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Parotid Gland Dose in Intensity-Modulated Radiotherapy for Head and Neck Cancer: Is What You Plan What You Get?

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Title: Parotid Gland Dose in Intensity-Modulated Radiotherapy for Head and Neck Cancer: Is What You Plan What You Get?
Authors: O'Daniel, Jennifer C.1, Garden, Adam S.2, Schwartz, David L.2, Wang, He1, Ang, Kian K.2, Ahamad, Anesa2, Rosenthal, David I.2, Morrison, William H.2, Asper, Joshua A.2, Zhang, Lifei1, Tung, Shih-Ming1, Mohan, Radhe1, Dong, Lei1 ldong@mdanderson.org
Source: International Journal of Radiation Oncology, Biology, Physics. Nov2007, Vol. 69 Issue 4, p1290-1296. 7p.
Subjects: Cancer radiotherapy, Brain cancer, Head & neck cancer, Parotid glands
Abstract: Purpose: To quantify the differences between planned and delivered parotid gland and target doses, and to assess the benefits of daily bone alignment for head and neck cancer patients treated with intensity-modulated radiotherapy (IMRT).Methods and Materials: Eleven head and neck cancer patients received two CT scans per week with an in-room CT scanner over the course of their radiotherapy. The clinical IMRT plans, designed with 3-mm to 4-mm planning margins, were recalculated on the repeat CT images. The plans were aligned using the actual treatment isocenter marked with radiopaque markers (BB) and bone alignment to the cervical vertebrae to simulate image-guided setup. In-house deformable image registration software was used to map daily dose distributions to the original treatment plan and to calculate a cumulative delivered dose distribution for each patient.Results: Using conventional BB alignment led to increases in the parotid gland mean dose above the planned dose by 5 to 7 Gy in 45% of the patients (median, 3.0 Gy ipsilateral, p = 0.026; median, 1.0 Gy contralateral, p = 0.016). Use of bone alignment led to reductions relative to BB alignment in 91% of patients (median, 2 Gy; range, 0.3-8.3 Gy; 15 of 22 parotids improved). However, the parotid dose from bone alignment was still greater than planned (median, 1.0 Gy, p = 0.007). Neither approach affected tumor dose coverage.Conclusions: With conventional BB alignment, the parotid gland mean dose was significantly increased above the planned mean dose. Using daily bone alignment reduced the parotid dose compared with BB alignment in almost all patients. A 3- to 4-mm planning margin was adequate for tumor dose coverage. [ABSTRACT FROM AUTHOR]
Copyright of International Journal of Radiation Oncology, Biology, Physics is the property of Pergamon Press - An Imprint of Elsevier Science and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Engineering Source
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DbLabel: Engineering Source
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PubType: Academic Journal
PubTypeId: academicJournal
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  Data: Parotid Gland Dose in Intensity-Modulated Radiotherapy for Head and Neck Cancer: Is What You Plan What You Get?
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  Data: <searchLink fieldCode="AR" term="%22O'Daniel%2C+Jennifer+C%2E%22">O'Daniel, Jennifer C.</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Garden%2C+Adam+S%2E%22">Garden, Adam S.</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Schwartz%2C+David+L%2E%22">Schwartz, David L.</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Wang%2C+He%22">Wang, He</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Ang%2C+Kian+K%2E%22">Ang, Kian K.</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Ahamad%2C+Anesa%22">Ahamad, Anesa</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Rosenthal%2C+David+I%2E%22">Rosenthal, David I.</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Morrison%2C+William+H%2E%22">Morrison, William H.</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Asper%2C+Joshua+A%2E%22">Asper, Joshua A.</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Zhang%2C+Lifei%22">Zhang, Lifei</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Tung%2C+Shih-Ming%22">Tung, Shih-Ming</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Mohan%2C+Radhe%22">Mohan, Radhe</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Dong%2C+Lei%22">Dong, Lei</searchLink><relatesTo>1</relatesTo><i> ldong@mdanderson.org</i>
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  Data: <searchLink fieldCode="JN" term="%22International+Journal+of+Radiation+Oncology%2C+Biology%2C+Physics%22">International Journal of Radiation Oncology, Biology, Physics</searchLink>. Nov2007, Vol. 69 Issue 4, p1290-1296. 7p.
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  Data: <searchLink fieldCode="DE" term="%22Cancer+radiotherapy%22">Cancer radiotherapy</searchLink><br /><searchLink fieldCode="DE" term="%22Brain+cancer%22">Brain cancer</searchLink><br /><searchLink fieldCode="DE" term="%22Head+%26+neck+cancer%22">Head & neck cancer</searchLink><br /><searchLink fieldCode="DE" term="%22Parotid+glands%22">Parotid glands</searchLink>
– Name: Abstract
  Label: Abstract
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  Data: <bold>Purpose: </bold>To quantify the differences between planned and delivered parotid gland and target doses, and to assess the benefits of daily bone alignment for head and neck cancer patients treated with intensity-modulated radiotherapy (IMRT).<bold>Methods and Materials: </bold>Eleven head and neck cancer patients received two CT scans per week with an in-room CT scanner over the course of their radiotherapy. The clinical IMRT plans, designed with 3-mm to 4-mm planning margins, were recalculated on the repeat CT images. The plans were aligned using the actual treatment isocenter marked with radiopaque markers (BB) and bone alignment to the cervical vertebrae to simulate image-guided setup. In-house deformable image registration software was used to map daily dose distributions to the original treatment plan and to calculate a cumulative delivered dose distribution for each patient.<bold>Results: </bold>Using conventional BB alignment led to increases in the parotid gland mean dose above the planned dose by 5 to 7 Gy in 45% of the patients (median, 3.0 Gy ipsilateral, p = 0.026; median, 1.0 Gy contralateral, p = 0.016). Use of bone alignment led to reductions relative to BB alignment in 91% of patients (median, 2 Gy; range, 0.3-8.3 Gy; 15 of 22 parotids improved). However, the parotid dose from bone alignment was still greater than planned (median, 1.0 Gy, p = 0.007). Neither approach affected tumor dose coverage.<bold>Conclusions: </bold>With conventional BB alignment, the parotid gland mean dose was significantly increased above the planned mean dose. Using daily bone alignment reduced the parotid dose compared with BB alignment in almost all patients. A 3- to 4-mm planning margin was adequate for tumor dose coverage. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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  Data: <i>Copyright of International Journal of Radiation Oncology, Biology, Physics is the property of Pergamon Press - An Imprint of Elsevier Science and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1016/j.ijrobp.2007.07.2345
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        Text: English
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      – SubjectFull: Brain cancer
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      – SubjectFull: Head & neck cancer
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              Text: Nov2007
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