Journal of the Korean Physical Society

Korean Physical Society (한국물리학회)
권호 표지
DOI QR코드

DOI QR Code

When Should an Adaptive Plan be Considered for Head-and-neck Cancer Patients Undergoing Tomotherapy Treatment?

  • Park, Soah (Department of Radiation Oncology, Hallym University College of Medicine) ;
  • Cheong, Kwang-Ho (Department of Radiation Oncology, Hallym University College of Medicine) ;
  • Hawng, Tai-Jin (Department of Radiation Oncology, Hallym University College of Medicine) ;
  • Kang, Sei-Kwon (Department of Radiation Oncology, Hallym University College of Medicine) ;
  • Lee, Me-Yeon (Department of Radiation Oncology, Hallym University College of Medicine) ;
  • Kim, Kyoung-Joo (Department of Radiation Oncology, Hallym University College of Medicine) ;
  • Oh, Do-Hoon (Department of Radiation Oncology, Hallym University College of Medicine) ;
  • Bae, Hoon-Sik (Department of Radiation Oncology, Hallym University College of Medicine) ;
  • Yoon, Myong-Geun (Research Institute and Hospital, National Cancer Center) ;
  • Kim, Tae-Yoon (Research Institute and Hospital, National Cancer Center) ;
  • Kim, Dong-Wook (Research Institute and Hospital, National Cancer Center) ;
  • Shin, Dong-Ho (Research Institute and Hospital, National Cancer Center) ;
  • Park, Sung-Yong (Research Institute and Hospital, National Cancer Center) ;
  • Cho, Kwan-Ho (Research Institute and Hospital, National Cancer Center)
  • Published : 20100300
⟨ Previous Next ⟩

Abstract

Changes in target-induced cold and hot spots may result in significant dose differences to some parts of a target, which might be related to clinical outcome. We suggest a guideline for adaptive planning using megavoltage CT (MVCT) during tomotherapy. Twenty-one head-and-neck cancer patients, including eight who experienced relatively large weight loss during tomotherapy treatment, were evaluated retrospectively with initial and final MVCT images to quantify the greatest weightloss effects. Kilovoltage CTs (KVCTs) of five patients were obtained during radiation therapy (RT), and volumes of targets and organs were delineated on the KVCTs. Direct machine parameter optimization (DMPO) was used to generate intensity-modulated radiotherapy (IMRT) plans. The beam configurations of the initial plans were applied to the second KVCT images. We compared changes in target dose and organs with various parameters. We compared the initial and the final MVCTs of the 21 patients undergoing tomotherapy with the same initial target. We found that the average of the maximum and mean doses delivered to the gross tumor increased. Data on modified targets and organs on KVCT imaging from five patients showed that the maximum and the mean doses delivered to the gross tumor increased and that the minimum dose decreased. Heterogeneity and coverage also decreased similarly when the overall results from the 21 patients were assessed. The relative thicknesses of the five patients were close to 0.9, and therapy for some patients required replanning. When the thickness value was less than 0.85, adaptive planning was recommended during tomotherapy even if the setup variation had also been considered. Attention should be paid to weight loss during tomotherapy treatment, and if a patient shows significant weight loss, an adaptive plan should be considered to achieve prescribed doses to targets and to spare nearby critical structures.

Keywords

Acknowledgement

This work was supported by a Korea Science and Engineering Foundation (KOSEF) grant funded by the Korea government (MOST) (No.M20706000007-07M0600-00710) and a research grant from the National Cancer Center, Korea (No. 0810210).

References

  1. M. C. Barbosa-Silva and A. J. Barros, Clin. Nutr. 24, 830 (2005) https://doi.org/10.1016/j.clnu.2005.05.005
  2. M. H. Seltzer, B. A. Slocum, E. L. Cataldi-Betcher, C. Fileti and N. Gerson, JPEN-Parenter. Enter. 6, 218 (1982) https://doi.org/10.1177/0148607182006003218
  3. M.A. van Bokhorst-de van der Schueren, et al., Head Neck 19, 419 (1997) https://doi.org/10.1002/(SICI)1097-0347(199708)19:5<419::AID-HED9>3.0.CO;2-2
  4. S. S. Donaldson, Cancer Res. 37, 2407 (1977)
  5. J. Lees, Eur. J. Cancer. Care. 8, 133 (1999) https://doi.org/10.1046/j.1365-2354.1999.00156.x
  6. J. L. Barker Jr et al., Int. J. Radiat. Oncol. Biol. Phys. 59, 960 (2004) https://doi.org/10.1016/j.ijrobp.2003.12.024
  7. S. Sobel, P. Rubin, B. Keller and C. Poulter, Int. J. Radiat. Oncol. Biol. Phys. 1, 873 (1976)
  8. H. D. Suit and A. M. Walker, Brit. J. Cancer 4, 1 (1980)
  9. R. Mohan et al., Int. J. Radiat. Oncol. Biol. Phys. 61, 1258 (2005)
  10. D. Huang et al., Int. J. Radiat. Oncol. Biol. Phys. 56, 158 (2003)
  11. M. K. Kam et al., Int. J. Radiat. Oncol. Biol. Phys. 56, 145 (2003)
  12. N. Lee et al., Int. J. Radiat. Oncol. Biol. Phys. 53, 12 (2002)
  13. P. Castadot et al., Radiother. Oncol. 89, 1 (2008) https://doi.org/10.1016/j.radonc.2008.04.010
  14. E. K. Hansen et al., Int. J. Radiat. Oncol. Biol. Phys. 64, 355 (2006)
  15. K. Kubota et al., Eur. J. Nucl. Med. Mol. I. 31, 590 (2004) https://doi.org/10.1007/s00259-003-1408-6
  16. S. V. Porceddu et al., Head Neck 27, 175 (2005) https://doi.org/10.1002/hed.20130
  17. P. A. Kupelian et al., Int. J. Radiat. Oncol. Biol. Phys. 63, 1024 (2005)
  18. M. L. Siker, W. A. Tome and M. P. Mehta, Int. J. Radiat. Oncol. Biol. Phys. 66, 135 (2006)
  19. C. Woodford et al., Int. J. Radiat. Oncol. Biol. Phys. 69, 1316 (2007)
  20. W. S. Koom et al., Head Neck 30, 159 (2008) https://doi.org/10.1002/hed.20667
  21. D. M. Shepard, G. H. Olivera, P. J. Reckwerdt and T. R. Mackie, Phys. Med. Biol. 45, 69 (2000) https://doi.org/10.1088/0031-9155/45/1/306
  22. T. R. Mackie et al., Med. Phys. 20, 1709 (1993)
  23. A. Niemierko, Med. Phys. 24, 103 (1997) https://doi.org/10.1118/1.598063
  24. D. juki´c and R. Scitovski, Appl. Math. Comput. 167, 286 (2005) https://doi.org/10.1016/j.amc.2004.06.084
  25. C. Lee et al., Radiother. Oncol. 89, 81 (2008) https://doi.org/10.1016/j.radonc.2008.07.006
  26. C. Lee et al., Int. J. Radiat. Oncol. Biol. Phys. 71, 1563 (2008)

Cited by

  1. 토모테라피를 이용한 두경부암 방사선치료에서 Aid-pillow 사용에 따른 Pitch와 Yaw의 변화 분석 vol.24, pp.1, 2010, https://doi.org/10.14316/pmp.2013.24.1.54