Volume 68, Issue 8 (November 2010)
Tehran Univ Med J 2010, 68(8): 465-472 |
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Aghili M, Moshtaghi M, Samiee F, Esmati E, Esfahani M, Nedaee H A et al . 3-Dimentional radiotherapy versus conventional treatment plans for gastric cancer. Tehran Univ Med J 2010; 68 (8) :465-472
URL: http://tumj.tums.ac.ir/article-1-5652-en.html
URL: http://tumj.tums.ac.ir/article-1-5652-en.html
Mahdi Aghili1 
, Maryam Moshtaghi * 2, Farhad Samiee1 , Ebrahim Esmati1 , Mahbod Esfahani3 , Hasan Ali Nedaee3 , Peiman Haddad1
, Maryam Moshtaghi * 2, Farhad Samiee1 , Ebrahim Esmati1 , Mahbod Esfahani3 , Hasan Ali Nedaee3 , Peiman Haddad1
1- Department of Radiation Oncology, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran.
2- Department of Radiation Oncology, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran. ,moshtaghi_m@sina.tums.ac.ir
3- Department of Physics,
2- Department of Radiation Oncology, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran. ,
3- Department of Physics,
Abstract: (6375 Views)
Background: The current standard of adjuvant management for gastric cancer after curative resection based on the results of intergroup 0116 is concurrent chemoradiation. Current guidelines for designing these challenging fields still include two-dimensional simulation with simple AP-PA parallel opposed design. However, the implementation of radiotherapy (RT) remains a concern. Our objective was to compare three-dimensional (3D) techniques to the more commonly used AP-PA technique.
Methods: A total of 24 patients with stages II-IV adenocarcinoma of the stomach were treated with adjuvant postoperative chemoradiation with simple AP-PA technique, using Cobalt-60. Total radiation dose was 50.4Gy. Landmark-based fields were simulated to assess PTV coverage. For each patient, three additional radiotherapy treatment plans were generated using three-dimensional (3D) technique. The four treatment plans were then compared for target volume coverage and dose to normal tissues (liver, spinal cord, kidneys) using dose volume histogram (DVH) analysis.
Results: The three-dimensional planning techniques provided 10% superior PTV coverage compared to conventional AP-PA fields (p<0.001). Comparative DVHs for the right kidney, left kidney and spinal cord demonstrate lower radiation doses using the 3D planning techniques (p<0.0001), the liver dose is higher (p=0.03), but is still well below liver tolerance.
Conclusion: Despite the department protocol using conventional planning, 3D radiotherapy provides 10% superior PTV coverage. It is associated with reduced radiation doses to the kidneys and spinal cord compared to AP-PA techniques with the potential to reduce treatment toxicity.
Methods: A total of 24 patients with stages II-IV adenocarcinoma of the stomach were treated with adjuvant postoperative chemoradiation with simple AP-PA technique, using Cobalt-60. Total radiation dose was 50.4Gy. Landmark-based fields were simulated to assess PTV coverage. For each patient, three additional radiotherapy treatment plans were generated using three-dimensional (3D) technique. The four treatment plans were then compared for target volume coverage and dose to normal tissues (liver, spinal cord, kidneys) using dose volume histogram (DVH) analysis.
Results: The three-dimensional planning techniques provided 10% superior PTV coverage compared to conventional AP-PA fields (p<0.001). Comparative DVHs for the right kidney, left kidney and spinal cord demonstrate lower radiation doses using the 3D planning techniques (p<0.0001), the liver dose is higher (p=0.03), but is still well below liver tolerance.
Conclusion: Despite the department protocol using conventional planning, 3D radiotherapy provides 10% superior PTV coverage. It is associated with reduced radiation doses to the kidneys and spinal cord compared to AP-PA techniques with the potential to reduce treatment toxicity.
Type of Study: Original Article |
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