Dosimetric comparison between intensity-modulated radiotherapy and conformal radiotherapy for upper thoracic esophageal carcinoma
10.3321/j.issn:1000-467X.2009.11.002
- VernacularTitle:胸上段食管癌调强放疗与适形放疗计划的剂量学比较
- Author:
Zhang WU-ZHE
1
;
Chen ZHI-JIAN
;
Li DE-RUI
;
Lin ZHI-XIONG
;
Li DONG-SHENG
;
Chen CHUANG-ZHEN
Author Information
1. 汕头大学医学院附属肿瘤医院
- Keywords:
esophageal neoplasm;
radiotherapy;
intensity-modulated radiation therapy;
radiotherapy planning;
computer-assisted
- From:Chinese Journal of Cancer
2009;28(11):1127-1131
- CountryChina
- Language:Chinese
-
Abstract:
Background and Objective: Treatment planning for radiotherapy of upper thoracic esophageal carcinoma is challenging due to the anatomical features. The difficulty may be resolved by intensity-modulated radiotherapy (IMRT).This study was to compare the dosimetric advantages of IMRT to that of conformal radiotherapy (CRT) for upper thoracic esophageal carcinoma, and to explore the clinical application of IMRT. Methods: Eleven patients with upper thoracic esophageal carcinoma were enrolled. In addition to the actually used CRT plan,a five-field IMRT plan was generated for each case. The parameters of dose volume histogram for targets and organs at risk were compared between two techniques. Results: For the planning target volume (PTV) of tumor and para-tumor tissues, the mean dose, maximal dose, doses covering 99% and 95% volume were similar in IMRT and CRT plans (P＞0.05). However, IMRT plan had a higher conformity index than CRT plan (0.68 ±0.04 vs. 0.46 0.11, P＜0.01). For the PTV of supraclavicular region, IMRT plan showed a better dose heterogeneity index than CRT plan (1.17 0.05 vs. 1.33 0.15, P=0.01). IMRT plan had lower maximal dose to the planning risk volume of the spinal cord (44.4 Gy vs, 52.5 Gy, P＜0.05) and lower lung volume received dose of 10 Gy or higher [(32 6)%vs. (35 9)%, P＜0.05] than CRT plan. Conclusion: For the upper thoracic esophageal carcinoma,IMRT has more conformal distribution of dose and better spinal cord sparing than CRT, and can reduce the volume of lung that received dose of 10 Gy or higher.
