Comprasion of dose distribution for critical organs with intensity modulated radiotherapy and 3D Conformal radiotherapy for gastric cancer
Intensity modulated radiation therapy in gastric cancer
DOI:
https://doi.org/10.5281/zenodo.8266644Abstract
Objective: Early and late complication may occur depending on the radiation dose in patients receiving gastric radiotherapy (RT), especially in the liver and kidneys. With the development of modern RT techniques, many planning techniques have been developed to reduce side effects. This study compared 3-dimensional conformal radiotherapy (3DCRT) and intensity-modulated radiation therapy (IMRT) planning techniques to determine which is superior in clinical use for postoperative planning of gastric cancer patients.
Material and Method: The target volumes drawn on Oncentra 4.3 planning system for 3DCRT were transferred to Monaco 5.0 IMRT planning system without any change. The total dose of 50.4 Gy (1.8 Gy/fraction) was delivered to 95% isodose of planning target volume (PTV). The analyses of doses of the target volumes and critical organs were performed. Independent-Samples T and Mann-Whitney U tests were used to compare the doses of PTV and critical organs in both techniques. P value <0.05 was considered statistically significant.
Results: When 3DCRT and IMRT techniques were compared according to the 95% isodose of PTV, a statistically significant difference was not found (p=0.909). Considering % doses of liver and spinal cord exposed to 30 Gy and more in both planning techniques; the IMRT technique was found to be statistically superior to 3DCRT (p<0.05).
Conclusion: IMRT is recommended to protect critical organs better for gastric cancer patients receiving abdominal radiotherapy.
References
Hallissey MT, Dunn JA, Ward LC, Allum WH. The second British Stomach Cancer Group trial of adjuvant radiotherapy or chemotherapy in resectable gastric cancer: five-year follow-up. Lancet 1994;343(8909):1309-12. doi: 10.1016/s0140-6736(94)92464-3.
Zhang ZX, Gu XZ, Yin WB, Huang GJ, Zhang DW, Zhang RG. Randomized clinical trial on the combination of preoperative irradiation and surgery in the treatment of adenocarcinoma of gastric cardia (AGC)--report on 370 patients. Int J Radiat Oncol Biol Phys 1998;42(5):929-34. doi: 10.1016/s0360-3016(98)00280-6.
Valentini V, Cellini F, Minsky BD et al. Survival after radiotherapy in gastric cancer: systematic review and meta-analysis. Radiother Oncol 2009;92(2):176-83. doi: 10.1016/j.radonc.2009.06.014. Epub 2009 Jul 6.
Ren F, Li S, Zhang Y, Zhao Z, et al. Efficacy and safety of intensity-modulated radiation therapy versus three-dimensional conformal radiation treatment for patients with gastric cancer: a systematic review and meta-analysis. Radiat Oncol 2019;14(1):84.
Milano MT, Garofalo MC, Chmura SJ et al. Intensity-modulated radiation therapy in the treatment of gastric cancer: early clinical outcome and dosimetric comparison with conventional techniques. Br J Radiol 2006;79(942):497-503. doi: 10.1259/bjr/43441736.
Minn AY, Hsu A, La T et al. Comparison of intensity-modulated radiotherapy and 3-dimensional conformal radiotherapy as adjuvant therapy for gastric cancer. Cancer 2010;116(16):3943-52. doi: 10.1002/cncr.25246.
Chen D, Wang R, Meng X et al. A comparison of liver protection among 3-D conformal radiotherapy, intensity-modulated radiotherapy and RapidArc for hepatocellular carcinoma. Radiat Oncol 2014;9:48. doi: 10.1186/1748-717X-9-48.
Nour AA, Alaradi A, Mohamed A, Altuwaijri S, Rudat V. Intensity modulated radiotherapy of upper abdominal malignancies: dosimetric comparison with 3D conformal radiotherapy and acute toxicity. Radiat Oncol 2013;8:207. doi: 10.1186/1748-717X-8-207.
Zhang T, Liang ZW, Han J, Bi JP, Yang ZY, Ma H. Double-arc volumetric modulated therapy improves dose distribution compared to static gantry IMRT and 3D conformal radiotherapy for adjuvant therapy of gastric cancer. Radiat Oncol 2015;10:114. doi: 10.1186/s13014-015-0420-x.
Podgorsak, E.B. Radiation Oncology Physics: A Handbook for Teachers and Students. Vienna: IAEA; 2005.
Pan CC, Kavanagh BD, Dawson LA, et al. Radiation-associated liver injury. Int J Radiat Oncol Biol Phys 2010;76:S94-100. doi: 10.1016/j.ijrobp.2009.06.092.
Cassady JR. Clinical radiation nephropathy. Int J Radiat Oncol Biol Phys 1995;31(5):1249–56.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 EJONS INTERNATIONAL JOURNAL
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
