Dosimetric comparison of axilla and groin radiotherapy techniques for high-risk and locally advanced skin cancer
Identifieur interne : 001171 ( Main/Exploration ); précédent : 001170; suivant : 001172Dosimetric comparison of axilla and groin radiotherapy techniques for high-risk and locally advanced skin cancer
Auteurs : Malcolm D. Mattes [États-Unis] ; Ying Zhou [États-Unis] ; Sean L. Berry [États-Unis] ; Christopher A. Barker [États-Unis]Source :
- Radiation Oncology Journal [ 2234-1900 ] ; 2016.
Abstract
Radiation therapy targeting axilla and groin lymph nodes improves regional disease control in locally advanced and high-risk skin cancers. However, trials generally used conventional two-dimensional radiotherapy (2D-RT), contributing towards relatively high rates of side effects from treatment. The goal of this study is to determine if three-dimensional conformal radiation therapy (3D-CRT), intensity-modulated radiation therapy (IMRT), or volumetric-modulated arc therapy (VMAT) may improve radiation delivery to the target while avoiding organs at risk in the clinical context of skin cancer regional nodal irradiation.
Twenty patients with locally advanced/high-risk skin cancers underwent computed tomography simulation. The relevant axilla or groin planning target volumes and organs at risk were delineated using standard definitions. Paired t-tests were used to compare the mean values of several dose-volumetric parameters for each of the 4 techniques.
In the axilla, the largest improvement for 3D-CRT compared to 2D-RT was for homogeneity index (13.9 vs. 54.3), at the expense of higher lung V20 (28.0% vs. 12.6%). In the groin, the largest improvements for 3D-CRT compared to 2D-RT were for anorectum Dmax (13.6 vs. 38.9 Gy), bowel D200cc (7.3 vs. 23.1 Gy), femur D50 (34.6 vs. 57.2 Gy), and genitalia Dmax (37.6 vs. 51.1 Gy). IMRT had further improvements compared to 3D-CRT for humerus Dmean (16.9 vs. 22.4 Gy), brachial plexus D5 (57.4 vs. 61.3 Gy), bladder D5 (26.8 vs. 36.5 Gy), and femur D50 (18.7 vs. 34.6 Gy). Fewer differences were observed between IMRT and VMAT.
Compared to 2D-RT and 3D-CRT, IMRT and VMAT had dosimetric advantages in the treatment of nodal regions of skin cancer patients.
Url:
DOI: 10.3857/roj.2015.01592
PubMed: 27306779
PubMed Central: 4938352
Affiliations:
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Mattes</name><affiliation wicri:level="1"><nlm:aff id="af1-roj-2015-01592">Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY,<country>USA</country></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Zhou, Ying" sort="Zhou, Ying" uniqKey="Zhou Y" first="Ying" last="Zhou">Ying Zhou</name><affiliation wicri:level="1"><nlm:aff id="af2-roj-2015-01592">Department of Physics, Memorial Sloan Kettering Cancer Center, New York, NY,<country>USA</country></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Berry, Sean L" sort="Berry, Sean L" uniqKey="Berry S" first="Sean L." last="Berry">Sean L. Berry</name><affiliation wicri:level="1"><nlm:aff id="af2-roj-2015-01592">Department of Physics, Memorial Sloan Kettering Cancer Center, New York, NY,<country>USA</country></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Barker, Christopher A" sort="Barker, Christopher A" uniqKey="Barker C" first="Christopher A." last="Barker">Christopher A. Barker</name><affiliation wicri:level="1"><nlm:aff id="af1-roj-2015-01592">Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY,<country>USA</country></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">27306779</idno><idno type="pmc">4938352</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4938352</idno><idno type="RBID">PMC:4938352</idno><idno type="doi">10.3857/roj.2015.01592</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">000850</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000850</idno><idno type="wicri:Area/Pmc/Curation">000850</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000850</idno><idno type="wicri:Area/Pmc/Checkpoint">000A43</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000A43</idno><idno type="wicri:Area/Ncbi/Merge">008435</idno><idno type="wicri:Area/Ncbi/Curation">008435</idno><idno type="wicri:Area/Ncbi/Checkpoint">008435</idno><idno type="wicri:doubleKey">2234-1900:2016:Mattes M:dosimetric:comparison:of</idno><idno type="wicri:Area/Main/Merge">001173</idno><idno type="wicri:Area/Main/Curation">001171</idno><idno type="wicri:Area/Main/Exploration">001171</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Dosimetric comparison of axilla and groin radiotherapy techniques for high-risk and locally advanced skin cancer</title><author><name sortKey="Mattes, Malcolm D" sort="Mattes, Malcolm D" uniqKey="Mattes M" first="Malcolm D." last="Mattes">Malcolm D. Mattes</name><affiliation wicri:level="1"><nlm:aff id="af1-roj-2015-01592">Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY,<country>USA</country></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Zhou, Ying" sort="Zhou, Ying" uniqKey="Zhou Y" first="Ying" last="Zhou">Ying Zhou</name><affiliation wicri:level="1"><nlm:aff id="af2-roj-2015-01592">Department of Physics, Memorial Sloan Kettering Cancer Center, New York, NY,<country>USA</country></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Berry, Sean L" sort="Berry, Sean L" uniqKey="Berry S" first="Sean L." last="Berry">Sean L. Berry</name><affiliation wicri:level="1"><nlm:aff id="af2-roj-2015-01592">Department of Physics, Memorial Sloan Kettering Cancer Center, New York, NY,<country>USA</country></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Barker, Christopher A" sort="Barker, Christopher A" uniqKey="Barker C" first="Christopher A." last="Barker">Christopher A. Barker</name><affiliation wicri:level="1"><nlm:aff id="af1-roj-2015-01592">Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY,<country>USA</country></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></analytic><series><title level="j">Radiation Oncology Journal</title><idno type="ISSN">2234-1900</idno><idno type="eISSN">2234-3164</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Purpose:</title><p>Radiation therapy targeting axilla and groin lymph nodes improves regional disease control in locally advanced and high-risk skin cancers. However, trials generally used conventional two-dimensional radiotherapy (2D-RT), contributing towards relatively high rates of side effects from treatment. The goal of this study is to determine if three-dimensional conformal radiation therapy (3D-CRT), intensity-modulated radiation therapy (IMRT), or volumetric-modulated arc therapy (VMAT) may improve radiation delivery to the target while avoiding organs at risk in the clinical context of skin cancer regional nodal irradiation.</p></sec><sec><title>Materials and Methods:</title><p>Twenty patients with locally advanced/high-risk skin cancers underwent computed tomography simulation. The relevant axilla or groin planning target volumes and organs at risk were delineated using standard definitions. Paired t-tests were used to compare the mean values of several dose-volumetric parameters for each of the 4 techniques.</p></sec><sec><title>Results:</title><p>In the axilla, the largest improvement for 3D-CRT compared to 2D-RT was for homogeneity index (13.9 vs. 54.3), at the expense of higher lung V<sub>20</sub> (28.0% vs. 12.6%). In the groin, the largest improvements for 3D-CRT compared to 2D-RT were for anorectum D<sub>max</sub> (13.6 vs. 38.9 Gy), bowel D<sub>200cc</sub> (7.3 vs. 23.1 Gy), femur D<sub>50</sub> (34.6 vs. 57.2 Gy), and genitalia D<sub>max</sub> (37.6 vs. 51.1 Gy). IMRT had further improvements compared to 3D-CRT for humerus D<sub>mean</sub> (16.9 vs. 22.4 Gy), brachial plexus D<sub>5</sub> (57.4 vs. 61.3 Gy), bladder D<sub>5</sub> (26.8 vs. 36.5 Gy), and femur D<sub>50</sub> (18.7 vs. 34.6 Gy). Fewer differences were observed between IMRT and VMAT.</p></sec><sec><title>Conclusion:</title><p>Compared to 2D-RT and 3D-CRT, IMRT and VMAT had dosimetric advantages in the treatment of nodal regions of skin cancer patients.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Burmeister, Bh" uniqKey="Burmeister B">BH Burmeister</name></author><author><name sortKey="Henderson, Ma" uniqKey="Henderson M">MA Henderson</name></author><author><name sortKey="Ainslie, J" uniqKey="Ainslie J">J Ainslie</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Jouary, T" uniqKey="Jouary T">T Jouary</name></author><author><name sortKey="Leyral, C" uniqKey="Leyral C">C Leyral</name></author><author><name sortKey="Dreno, B" uniqKey="Dreno B">B Dreno</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="O Hara, J" uniqKey="O Hara J">J O'Hara</name></author><author><name 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uniqKey="Jackson A">A Jackson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kachnic, La" uniqKey="Kachnic L">LA Kachnic</name></author><author><name sortKey="Winter, K" uniqKey="Winter K">K Winter</name></author><author><name sortKey="Myerson, Rj" uniqKey="Myerson R">RJ Myerson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hallemeier, Cl" uniqKey="Hallemeier C">CL Hallemeier</name></author><author><name sortKey="Garces, Yi" uniqKey="Garces Y">YI Garces</name></author><author><name sortKey="Neben Wittich, Ma" uniqKey="Neben Wittich M">MA Neben-Wittich</name></author></analytic></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>États-Unis</li></country></list><tree><country name="États-Unis"><noRegion><name sortKey="Mattes, Malcolm D" sort="Mattes, Malcolm D" uniqKey="Mattes M" first="Malcolm D." last="Mattes">Malcolm D. Mattes</name></noRegion><name sortKey="Barker, Christopher A" sort="Barker, Christopher A" uniqKey="Barker C" first="Christopher A." last="Barker">Christopher A. Barker</name><name sortKey="Berry, Sean L" sort="Berry, Sean L" uniqKey="Berry S" first="Sean L." last="Berry">Sean L. Berry</name><name sortKey="Zhou, Ying" sort="Zhou, Ying" uniqKey="Zhou Y" first="Ying" last="Zhou">Ying Zhou</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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