Report on planning comparison of VMAT, IMRT and helical tomotherapy for the ESCALOX-trial pre-study

Radiation Oncology

Steffi U. Pigorsch¹  Markus Oechsner¹  Kerstin K. Kessel¹  Jan J. Wilkens¹  Petra Mozes¹  Severin Kampfer¹  Michal Devecka¹  Stephanie E. Combs²  Michael C. Mayinger³ 

[1] Department of Radiation Oncology, Technical University of Munich (TUM), School of Medicine, Klinikum Rechts Der Isar, Ismaninger Straße 22, 81675, Munich, Germany;Department of Radiation Oncology, Technical University of Munich (TUM), School of Medicine, Klinikum Rechts Der Isar, Ismaninger Straße 22, 81675, Munich, Germany;Institute of Radiation Medicine (IRM), Helmholtz Zentrum München, Ingolstädter Landstraße 1, Neuherberg, Germany;Department of Radiation Oncology, University Hospital Zurich, Rämistrasse 100, Zurich, Switzerland;

关键词: Dose escalation;    Head and neck cancer;    Combined chemoradiation therapy;    RT planning comparison;    IMRT;    VMAT;    Helical tomotherapy;    SIB;   

DOI  :  10.1186/s13014-020-01693-2

来源: Springer

【 摘 要 】

BackgroundThe ESCALOX trial was designed as a multicenter, randomized prospective dose escalation study for head and neck cancer. Therefore, feasibility of treatment planning via different treatment planning systems (TPS) and radiotherapy (RT) techniques is essential. We hypothesized the comparability of dose distributions for simultaneous integrated boost (SIB) volumes respecting the constraints by different TPS and RT techniques.MethodsCT data sets of the first six patients (all male, mean age: 61.3 years) of the pre-study (up to 77 Gy) were used for comparison of IMRT, VMAT, and helical tomotherapy (HT). Oropharynx was the primary tumor location. Normalization of the three step SIB (77 Gy, 70 Gy, 56 Gy) was D95% = 77 Gy. Coverage (CVF), healthy tissue conformity index (HTCI), conformation number (CN), and dose homogeneity (HI) were compared for PTVs and conformation index (COIN) for parotids.ResultsAll RT techniques achieved good coverage. For SIB77Gy, CVF was best for IMRT and VMAT, HT achieved highest CN followed by VMAT and IMRT. HT reached good HTCI value, and HI compared to both other techniques. For SIB70Gy, CVF was best by IMRT. HTCI favored HT, consequently CN as well. HI was slightly better for HT. For SIB56Gy, CVF resulted comparably. Conformity favors VMAT as seen by HTCI and CN. Dmean of ipsilateral and contralateral parotids favor HT.ConclusionDifferent TPS for dose escalation reliably achieved high plan quality. Despite the very good results of HT planning for coverage, conformity, and homogeneity, the TPS also achieved acceptable results for IMRT and VMAT.Trial registration ClinicalTrials.gov Identifier: NCT 01212354, EudraCT-No.: 2010-021139-15. ARO: ARO 14-01

【 授权许可】

CC BY