Comparison of coplanar and noncoplanar intensity-modulated radiation therapy and helical tomotherapy for hepatocellular carcinoma
Journal
Radiation Oncology
Journal Volume
5
Journal Issue
1
Pages
40
Date Issued
2010
Author(s)
Hsieh C.-H.
Liu C.-Y.
Shueng P.-W.
Chong N.-S.
Chen C.-J.
Chen M.-J.
Lin C.-C.
Wang T.-E.
Lin S.-C.
Tai H.-C.
Tien H.-J.
Chen K.-H.
Hsieh Y.-P.
Huang D.Y.C.
Chen Y.-J.
Abstract
Background: To compare the differences in dose-volume data among coplanar intensity modulated radiotherapy (IMRT), noncoplanar IMRT, and helical tomotherapy (HT) among patients with hepatocellular carcinoma (HCC) and portal vein thrombosis (PVT).Methods: Nine patients with unresectable HCC and PVT underwent step and shoot coplanar IMRT with intent to deliver 46 - 54 Gy to the tumor and portal vein. The volume of liver received 30Gy was set to keep less than 30% of whole normal liver (V30 < 30%). The mean dose to at least one side of kidney was kept below 23 Gy, and 50 Gy as for stomach. The maximum dose was kept below 47 Gy for spinal cord. Several parameters including mean hepatic dose, percent volume of normal liver with radiation dose at X Gy (Vx), uniformity index, conformal index, and doses to organs at risk were evaluated from the dose-volume histogram.Results: HT provided better uniformity for the planning-target volume dose coverage than both IMRT techniques. The noncoplanar IMRT technique reduces the V10 to normal liver with a statistically significant level as compared to HT. The constraints for the liver in the V30 for coplanar IMRT vs. noncoplanar IMRT vs. HT could be reconsidered as 21% vs. 17% vs. 17%, respectively. When delivering 50 Gy and 60-66 Gy to the tumor bed, the constraints of mean dose to the normal liver could be less than 20 Gy and 25 Gy, respectively.Conclusion: Noncoplanar IMRT and HT are potential techniques of radiation therapy for HCC patients with PVT. Constraints for the liver in IMRT and HT could be stricter than for 3DCRT. ? 2010 Hsieh et al; licensee BioMed Central Ltd.
SDGs
Other Subjects
article; cancer radiotherapy; clinical article; comparative study; computer assisted tomography; coplanar intensity modulated radiation therapy; histogram; human; intensity modulated radiation therapy; liver cell carcinoma; noncoplanar intensity modulated radiation therapy; portal vein thrombosis; radiation dose; self evaluation; spinal cord; tomotherapy; tumor volume; ultrasound; computer assisted radiotherapy; female; follow up; liver; lung tumor; male; pathology; portal vein; radiation exposure; retrospective study; spiral computer assisted tomography; survival rate; thrombosis; treatment outcome; Carcinoma, Hepatocellular; Female; Follow-Up Studies; Humans; Liver; Lung Neoplasms; Male; Portal Vein; Radiotherapy Dosage; Radiotherapy Planning, Computer-Assisted; Radiotherapy, Intensity-Modulated; Retrospective Studies; Survival Rate; Thrombosis; Tomography, Spiral Computed; Treatment Outcome
Type
journal article