Comparison of Dosimetry of Organs at Risk for the Treatment of Nasopharyngeal Cancer Using Two Methods of Helical Tomotherapy and Three Dimensional Conformal Radiation Therapy

Document Type : Original Article(s)

Authors

1 Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Professor, Department of Medical Physics and Medical Engineering, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

3 PhD in Medical Physics, Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

4 Assistant Professor, Department of Radio Oncology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

5 MSc in Medical Physics, Omid Hospital, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Nasopharyngeal cancer is one of the common head and neck cancers and the main treatment for this type of cancer is radiotherapy. The purpose of this study is to investigate and compare the dose of organs at risk in two adaptive three-dimensional methods (3D-CRT) and helical tomotherapy (HT) in patients with head and neck cancers.
Methods: This study is a cross-sectional experimental retrospective study and to conduct this study, CT scan images (Computed Tomography) of 16 patients with early stages of NPC with an average age range of 16-81 years (42.7 ± 16.3) those were randomly selected. The organs at risk and their target volume were contoured and the treatment plan of the patients was done for both HT and 3D-CRT methods. In the end, using a Volume-Dose histogram (DVH), the dosimetry variables of organs at risk and target volume were extracted and compared with each other.
Findings: Compared to 3D-CRT, the HT method improved the homogeneity index and concordance index. It also significantly reduced the dose of the studied OARs compared to 3D-CRT, although the dose of some of these organs exceeded the prescribed dose limit.
Conclusion: HT method is a better technique for treating nasopharyngeal cancer patients who are candidates for radiotherapy due to better coverage of the target volume and also, better performance in preserving OARs compared to the 3D-CRT method.

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  1. Ensley JF, Gutkind S, Jacobs JA, Lippman S. Head and neck cancer: emerging perspectives. 1st Cambridge, MA: Academic Press; 2003.
  2. Siegel RL, Miller KD, Goding Sauer A, Fedewa SA, Butterly LF, Anderson JC, et al. Colorectal cancer statistics, 2020. CA: CA Cancer J Clin 2020; 70(3): 145-64.
  3. Pytel A, Zielińska A, Staś J, Chabowski M. Quality of Life, Psychological Distress, and Nutritional Status of Polish Patients with Head and Neck Cancer Treated with Radiotherapy. J Clin Med 2023; 12(2): 659.
  4. Alsafadi N, Alqarni MS, Attar M, Mgarry R, Bokhari A. Nasopharyngeal cancer: prevalence, outcome, and impact on health-related quality of life at Princess Norah Oncology Center, Jeddah, Saudi Arabia. Cureus 2020; 12(5): e8199.
  5. Monadi N, Shahbazi-Gahrouei D, Monadi S, Shams A, Akhavan A. Dosimetric comparison of two methods of three-dimensional conformal radiotherapy and helical tomotherapy in head and neck cancer patients with involvement of regional lymph nodes [in Persian].
    J Isfahan Med Sch 2023; 40(699): 1023-8.
  6. Parahyba CJ, Ynoe Moraes F, Ramos PAM, Haddad CMK, da Silva JLF, Fregnani ER. Radiation dose distribution in the teeth, maxilla, and mandible of patients with oropharyngeal and nasopharyngeal tumors who were treated with intensity‐modulated radiotherapy. Head Neck 2016; 38(11): 1621-7.
  7. Bagherzadeh S, Shahbazi-Gahrouei D, Torabinezhad F, Mahdavi SR, Salmanian S. The effects of (chemo) radiation therapy on the voice and quality of life in patients with non-laryngeal head and neck cancers: a subjective and objective assessment. Int J Radiat Res 2022; 20(2): 397-402.
  8. Trip AK, Nijkamp J, van Tinteren H, Cats A, Boot H, Jansen EPM, et al. IMRT limits nephrotoxicity after chemoradiotherapy for gastric cancer. Radiother Oncol 2014; 112(2): 289-94.
  9. Basu T, Bhaskar N. Overview of Important “Organs at Risk”(OAR) in Modern Radiotherapy for Head and Neck Cancer (HNC). Cancer Survivorship 2019: 1.
  10. Mahmood SS, Nohria A. Cardiovascular complications of cranial and neck radiation. C Curr Treat Options Cardiovasc Med 2016; 18(7): 45.
  11. Gupta T, Agarwal J, Jain S, Phurailatpam R, Kannan S, Ghosh-Laskar S, et al. Three-dimensional conformal radiotherapy (3D-CRT) versus intensity modulated radiation therapy (IMRT) in squamous cell carcinoma of the head and neck: a randomized controlled trial. Radiother Oncol 2012; 104(3): 343-8.
  12. Ruchala KJ, Olivera GH, Schloesser EA, Mackie TR. Megavoltage CT on a tomotherapy system. Phys Med Biol 1999; 44(10): 2597-621.
  13. Okutan M, Şengül B, Köksal C, Göksel EO, Toraman KÖ, Demi̇r B, et al. A Dosimetric plan study to increase the dose from 63 Gy to 70 Gy in early-stage glottic larynx cancer. Turk J Oncol 2020; 35(3): 306-14.
  14. Khan FM, Gibbons JP. Khan's the physics of radiation therapy. 5thPhiladelphia, PA: Lippincott Williams & Wilkins; 2014.
  15. Ekici K, Pepele EK, Yaprak B, Temelli O, Eraslan
    AF, Kucuk N, et al. Dosimetric comparison of helical tomotherapy, intensity-modulated radiation therapy, volumetric-modulated arc therapy, and 3-dimensional conformal therapy for the treatment of T1N0 glottic cancer. Med Dosim 2016; 41(4): 329-33.
  16. Liu X, Huang E, Wang Y, He Y, Luo H, Zhong M, et al. Dosimetric comparison of helical tomotherapy, VMAT, fixed-field IMRT and 3D-conformal radiotherapy for stage I-II nasal natural killer T-cell lymphoma. Radiat Oncol 2017; 12(1): 1-9.
  17. Herdian F, Lestari AASA, Jayalie VF, Wibowo WE, Djakaria M, Gondhowiardjo S. Analysis of dosimetric parameter on craniospinal irradiation with Helical Tomotherapy (HT), 3D Conformal Radiotherapy (3DCRT), and Intensity Modulated Radiotherapy (IMRT). Oncology and Radiotherapy 2020; 14(4): 1-6.
  18. Lu S, Fan H, Hu X, Li X, Kuang Y, Yu D, et al. Dosimetric comparison of helical tomotherapy, volume-modulated arc therapy, and fixed-field intensity-modulated radiation therapy in locally advanced nasopharyngeal carcinoma. Front Oncol 2021; 11: 764946.