadi, Collegiate Crescent, Sheffield, S10 2BP, UK. Tel: 0114 225 5555; E-mail: [email protected]
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Abstract

Purpose

To evaluate the extent to which intensity-modulated arc therapy (IMAT) for high-grade gliomas is comparable with three-dimensional conformal radiotherapy (3DCRT) in relation to the dose delivered to normal brain tissue (NBT), planning target volume (PTV) conformity and the dose delivered to brainstem and optic chiasma.

Method

A total of 16 randomly selected 3DCRT treatment plans of grade 3 gliomas were re-planned using an IMAT planning technique and dose–volume histograms were compared. Primary outcomes were maximum, mean, 1/3 and 2/3 doses to NBT outside the PTV. Also the maximum, mean, D50 and D20 doses to PTV. Secondary outcomes were maximum and mean doses to the brainstem and optic chiasm. Wilcoxon signed rank test was used to compare data.

Results

IMAT led to a statistically significant increase in mean dose to NBT (34·4 versus 33·3 Gy, (p=0·047) but a statistically significant reduction in maximum dose to NBT (62·7 versus 63·8 Gy, p=0·004) compared with 3DCRT. IMAT led to statistically significant reductions in maximum, D50 and D20 doses to the PTV (63·3 versus 64·7 Gy, p=0·001; 60·0 versus 60·7 Gy, p=0·001 and 60·5 versus 61·8 Gy, p=0·002, respectively). No statistically significant differences were seen in doses to brainstem and optic chiasm.

Conclusion

IMAT is at least comparable with 3DCRT in relation to minimising dose to NBT and ensuring good PTV conformity. Doses delivered to organs at risk using IMAT were also comparable with 3DCRT. This study supports the continued use of IMAT for the treatment of high-grade gliomas.

Keywords

3D conformal radiotherapydose–volume histogramshigh-grade gliomaintensity-modulated arc therapyradiotherapy planning
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 17 , Issue 3 , September 2018 , pp. 266 - 273
Copyright
© Cambridge University Press 2018 

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References

1. Barnett, G H. High-Grade Gliomas: Diagnosis and Treatment. Totowa, NJ: Humana Press, Springer, 2007.Google Scholar
2. Stupp, R, Hegi, M E, Mason, W P et al. Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-year analysis of the EORTC-NCIC trial. Lancet Oncol 2009; 10 (5): 459–466.Google Scholar
3. Teoh, M, Clark, C H, Wood, K, Whitaker, S, Nisbet, A. Volumetric modulated arc therapy: a review of current literature and clinical use in practice. Br J Radiol 2011; 84 (1007): 967–996.Google Scholar
4. Batchelor, T. Patient information: high-grade glioma in adults (Beyond the Basics). [online] 2017. http://www.uptodate.com/contents/high-grade-glioma-in-adults-beyond-the-basics. Accessed on 28th March 2018.Google Scholar
5. Schagen, S B, Klein, M, Reijneveld, J C et al. Monitoring and optimising cognitive function in cancer patients: present knowledge and future directions. European Journal of Cancer Supplements 2014; 12 (1): 29–40.Google Scholar
6. Ricard, D, Idbaih, A, Ducray, F, Lahutte, M, Hoang-Xuan, K, Delattre, JY. Primary brain tumours in adults. Lancet 2012; 379 (9830): 1984–1996.Google Scholar
7. Symonds, P, Deehan, C, Mills, J, Meredith, C. Walter and Miller’s Textbook of Radiotherapy, 7th edition, Edingburgh: Elsevier Churchill Livingstone, 2012.Google Scholar
8. Mirimanoff, R O, Gorlia, T, Mason, W et al. Radiotherapy and temozolomide for newly diagnosed glioblastoma: recursive partitioning analysis of the EORTC 26981/22981-NCIC CE3 phase III randomized trial. J Clin Oncol 2006; 24 (16): 2563–2569.Google Scholar
9. Panet‐Raymond, V, Ansbacher, W, Zavgorodni, S et al. Coplanar versus noncoplanar intensity‐modulated radiation therapy (IMRT) and volumetric‐modulated arc therapy (VMAT) treatment planning for fronto‐temporal high‐grade glioma. J Appl Clin Med Phys 2012; 13 (4): 44–53.Google Scholar
10. Sharyan, H A, Allehyani, S H, Tolba, A R. Dosimetric comparison of 3DCRT versus RapidArc in terms of iso-dose distribution, dose volume histogram (DVH) and dosimetric results for the PTV and critical organs for glioblastoma (GBM). Am J Med Sci 2015; 5 (5): 208–219.Google Scholar
11. Wagner, D, Christiansen, H, Wolff, H, Vorwerk, H. Radiotherapy of malignant gliomas: comparison of volumetric single arc technique (RapidArc), dynamic intensity-modulated technique and 3D conformal technique. Radiother Oncol 2009; 93 (3): 593–596.Google Scholar
12. Goswami, B, Mitra, S, Banerjee, S et al. RapidArc: initial experience in high grade glioma. Int J Radiat Res 2013; 11 (4): 203–206.Google Scholar
13. Shaffer, R, Nichol, A M, Vollans, E et al. A comparison of volumetric modulated arc therapy and conventional intensity-modulated radiotherapy for frontal and temporal high-grade gliomas. Int J Radiat Oncol Biol Phys 2010; 76 (4): 1177–1184.Google Scholar
14. International Commission on Radiation Unit 50. Prescribing, Recording, and Reporting Photon Beam Therapy. Bethesda, MD: International Commission on Radiation Units and Measurements, 1993.Google Scholar
15. International Commission on Radiation Units and Measurements. ICRU Report 62: Prescribing, Recording, and Reporting Photon Beam Therapy (Supplement to ICRU Report 50). Bethesda, MD: ICRU, 1999.Google Scholar
16. International Commission on Radiation Unit 83. Prescribing recording, and reporting intensity-modulated photon-beam therapy (IMRT) (ICRU Report 83). J ICRU 2010; 10 (1): 8–92.Google Scholar
17. Marks, L B, Yorke, E D, Jackson, A et al. Use of normal tissue complication probability models in the clinic. Int J Radiat Oncol Biol Phys 2010; 76 (3): S10–S19.Google Scholar
18. Zayat, D M A, Attalla, E M, Abouelenein, H S, Shady, F, Wafaa, K. Dosimetric comparison of intensity-modulated radiotherapy versus 3D conformal radiotherapy in patients with head and neck cancer. Physica Medica 2015; 31: S1.Google Scholar
19. Knisely, J P, Baehring, J M. A silver lining on the horizon for glioblastoma. Lancet Oncol 2009; 10 (5): 434–435.Google Scholar
20. Horber, E. Link to resources on SPSS. [online] 2017. http://www.unige.ch/ses/sococ/cl//edoc/spssresources.html. Accessed on 28th March 2018.Google Scholar
21. Fogliata, A, Clivio, A, Nicolini, G et al. Intensity modulation with photons for benign intracranial tumours: a planning comparison of volumetric single arc, helical arc and fixed gantry techniques. Radiother Oncol 2008; 89 (3): 254–262.Google Scholar