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首页> 外文期刊>Journal of Cancer Research and Therapeutics >Helical tomotherapy for head and neck squamous cell carcinoma: Dosimetric comparison with linear accelerator-based step-and-shoot IMRT
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Helical tomotherapy for head and neck squamous cell carcinoma: Dosimetric comparison with linear accelerator-based step-and-shoot IMRT

机译：头颈部鳞状细胞癌的螺旋层析疗法：与基于线性加速器的步进式IMRT的剂量学比较

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Background: Linear Accelerator-based Intensity Modulated Radiation Therapy (IMRT), either as step-and shoot (SS) or in dynamic mode, is now considered routine in the definitive management of head and neck squamous cell carcinoma (HNSCC). Helical TomoTherapy (HT) is a new platform to deliver IMRT. This study aims to compare step-and-shoot Intensity Modulated Radiation Therapy (SS IMRT) with dynamic Helical TomoTherapy (HT) dosimetrically in patients with head and neck squamous cell carcinoma (HNSCC). Materials and Methods: Twelve patients with HNSCC, previously treated with SS IMRT, were re-planned on HT using the same CT dataset. Plans were compared for target coverage and organs-at-risk (OARs) sparing. Sparing of parotids was assessed after stratifying for side (contralateral vs. ipsilateral) and site of disease (laryngopharynx vs. oropharynx). Normal tissue complication probabilities (NTCP) were also compared for the parotid glands. Results: All HT plans showed improvement in target coverage and homogeneity, and reduction in OAR doses as compared to SS IMRT plans. For PTV 66, the mean V 99 improved by 14.65% ( P = 0.02). Dose Homogeneity (D 10-90 ) was significantly better in the HT plans (mean 2.07Gy as compared to 4.5Gy in the SS IMRT plans, P = 0.02). HT resulted in an average reduction of mean parotid dose of 12.66Gy and 18.28Gy for the contralateral and ipsilateral glands ( P = 0.003) respectively. This translated into a 24.09% and 35.22% reduction in Normal Tissue Complication Probability (NTCP) for the contralateral and ipsilateral parotids respectively ( P Conclusion: Helical Tomotherapy achieved better target coverage with improved OAR sparing as compared to SS IMRT. The significant reduction in mean parotid doses translated into meaningful reduction in NTCP, with potential clinical implications in terms of reduction in Xerostomia and improved quality of life in patients with HNSCC.
机译：背景：基于线性加速器的调强放射治疗（IMRT），无论是分步射击（SS）还是动态模式，现在都被认为是头颈部鳞状细胞癌（HNSCC）最终治疗中的常规方法。 Helical TomoTherapy（HT）是提供IMRT的新平台。这项研究旨在比较头颈鳞状细胞癌（HNSCC）患者的剂量-步调强度调节放射疗法（SS IMRT）与动态螺旋层析疗法（HT）。材料和方法：使用相同的CT数据集对12例先前接受过SS IMRT治疗的HNSCC患者进行HT计划。比较了计划的目标覆盖率和高风险器官保留率。对患侧（对侧与同侧）和疾病部位（喉咽与口咽）分层后，评估腮腺的保留。还比较了腮腺的正常组织并发症概率（NTCP）。结果：与SS IMRT计划相比，所有HT计划均显示靶覆盖率和同质性得到改善，OAR剂量减少。对于PTV 66，平均V 99 提高了14.65％（P = 0.02）。在HT计划中，剂量均一性（D 10-90 ）明显更好（平均2.07Gy，而SS IMRT计划中为4.5Gy，P = 0.02）。 HT导致对侧和同侧腺平均腮腺平均剂量分别降低了12.66Gy和18.28Gy（P = 0.003）。这意味着对侧和同侧腮腺的正常组织并发症发生率（NTCP）分别降低了24.09％和35.22％（P结论：与SS IMRT相比，螺旋CT疗法的目标覆盖率更高，OAR保留率更高。腮腺剂量转化为NTCP的有意义的减少，对于减少口干症和改善HNSCC患者的生活质量具有潜在的临床意义。

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