DOI QR코드

DOI QR Code

Dosimetric Comparison between Intensity Modulated Radiotherapy and 3 Dimensional Conformal Radiotherapy in the Treatment of Rectal Cancer

  • 발행 : 2016.11.01

초록

Objective: To compare dosimetric parameters of 3 dimensional conformal radiotherapy (3 DCRT) and intensity modulated radiotherapy (IMRT) in terms of target coverage and doses to organs at risk (OAR) in the management of rectal carcinoma. Methods: In this prospective study, conducted between August 2014 and March 2016, all patients underwent CT simulation along with a bladder protocol and target contouring according to the Radiation Therapy Oncology Group (RTOG) guidelines. Two plans were made for each patient (3 DCRT and IMRT) for comparison of target coverage and OAR. Result: A total of 43 patients were recruited into this study. While there were no significant differences in mean Planning Target Volume (PTV) D95% and mean PTV D98% between 3 DCRT and IMRT, mean PTV D2% and mean PTV D50% were significantly higher in 3 DCRT plans. Compared to IMRT, 3 DCRT resulted in significantly higher volumes of hot spots, lower volumes of cold spots, and higher doses to the entire OAR. Conclusion: This study demonstrated that IMRT achieves superior normal tissue avoidance (bladder and bowel) compared to 3 DCRT, with comparable target dose coverage.

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참고문헌

  1. Arbea L, Ramos LI, Martinez-Monge R, et al (2010). Intensity-modulated radiation therapy (IMRT) vs. 3D conformal radiotherapy (3DCRT) in locally advanced rectal cancer (LARC): dosimetric comparison and clinical implications. Radiat Oncol, 5, 1-9. https://doi.org/10.1186/1748-717X-5-1
  2. Baglan KL, Frazier RC, Yan D, et al (2002). The dose-volume relationship of acute small bowel toxicity from concurrent 5-FU-based chemotherapy and radiation therapy for rectal cancer. Int J Radiat Oncol Biol Phys, 52, 176-83. https://doi.org/10.1016/S0360-3016(01)01820-X
  3. Bentzen SM, Constine LS, Deasy JO, et al (2010). Quantitative Analyses of Normal Tissue Effects in the Clinic (QUANTEC): an introduction to the scientific issues. Int J Radiat Oncol Biol Phys, 76, 3-9. https://doi.org/10.1016/j.ijrobp.2009.09.040
  4. Chen RC, Mamon HJ, Ancukiewicz M, et al (2012). Dose-Volume effects on patient-reported acute gastrointestinal symptoms during chemoradiation therapy for rectal cancer. Int J Radiat Oncol Biol Phys, 83, 513-7. https://doi.org/10.1016/j.ijrobp.2012.01.013
  5. Diaz-Gonzalez JA, Arbea L, Aristu J, et al (2007). Rectal cancer treatment: Improving the picture. World J Gastroenterol, 13, 5805-12. https://doi.org/10.3748/wjg.v13.i44.5805
  6. Duthoy W, De Gersem W, Vergote K, et al (2004); Clinical implementation of intensity-modulated arc therapy (IMAT) for rectal cancer. Int J Radiat Oncol Biol Phys, 60, 794-806. https://doi.org/10.1016/j.ijrobp.2004.04.016
  7. Ferlay J, Soerjomataram I, Dikshit R, et al (2015). Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer, 136, 359-86. https://doi.org/10.1002/ijc.29210
  8. Guerrero Urbano MT, Henrys AJ, Adams EJ, et al (2006). Intensity-modulated radiotherapy in patients with locally advanced rectal cancer reduces volume of bowel treated to high dose levels. Int J Radiat Oncol Biol Phys, 65, 907-16. https://doi.org/10.1016/j.ijrobp.2005.12.056
  9. Myerson RJ, Garofalo MC, El Naqa I, et al (2009). Elective clinical target volumes for conformal therapy in anorectal cancer: a radiation therapy oncology group consensus panel contouring atlas. Int J Radiat Oncol Biol Phys, 74, 824-30. https://doi.org/10.1016/j.ijrobp.2008.08.070
  10. Mzenda B, Peters P, Pettingell J, et al (2011). 1336 poster, A comparison of doses to OARs in inverse planned IMRT and 3D conformal prostate treatment planning. Radiother Oncol, 99, 499-500.
  11. O'Connell MJ, Martenson JA, Wieand HS, et al (1994). Improving adjuvant therapy for rectal cancer by combining protracted-infusion fluorouracil with radiation therapy after curative surgery. N Engl J Med, 331, 502-7. https://doi.org/10.1056/NEJM199408253310803
  12. Tho LM, Glegg M, Paterson J, et al (2006). Acute small bowel toxicity and preoperative chemoradiotherapy for rectal cancer: investigating dose-volume relationships and role for inverse planning. Int J Radiat Oncol Biol Phys, 66, 505-13. https://doi.org/10.1016/j.ijrobp.2006.05.005