Dosimetric comparison between helical tomotherapy and volumetric modulated arc-therapy for non-anaplastic thyroid cancer treatment

Radiation Oncology

Anne Laprie³  Michel Rives²  Thomas Filleron⁴  Monia Ouali⁴  Sabrina Boyrie²  Laure Vieillevigne¹  Jonathan Khalifa² 

[1] Department of Medical Physics, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse, Oncopôle – 1, avenue Irène Joliot Curie, Toulouse, 31059, France;Department of Radiation Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse, Oncopôle – 1, avenue Irène Joliot Curie, Toulouse, 31059, France;INSERM, UMR825, Toulouse 24 F-31059, France;Department of Biostatistics, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse, Oncopôle – 1, avenue Irène Joliot Curie, Toulouse, 31059, France

关键词: Dosimetric comparison;    Non-anaplastic thyroid cancer;    Helical tomotherapy;    Volumetric modulated arctherapy;   

Others  :  1150865
DOI  :  10.1186/s13014-014-0247-x

 received in 2014-05-19, accepted in 2014-11-03,  发布年份 2014

【 摘 要 】

Background

To evaluate and compare dosimetric parameters of volumetric modulated arctherapy (VMAT) and helical tomotherapy (HT) for non-anaplastic thyroid cancer adjuvant radiotherapy.

Methods

Twelve patients with non-anaplastic thyroid cancer at high risk of local relapse received adjuvant external beam radiotherapy with curative intent in our institution, using a two-dose level prescription with a simultaneous integrated boost approach. Each patient was re-planned by the same physicist twice using both VMAT and HT. Several dosimetric quality indexes were used: target coverage index (proportion of the target volume covered by the reference isodose), healthy tissue conformity index (proportion of the reference isodose volume including the target volume), conformation number (combining both previous indexes), Dice Similarity Coefficient (DSC), and homogeneity index ((D2%-D98%)/prescribed dose). Dose-volume histogram statistics were also compared.

Results

HT provided statistically better target coverage index and homogeneity index for low risk PTV in comparison with VMAT (respectively 0.99 vs. 0.97 (p = 0.008) and 0.22 vs. 0.25 (p = 0.016)). However, HT provided poorer results for healthy tissue conformity index, conformation number and DSC with low risk and high risk PTV. As regards organs at risk sparing, by comparison with VMAT, HT statistically decreased the D2% to medullary canal (25.3 Gy vs. 32.6 Gy (p = 0.003)). Besides, HT allowed a slight sparing dose for the controlateral parotid (Dmean: 4.3 Gy vs. 6.6 Gy (p = 0.032)) and for the controlateral sub-maxillary gland (Dmean: 29.1 Gy vs. 33.1 Gy (p = 0.041)).

Conclusions

Both VMAT and HT techniques for adjuvant treatment of non-anaplastic thyroid cancer provide globally attractive treatment plans with slight dosimetric differences. However, helical tomotherapy clearly provides a benefit in term of medullary canal sparing.

【 授权许可】

   
2014 Khalifa et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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