The transition from conformal to advanced radiotherapy techniques in the treatment planning of gynecological cancer patients
Background/Aim. The transition from standard to highly conformal radiation therapy techniques requires the implementation of complex advanced dosimetry. The aim of the study was to compare dosimetric parameters of the three-dimensional conformal radiotherapy (3DCRT) and volumetric modulated arc ther...
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Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade
2022-01-01
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| Series: | Vojnosanitetski Pregled |
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| Online Access: | http://www.doiserbia.nb.rs/img/doi/0042-8450/2022/0042-84502100077P.pdf |
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| author | Petrović Borislava Ivanov Olivera Marjanović Milana Ličina Jelena Gencel Ivan Golubovac Nemanja |
| author_facet | Petrović Borislava Ivanov Olivera Marjanović Milana Ličina Jelena Gencel Ivan Golubovac Nemanja |
| author_sort | Petrović Borislava |
| collection | DOAJ |
| description | Background/Aim. The transition from standard to highly conformal radiation therapy techniques requires the implementation of complex advanced dosimetry. The aim of the study was to compare dosimetric parameters of the three-dimensional conformal radiotherapy (3DCRT) and volumetric modulated arc therapy (VMAT) plan, as well as complications after treatment in relation to dosimetric parameters in gynecological cancer patients. Methods. A total of 49 gynecological cancer patients were included in the study. All patients were planned for 3DCRT, but due to un-acceptable doses to organs at risk (OARs), treatment plans for intensity modulated radiation therapy (IMRT), or VMAT, were generated for 21 patients. The patients were prescribed 50.4 Gy/28 fractions (4 patients) and 45 Gy/25 fractions (45 patients). The coverage of planning target volume (PTV) and doses to OARs were recorded. PTV margins were evaluated for both techniques according to the Van Herk formula. Results. ICRU 83 criteria were fulfilled in all 3DCRT/VMAT/IMRT plans providing optimal coverage of PTV. Doses to OARs, on average, the V45Gy in the small bowel in IMRT/VMAT plans was four times smaller than the same in 3DCRT plans. The V45 Gy of small bowels was, on average, 49.4 cm3 in IMRT/VMAT plans, while in 3DCRT plans, it was 211.6 cm3. In the case of the femoral head, a significant reduction in V30Gy (10.8% vs. 33.1%) and mean dose in the case of IMRT/VMAT plans was recorded (30.4 Gy in 3DCRT vs. 23.6 Gy). Rectum was planned with a significantly lower dose in terms of V30Gy (79.5% vs. 95.2%) in IMRT/VMAT plans. The bladder was better spared in VMAT plans in terms of V40Gy (51% vs. 91%), but the maximum dose was higher in VMAT plans than in 3DCRT (50.1 Gy to 48.1 Gy on average). For all OARs, there was a statistically significant difference registered at p ˂ 0.05. Toxicities recorded in VMAT and 3DCRT patients included mainly radiation-induced cystitis and enteritis. Patients treated with 3DCRT generally had longer recovery time. The homogeneity index was 0.11 for VMAT plans and 0.09 for 3DCRT plans. Conclusions. Analysis of dosimetric parameters revealed significant differences in normal tissue doses for the same 3DCRT and VMAT patients, which confirmed the necessity for the implementation of advanced techniques for as many patients as possible. |
| format | Article |
| id | doaj-art-5e6adca7da0048449b1104d1a6b15070 |
| institution | OA Journals |
| issn | 0042-8450 2406-0720 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade |
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| series | Vojnosanitetski Pregled |
| spelling | doaj-art-5e6adca7da0048449b1104d1a6b150702025-08-20T01:57:16ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502406-07202022-01-01791095195710.2298/VSP210520077P0042-84502100077PThe transition from conformal to advanced radiotherapy techniques in the treatment planning of gynecological cancer patientsPetrović Borislava0https://orcid.org/0000-0001-5327-9365Ivanov Olivera1Marjanović Milana2https://orcid.org/0000-0002-8447-606XLičina Jelena3Gencel Ivan4https://orcid.org/0000-0001-6284-2076Golubovac Nemanja5Oncology Institute Vojvodina, Radiotherapy Department, Sremska Kamenica, Serbia + University of Novi Sad, Faculty of Sciences, Department of Physics, Novi Sad, SerbiaOncology Institute Vojvodina, Radiotherapy Department, Sremska Kamenica, Serbia + University of Novi Sad, Faculty of Medicine, Novi Sad, SerbiaOncology Institute Vojvodina, Radiotherapy Department, Sremska Kamenica, Serbia + University of Novi Sad, Faculty of Sciences, Department of Physics, Novi Sad, SerbiaOncology Institute Vojvodina, Radiotherapy Department, Sremska Kamenica, Serbia + University of Novi Sad, Faculty of Medicine, Novi Sad, SerbiaOncology Institute Vojvodina, Radiotherapy Department, Sremska Kamenica, SerbiaOncology Institute Vojvodina, Radiotherapy Department, Sremska Kamenica, Serbia + University of Novi Sad, Faculty of Sciences, Department of Physics, Novi Sad, SerbiaBackground/Aim. The transition from standard to highly conformal radiation therapy techniques requires the implementation of complex advanced dosimetry. The aim of the study was to compare dosimetric parameters of the three-dimensional conformal radiotherapy (3DCRT) and volumetric modulated arc therapy (VMAT) plan, as well as complications after treatment in relation to dosimetric parameters in gynecological cancer patients. Methods. A total of 49 gynecological cancer patients were included in the study. All patients were planned for 3DCRT, but due to un-acceptable doses to organs at risk (OARs), treatment plans for intensity modulated radiation therapy (IMRT), or VMAT, were generated for 21 patients. The patients were prescribed 50.4 Gy/28 fractions (4 patients) and 45 Gy/25 fractions (45 patients). The coverage of planning target volume (PTV) and doses to OARs were recorded. PTV margins were evaluated for both techniques according to the Van Herk formula. Results. ICRU 83 criteria were fulfilled in all 3DCRT/VMAT/IMRT plans providing optimal coverage of PTV. Doses to OARs, on average, the V45Gy in the small bowel in IMRT/VMAT plans was four times smaller than the same in 3DCRT plans. The V45 Gy of small bowels was, on average, 49.4 cm3 in IMRT/VMAT plans, while in 3DCRT plans, it was 211.6 cm3. In the case of the femoral head, a significant reduction in V30Gy (10.8% vs. 33.1%) and mean dose in the case of IMRT/VMAT plans was recorded (30.4 Gy in 3DCRT vs. 23.6 Gy). Rectum was planned with a significantly lower dose in terms of V30Gy (79.5% vs. 95.2%) in IMRT/VMAT plans. The bladder was better spared in VMAT plans in terms of V40Gy (51% vs. 91%), but the maximum dose was higher in VMAT plans than in 3DCRT (50.1 Gy to 48.1 Gy on average). For all OARs, there was a statistically significant difference registered at p ˂ 0.05. Toxicities recorded in VMAT and 3DCRT patients included mainly radiation-induced cystitis and enteritis. Patients treated with 3DCRT generally had longer recovery time. The homogeneity index was 0.11 for VMAT plans and 0.09 for 3DCRT plans. Conclusions. Analysis of dosimetric parameters revealed significant differences in normal tissue doses for the same 3DCRT and VMAT patients, which confirmed the necessity for the implementation of advanced techniques for as many patients as possible.http://www.doiserbia.nb.rs/img/doi/0042-8450/2022/0042-84502100077P.pdfgenital neoplasms, femaleradiotherapyradiotherapy, conformalradiotherapy planning, computer-assistedtreatment outcome |
| spellingShingle | Petrović Borislava Ivanov Olivera Marjanović Milana Ličina Jelena Gencel Ivan Golubovac Nemanja The transition from conformal to advanced radiotherapy techniques in the treatment planning of gynecological cancer patients Vojnosanitetski Pregled genital neoplasms, female radiotherapy radiotherapy, conformal radiotherapy planning, computer-assisted treatment outcome |
| title | The transition from conformal to advanced radiotherapy techniques in the treatment planning of gynecological cancer patients |
| title_full | The transition from conformal to advanced radiotherapy techniques in the treatment planning of gynecological cancer patients |
| title_fullStr | The transition from conformal to advanced radiotherapy techniques in the treatment planning of gynecological cancer patients |
| title_full_unstemmed | The transition from conformal to advanced radiotherapy techniques in the treatment planning of gynecological cancer patients |
| title_short | The transition from conformal to advanced radiotherapy techniques in the treatment planning of gynecological cancer patients |
| title_sort | transition from conformal to advanced radiotherapy techniques in the treatment planning of gynecological cancer patients |
| topic | genital neoplasms, female radiotherapy radiotherapy, conformal radiotherapy planning, computer-assisted treatment outcome |
| url | http://www.doiserbia.nb.rs/img/doi/0042-8450/2022/0042-84502100077P.pdf |
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