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. 2022 Apr 21;12(5):668.
doi: 10.3390/jpm12050668.

Adaptive Radiotherapy in Head and Neck Cancer Using Volumetric Modulated Arc Therapy

Nikolett Buciuman  1   2 , Loredana G Marcu  1   3   4
Affiliations

Adaptive Radiotherapy in Head and Neck Cancer Using Volumetric Modulated Arc Therapy

Nikolett Buciuman et al. J Pers Med. .

Abstract

A dosimetric study was performed to show the importance of adaptive radiotherapy (ART) for head and neck cancer (HNC) patients using volumetric modulated arc therapy (VMAT). A total of 13 patients with HNC who required replanning during radiotherapy were included in this study. All plans succeeded to achieve the set objectives regarding target volume coverage and organ sparing. All target volumes presented a significant decrease with an average of 76.44 cm3 (p = 0.007) for PTVlow risk, 102.81 cm3 (p = 0.021) for PTVintermediate risk, and 47.10 cm3 (p = 0.003) for PTVhigh risk. Additionally, a positive correlation was found between PTV shrinkage and the number of fractions completed before replanning. Significant volume decrease was also observed for the parotid glands. The ipsilateral parotid decreased in volume by a mean of 3.75 cm3 (14.43%) (p = 0.067), while the contralateral decreased by 4.23 cm3 (13.23%) (p = 0.033). For all analyzed organs, a reduction in the final dose received after replanning was found. Our study showed that ART via rescanning, recontouring, and replanning using VMAT is essential whenever anatomical and positional variations occur. Furthermore, comparison with the literature has confirmed that ART using VMAT offers similar results to ART with intensity modulated radiotherapy.

Keywords: intensity modulated radiotherapy; parotid gland; planning target volume; recontouring; replanning.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Tumor volumes contoured at first CT scan (left) and second CT scan after completion of 21 radiotherapy fractions (right).
Figure 2
Figure 2
Tumor volumes contoured at first CT scan (left) and second CT scan after completion of 18 radiotherapy fractions (right).
Figure 3
Figure 3
Graphical representation of the PTVlow reduction in correlation with the number of fractions completed before replanning.
Figure 4
Figure 4
Graphical representation of the PTVintermediate reduction in correlation with the number of fractions completed before replanning.
Figure 5
Figure 5
Graphical representation of the PTVhigh reduction in correlation with the number of fractions completed before replanning.
Figure 6
Figure 6
Box plot diagrams for OARs before and after replanning.
See this image and copyright information in PMC

References

    1. Ghosh A., Gupta S., Johny D., Bhosale V.V., Negi M.P.S. A Study to Assess the Dosimetric Impact of the Anatomical Changes Occurring in the Parotid Glands and Tumour Volume during Intensity Modulated Radiotherapy using Simultaneous Integrated Boost (IMRT-SIB) in Head and Neck Squamous Cell Cancers. Cancer Med. 2021;10:5175–5190. doi: 10.1002/cam4.4079. - DOI - PMC - PubMed
    1. Ho K.F., Marchant T., Moore C., Webster G., Rowbottom C., Penington H., Lee L., Yap B., Sykes A., Slevin N. Monitoring dosimetric impact of weight loss with kilovoltage (KV) cone beam CT (CBCT) during parotid-sparing IMRT and concurrent chemotherapy. Int. J. Radiat. Oncol. Biol. Phys. 2012;82:e375–e382. doi: 10.1016/j.ijrobp.2011.07.004. - DOI - PubMed
    1. Bhandari V., Patel P., Gurjar O.P., Gupta K.L. Impact of repeat computerized tomography replans in the radiation therapy of head and neck cancers. J. Med. Phys. 2014;39:164–168. doi: 10.4103/0971-6203.139005. - DOI - PMC - PubMed
    1. Burela N., Soni T.P., Patni N., Natarajan T. Adaptive intensity-modulated radiotherapy in head-and-neck cancer: A volumetric and dosimetric study. J. Cancer Res. Ther. 2019;15:533–538. doi: 10.4103/jcrt.JCRT_594_17. - DOI - PubMed
    1. Bhide S.A., Davies M., Burke K., McNair H.A. Weekly volume and dosimetric changes during chemoradiotherapy with intensity-modulated radiation therapy for head and neck cancer: A prospective observational study. Int. J. Radiat. Oncol. Biol. Phys. 2010;6:1360–1368. doi: 10.1016/j.ijrobp.2009.04.005. - DOI - PubMed

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