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

Document Type : Original Article(s)

Authors

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

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

3 MSc of Medical Physics, Department of Radiation Oncology, Seyed Al-Shohada Hospital, Isfahan University of Medical Sciences, Isfahan, Iran

4 Associate Professor, Department of Radiation Oncology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Head and Neck cancers remain a significant problem due to their high morbidity and mortality and in most cases, require regional lymph nodes radiotherapy treatment. This work aims to evaluate and compare two methods of Three-Dimensional Conformal Radiation Therapy (3D-CRT) and Helical Tomotherapy (HT) based on treatment planning and selection of the most appropriate method to reduce side effects.
Methods: In this study, 20 patients with head and neck cancers were considered for treatment in the radiotherapy department of Seyed Alshohada Hospital, Isfahan, Iran. Two methods of HT and 3D-CRT were done using a 6 MeV photon energy apparatus and specific treatment planning algorithms. The dose-volume distribution curve (DVH), the dosimetric variables of the target organ, the radiation delivery efficiency, and the organs at risk were determined and results were compared with each other.
Findings: In HT the dose received by %95 planning target volume (PTV) and value doses of %2 and %98 showed significant improvement over 3D-CRT. For all studied organs at risk (OARs), the decrease in Dmax of HT was significant compared to 3-DCRT.
Conclusion: Helical tomotherapy enhances the target volume coverage and offers a good dose distribution. HT compared to 3D-CRT is a desirable method in treating head and neck cancer patients with the involvement of regional lymph nodes.

Keywords


  1. Marur S, Forastiere AA. Head and neck cancer: changing epidemiology, diagnosis, and treatment. Mayo Clin Proc 2008; 83(4): 489-501.
  2. Santa Cruz O, Tsoutsou P, Castella C, Khanfir K, Anchisi S, Bouayed S, et al. Locoregional control and toxicity in head and neck carcinoma patients following helical Tomotherapy-delivered intensity-modulated radiation therapy compared with 3D-CRT data. Oncology 2018; 95: 61-8.
  3. 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.
  4. Kreps S, Berges O, Belin L, Zefkili S, Petras S, Giraud P. Salivary gland-sparing helical tomotherapy for head and neck cancer: Preserved salivary function on quantitative salivary gland scintigraphy after tomotherapy. Eur Ann Otorhinolaryngol Head Neck Dis 2016; 133(4): 257-62.
  5. 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.
  6. Hsieh CH, Shueng PW, Wang LY, Liao LJ, Lin YC, Kuo YS, et al. Clinical effectiveness, toxicity, and failure patterns of helical tomotherapy for postoperative oral cavity cancer patients. OncoTargets Ther 2014; 7: 405-14.
  7. Leung SW, Lee TF. Treatment of nasopharyngeal carcinoma by tomotherapy: five-year experience. Radiat Oncol 2013; 8: 107.
  8. Clavel S, Nguyen DHA, Fortin B, Després P, Khaouam N, Donath D, et al. Simultaneous integrated boost using intensity-modulated radiotherapy compared with conventional radiotherapy in patients treated with concurrent carboplatin and 5-fluorouracil for locally advanced oropharyngeal Int J Radiat Oncol Biol Phys 2012; 82(2): 582-9.
  9. Hitt R, Grau JJ, Lopez-Pousa A, Berrocal A, García-Girón C, Irigoyen A, et al. A randomized phase III trial comparing induction chemotherapy followed by chemoradiotherapy versus chemoradiotherapy alone as treatment of unresectable head and neck cancer. Annals Oncol 2014; 25(1): 216-25.
  10. Teng F, Fan W, Luo Y, Ju Z, Gong H, Ge R, et al. Reducing xerostomia by comprehensive protection of salivary glands in intensity-modulated radiation therapy with helical tomotherapy technique for head-and-neck cancer patients: a prospective observational study. BioMed Res Int 2019; 2019: 2401743.
  11. Fiorino C, Dell'Oca I, Pierelli A, Broggi S, De Martin E, Di Muzio N, et al. Significant improvement in normal tissue sparing and target coverage for head and neck cancer by means of helical tomotherapy. Radiother Oncol 2006; 78(3): 276-82.