Helical Tomotherapy for Radiotherapy in Esophageal Cancer: A Preferred Plan With Better Conformal Target Coverage and More Homogeneous Dose Distribution

Yi Jen Chen, An Liu, Chunhui Han, Peter T. Tsai, Timothy E. Schultheiss, Richard D. Pezner, Nilesh Vora, Dean Lim, Stephen Shibata, Kemp H. Kernstine, Jeffrey Y C Wong

Research output: Contribution to journalArticle

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Abstract

We compare different radiotherapy techniques-helical tomotherapy (tomotherapy), step-and-shoot IMRT (IMRT), and 3-dimensional conformal radiotherapy (3DCRT)-for patients with mid-distal esophageal carcinoma on the basis of dosimetric analysis. Six patients with locally advanced mid-distal esophageal carcinoma were treated with neoadjuvant chemoradiation followed by surgery. Radiotherapy included 50 Gy to gross planning target volume (PTV) and 45 Gy to elective PTV in 25 fractions. Tomotherapy, IMRT, and 3DCRT plans were generated. Dose-volume histograms (DVHs), homogeneity index (HI), volumes of lung receiving more than 10, 15, or 20 Gy (V10, V15, V20), and volumes of heart receiving more than 30 or 45 Gy (V30, V45) were determined. Statistical analysis was performed by paired t-tests. By isodose distributions and DVHs, tomotherapy plans showed sharper dose gradients, more conformal coverage, and better HI for both gross and elective PTVs compared with IMRT or 3DCRT plans. Mean V20 of lung was significantly reduced in tomotherapy plans. However, tomotherapy and IMRT plans resulted in larger V10 of lung compared to 3DCRT plans. The heart was significantly spared in tomotherapy and IMRT plans compared to 3DCRT plans in terms of V30 and V45. We conclude that tomotherapy plans are superior in terms of target conformity, dose homogeneity, and V20 of lung.

Original languageEnglish (US)
Pages (from-to)166-171
Number of pages6
JournalMedical Dosimetry
Volume32
Issue number3
DOIs
StatePublished - Sep 2007

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Conformal Radiotherapy
Intensity-Modulated Radiotherapy
Esophageal Neoplasms
radiation therapy
Radiotherapy
cancer
dosage
Lung
lungs
homogeneity
Carcinoma
Cardiac Volume
histograms
planning
surgery
statistical analysis
gradients

Keywords

  • Esophageal cancer
  • Helical tomotherapy
  • IMRT
  • Radiotherapy

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Health Professions(all)
  • Radiation

Cite this

Helical Tomotherapy for Radiotherapy in Esophageal Cancer : A Preferred Plan With Better Conformal Target Coverage and More Homogeneous Dose Distribution. / Chen, Yi Jen; Liu, An; Han, Chunhui; Tsai, Peter T.; Schultheiss, Timothy E.; Pezner, Richard D.; Vora, Nilesh; Lim, Dean; Shibata, Stephen; Kernstine, Kemp H.; Wong, Jeffrey Y C.

In: Medical Dosimetry, Vol. 32, No. 3, 09.2007, p. 166-171.

Research output: Contribution to journalArticle

Chen, Yi Jen ; Liu, An ; Han, Chunhui ; Tsai, Peter T. ; Schultheiss, Timothy E. ; Pezner, Richard D. ; Vora, Nilesh ; Lim, Dean ; Shibata, Stephen ; Kernstine, Kemp H. ; Wong, Jeffrey Y C. / Helical Tomotherapy for Radiotherapy in Esophageal Cancer : A Preferred Plan With Better Conformal Target Coverage and More Homogeneous Dose Distribution. In: Medical Dosimetry. 2007 ; Vol. 32, No. 3. pp. 166-171.
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AU - Tsai, Peter T.

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AU - Pezner, Richard D.

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AB - We compare different radiotherapy techniques-helical tomotherapy (tomotherapy), step-and-shoot IMRT (IMRT), and 3-dimensional conformal radiotherapy (3DCRT)-for patients with mid-distal esophageal carcinoma on the basis of dosimetric analysis. Six patients with locally advanced mid-distal esophageal carcinoma were treated with neoadjuvant chemoradiation followed by surgery. Radiotherapy included 50 Gy to gross planning target volume (PTV) and 45 Gy to elective PTV in 25 fractions. Tomotherapy, IMRT, and 3DCRT plans were generated. Dose-volume histograms (DVHs), homogeneity index (HI), volumes of lung receiving more than 10, 15, or 20 Gy (V10, V15, V20), and volumes of heart receiving more than 30 or 45 Gy (V30, V45) were determined. Statistical analysis was performed by paired t-tests. By isodose distributions and DVHs, tomotherapy plans showed sharper dose gradients, more conformal coverage, and better HI for both gross and elective PTVs compared with IMRT or 3DCRT plans. Mean V20 of lung was significantly reduced in tomotherapy plans. However, tomotherapy and IMRT plans resulted in larger V10 of lung compared to 3DCRT plans. The heart was significantly spared in tomotherapy and IMRT plans compared to 3DCRT plans in terms of V30 and V45. We conclude that tomotherapy plans are superior in terms of target conformity, dose homogeneity, and V20 of lung.

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