Intensity-modulated radiotherapy increases dose to the brachial plexus compared with conventional radiotherapy for head and neck cancer

被引:21
作者
Chen, A. M. [1 ]
Hall, W. H. [1 ]
Li, B-Q [1 ]
Guiou, M. [1 ]
Wright, C. [1 ]
Mathai, M. [1 ]
Dublin, A. [2 ]
Purdy, J. A. [1 ]
机构
[1] Univ Calif Davis, Ctr Canc, Dept Radiat Oncol, Sacramento, CA 95817 USA
[2] Univ Calif Davis, Ctr Canc, Dept Diagnost Radiol, Sacramento, CA 95817 USA
关键词
RADIATION-THERAPY; IMRT; IRRADIATION;
D O I
10.1259/bjr/62332495
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Objective: The preferential use of intensity-modulated radiotherapy (IMRT) over conventional radiotherapy (CRT) in the treatment of head and neck cancer has raised concerns regarding dose to non-target tissue. The purpose of this study was to compare dose-volume characteristics with the brachial plexus between treatment plans generated by IMRT and CRT using several common treatment scenarios. Method: The brachial plexus was delineated on radiation treatment planning CT scans from 10 patients undergoing IMRT for locally advanced head and neck cancer using a Radiation Therapy Oncology Group-endorsed atlas. No brachial plexus constraint was used. For each patient, a conventional three-field shrinking-field plan was generated and the dose-volume histogram (DVH) for the brachial plexus was compared with that of the IMRT plan. Results: The mean irradiated volumes of the brachial plexus using the IMRT vs the CRT plan, respectively, were as follows: V50 (18 +/- 5 ml) vs (11 +/- 6 ml), p=0.01; V60 (6 +/- 4 ml) vs (3 +/- 3 ml), p=0.02; V66 (3 +/- 1 ml) vs (1 +/- 1 ml), p=0.04, V70 (0 +/- 1 ml) vs (0 +/- 1 ml), p=0.68. The maximum point dose to the brachial plexus was 68.9 Gy (range 62.3-78.7 Gy) and 66.1 Gy (range 60.2-75.6 Gy) for the IMRT and CRT plans, respectively (p=0.01). Conclusion: Dose to the brachial plexus is significantly increased among patients undergoing IMRT compared with CRT for head and neck cancer. Preliminary studies on brachial plexus-sparing IMRT are in progress.
引用
收藏
页码:58 / 63
页数:6
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