Journal of Isfahan Medical School

Journal of Isfahan Medical School

Investigation and Comparison of Coplanar Versus Noncoplanar Intensity-Modulated Radiation Therapy (IMRT) Techniques in Glioblastoma Multiforme Tumors

Document Type : Original Article (s)

Authors
Roya Parhizkar-Kalnadani 1
Keyvan Jabbari 2
Seyyed Rabie Mahdavi 3
Golbarg Esmaili 4
1 MSc Student, Department of Medical Physics and Engineering, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Associate Professor, Department of Medical Physics and Engineering, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
3 Associate Professor, Department of Medical Physics and Engineering, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
4 PhD, Department of Medical Physics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
10.22122/jims.v36i478.9947
Abstract
Background: This study aimed to make a comparison among 4 coplanar and noncoplanar intensity-modulated radiation therapy (IMRT) techniques in glioblastoma multiforme (GBM) tumors, to achieve an optimal treatment technique considering the absorbed doses of organs at risk.Methods: Treatment planning and contouring were performed on 20 patients with glioblastoma multiforme tumors in 2 phases based on Radiation Therapy Oncology Group (RTOG) protocol. Four coplanar and noncoplanar intensity-modulated radiation therapy techniques at 6 and 15 MV energy levels were compared. Finally, comparing the conformity and homogeneity indices, and maximum and mean doses (using dose volume histogram), the optimal treatment technique was proposed.Findings: The absorbed doses of critical organs in the cases of noncoplanar techniques reduced drastically compared with the cases of coplanar techniques. Increase in energy levels in noncoplanar techniques did not impose any significant changes.Conclusion: The absorbed doses of all critical organs in noncoplanar technique with 6 MV energy level reduced significantly. Besides, in this technique, there was no neutron contamination, because of the employment of 6 MV energy.
Keywords
Treatment protocols
Glioblastoma multiforme
Radiation therapy
  1. Pourhoseingholi MA, Fazeli Z, Ashtari S, Bavand-Pour FS. Mortality trends of gastrointestinal cancers in Iranian population. Gastroenterol Hepatol Bed Bench 2013; 6(Suppl 1): S52-S57.
  2. Mousavi SM, Gouya MM, Ramazani R, Davanlou M, Hajsadeghi N, Seddighi Z. Cancer incidence and mortality in Iran. Ann Oncol 2009; 20(3): 556-63.
  3. Young RM, Jamshidi A, Davis G, Sherman JH. Current trends in the surgical management and treatment of adult glioblastoma. Ann Transl Med 2015; 3(9): 121.
  4. Ellor SV, Pagano-Young TA, Avgeropoulos NG. Glioblastoma: Background, Standard Treatment Paradigms, and Supportive Care Considerations. The Journal of Law, Medicine & Ethics 2014; 42(2): 171-82.
  5. Maher EA, Furnari FB, Bachoo RM, Rowitch DH, Louis DN, Cavenee WK, et al. Malignant glioma: genetics and biology of a grave matter. Genes Dev 2001; 15(11): 1311-33.
  6. Dolecek TA, Propp JM, Stroup NE, Kruchko C. CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2005-2009. Neuro Oncol 2012; 14(Suppl 5): v1-49.
  7. Stummer W, Pichlmeier U, Meinel T, Wiestler OD, Zanella F, Reulen HJ. Fluorescence-guided surgery with 5-aminolevulinic acid for resection of malignant glioma: a randomised controlled multicentre phase III trial. Lancet Oncol 2006; 7(5): 392-401.
  8. Reardon DA, Wen PY. Therapeutic advances in the treatment of glioblastoma: rationale and potential role of targeted agents. Oncologist 2006; 11(2): 152-64.
  9. Kan MW, Leung LH, Kwong DL, Wong W, Lam N. Peripheral doses from noncoplanar IMRT for pediatric radiation therapy. Med Dosim 2010; 35(4): 255-63.
  10. Chen X, Jin D, Wang S, Li M, Huang P, Dai J. Noncoplanar intensity-modulated radiation therapy for young female patients with mediastinal lymphoma. J Appl Clin Med Phys 2012; 13(6): 147-56.
  11. Vissink A, Jansma J, Spijkervet FK, Burlage FR, Coppes RP. Oral sequelae of head and neck radiotherapy. Crit Rev Oral Biol Med 2003; 14(3): 199-212.
  12. Rose-Ped AM, Bellm LA, Epstein JB, Trotti A, Gwede C, Fuchs HJ. Complications of radiation therapy for head and neck cancers. The patient's perspective. Cancer Nurs 2002; 25(6): 461-7.
  13. Hunt MA, Zelefsky MJ, Wolden S, Chui CS, LoSasso T, Rosenzweig K, et al. Treatment planning and delivery of intensity-modulated radiation therapy for primary nasopharynx cancer. Int J Radiat Oncol Biol Phys 2001; 49(3): 623-32.
  14. Kam MK, Chau RM, Suen J, Choi PH, Teo PM. Intensity-modulated radiotherapy in nasopharyngeal carcinoma: dosimetric advantage over conventional plans and feasibility of dose escalation. Int J Radiat Oncol Biol Phys 2003; 56(1): 145-57.
  15. Khan FM. The physics of radiation therapy. Philadelphia, PA: Lippincott Williams and Wilkins; 2003.
  16. Fuller CD, Choi M, Forthuber B, Wang SJ, Rajagiriyil N, Salter BJ, et al. Standard fractionation intensity modulated radiation therapy (IMRT) of primary and recurrent glioblastoma multiforme. Radiat Oncol 2007; 2: 26.
  17. Combs SE, Widmer V, Thilmann C, Hof H, Debus J, Schulz-Ertner D. Stereotactic radiosurgery (SRS): treatment option for recurrent glioblastoma multiforme (GBM). Cancer 2005; 104(10): 2168-73.
  18. Chan MF, Schupak K, Burman C, Chui CS, Ling CC. Comparison of intensity-modulated radiotherapy with three-dimensional conformal radiation therapy planning for glioblastoma multiforme. Med Dosim 2003; 28(4): 261-5.
  19. Panet-Raymond V, Ansbacher W, Zavgorodni S, Bendorffe B, Nichol A, Truong PT, et al. Coplanar versus noncoplanar intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) treatment planning for fronto-temporal high-grade glioma. J Appl Clin Med Phys 2012; 13(4): 3826.
  20. Chamberlain MC. Pseudoprogression in glioblastoma. J Clin Oncol 2008; 26(26): 4359-60.
  21. Group RTO. Phase III double-blind placebo-controlled trial of conventional concurrent chemoradiation and adjuvant temozolomide plus bevacizumab versus conventional concurrent chemoradiation and adjuvant temozolomide in patients with newly diagnosed glioblastoma.
Journal of Isfahan Medical School
Volume 36, Issue 478 - Serial Number 478
March and April 2018
Pages 478-484

  • Receive Date 17 April 2018
  • Accept Date 06 April 2022