TY - JOUR
T1 - Helical Tomotherapy for Radiotherapy in Esophageal Cancer
T2 - A Preferred Plan With Better Conformal Target Coverage and More Homogeneous Dose Distribution
AU - Chen, Yi Jen
AU - Liu, An
AU - Han, Chunhui
AU - Tsai, Peter T.
AU - Schultheiss, Timothy E.
AU - Pezner, Richard D.
AU - Vora, Nilesh
AU - Lim, Dean
AU - Shibata, Stephen
AU - Kernstine, Kemp H.
AU - Wong, Jeffrey Y C
N1 - Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2007/9
Y1 - 2007/9
N2 - 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.
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.
KW - Esophageal cancer
KW - Helical tomotherapy
KW - IMRT
KW - Radiotherapy
UR - http://www.scopus.com/inward/record.url?scp=34547795396&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=34547795396&partnerID=8YFLogxK
U2 - 10.1016/j.meddos.2006.12.003
DO - 10.1016/j.meddos.2006.12.003
M3 - Article
C2 - 17707195
AN - SCOPUS:34547795396
SN - 0958-3947
VL - 32
SP - 166
EP - 171
JO - Medical Dosimetry
JF - Medical Dosimetry
IS - 3
ER -