Potential of helical tomotherapy to reduce dose to the ocular structures for patients treated for unresectable sinonasal cancer

Allen M. Chen, Radhika Sreeraman, Mathew Mathai, Srinivasan Vijayakumar, James A. Purdy

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Purpose: To compare intensity-modulated radiotherapy (IMRT) treatment plans generated by segmental multileaf collimator (SMLC) and helical tomotherapy (HT) techniques for patients with unresectable sinonasal cancer. Methods and Materials: SMLC-IMRT and HT-IMRT plans for 5 patients with cancer of the paranasal sinuses and nasal cavity were independently optimized using the Eclipse treatment planning system (Varian MedialSystems, Palo Alto, CA) and Tomotherapy HI-ART treatment planningsystem (Tomotherapy, Inc, Madison, WI). The goal was to deliver a prescribed dose of 70 Gy to at least 95% of the planning target volume (PTV) encompassing gross tumor over 35 treatments whereas respecting constraints to organs at risk, notably the ocular structures. Results: HT-IMRT reduced the maximum doses to the optic chiasm, as well as to the ipsilateral optic nerve and retina (P < 0.05, for all). Maximum doses to these structures were reduced by 10%, 16%, and 14%, respectively, using HT-IMRT compared with SMLC-IMRT. Additionally, the mean dose to the ipsilateral lacrimal gland was reduced by 32% using HT-IMRT. With respect to conformality, HT-IMRT improved dose homogeneity by decreasing "hotspots." The mean percentage of PTV70 receiving greater than 77 Gy (110% of the prescribed dose) was 4.0% for the HT-IMRT plans compared with 17.8% for the SMLC-IMRT plans (P = 0.001). Conclusions: HT-IMRT has the potential to improve dose homogeneity to PTVs whereas reducing dose to the optic structures. Clinical implications are discussed.

Original languageEnglish (US)
Pages (from-to)595-598
Number of pages4
JournalAmerican Journal of Clinical Oncology: Cancer Clinical Trials
Volume33
Issue number6
DOIs
StatePublished - Dec 2010

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Intensity-Modulated Radiotherapy
Neoplasms
Paranasal Sinus Neoplasms
Organs at Risk
Optic Chiasm
Lacrimal Apparatus

Keywords

  • Intensity-modulated radiotherapy
  • Ocular toxicity
  • Sinonasal
  • Tomotherapy

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Potential of helical tomotherapy to reduce dose to the ocular structures for patients treated for unresectable sinonasal cancer. / Chen, Allen M.; Sreeraman, Radhika; Mathai, Mathew; Vijayakumar, Srinivasan; Purdy, James A.

In: American Journal of Clinical Oncology: Cancer Clinical Trials, Vol. 33, No. 6, 12.2010, p. 595-598.

Research output: Contribution to journalArticle

Chen, Allen M. ; Sreeraman, Radhika ; Mathai, Mathew ; Vijayakumar, Srinivasan ; Purdy, James A. / Potential of helical tomotherapy to reduce dose to the ocular structures for patients treated for unresectable sinonasal cancer. In: American Journal of Clinical Oncology: Cancer Clinical Trials. 2010 ; Vol. 33, No. 6. pp. 595-598.
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T1 - Potential of helical tomotherapy to reduce dose to the ocular structures for patients treated for unresectable sinonasal cancer

AU - Chen, Allen M.

AU - Sreeraman, Radhika

AU - Mathai, Mathew

AU - Vijayakumar, Srinivasan

AU - Purdy, James A.

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N2 - Purpose: To compare intensity-modulated radiotherapy (IMRT) treatment plans generated by segmental multileaf collimator (SMLC) and helical tomotherapy (HT) techniques for patients with unresectable sinonasal cancer. Methods and Materials: SMLC-IMRT and HT-IMRT plans for 5 patients with cancer of the paranasal sinuses and nasal cavity were independently optimized using the Eclipse treatment planning system (Varian MedialSystems, Palo Alto, CA) and Tomotherapy HI-ART treatment planningsystem (Tomotherapy, Inc, Madison, WI). The goal was to deliver a prescribed dose of 70 Gy to at least 95% of the planning target volume (PTV) encompassing gross tumor over 35 treatments whereas respecting constraints to organs at risk, notably the ocular structures. Results: HT-IMRT reduced the maximum doses to the optic chiasm, as well as to the ipsilateral optic nerve and retina (P < 0.05, for all). Maximum doses to these structures were reduced by 10%, 16%, and 14%, respectively, using HT-IMRT compared with SMLC-IMRT. Additionally, the mean dose to the ipsilateral lacrimal gland was reduced by 32% using HT-IMRT. With respect to conformality, HT-IMRT improved dose homogeneity by decreasing "hotspots." The mean percentage of PTV70 receiving greater than 77 Gy (110% of the prescribed dose) was 4.0% for the HT-IMRT plans compared with 17.8% for the SMLC-IMRT plans (P = 0.001). Conclusions: HT-IMRT has the potential to improve dose homogeneity to PTVs whereas reducing dose to the optic structures. Clinical implications are discussed.

AB - Purpose: To compare intensity-modulated radiotherapy (IMRT) treatment plans generated by segmental multileaf collimator (SMLC) and helical tomotherapy (HT) techniques for patients with unresectable sinonasal cancer. Methods and Materials: SMLC-IMRT and HT-IMRT plans for 5 patients with cancer of the paranasal sinuses and nasal cavity were independently optimized using the Eclipse treatment planning system (Varian MedialSystems, Palo Alto, CA) and Tomotherapy HI-ART treatment planningsystem (Tomotherapy, Inc, Madison, WI). The goal was to deliver a prescribed dose of 70 Gy to at least 95% of the planning target volume (PTV) encompassing gross tumor over 35 treatments whereas respecting constraints to organs at risk, notably the ocular structures. Results: HT-IMRT reduced the maximum doses to the optic chiasm, as well as to the ipsilateral optic nerve and retina (P < 0.05, for all). Maximum doses to these structures were reduced by 10%, 16%, and 14%, respectively, using HT-IMRT compared with SMLC-IMRT. Additionally, the mean dose to the ipsilateral lacrimal gland was reduced by 32% using HT-IMRT. With respect to conformality, HT-IMRT improved dose homogeneity by decreasing "hotspots." The mean percentage of PTV70 receiving greater than 77 Gy (110% of the prescribed dose) was 4.0% for the HT-IMRT plans compared with 17.8% for the SMLC-IMRT plans (P = 0.001). Conclusions: HT-IMRT has the potential to improve dose homogeneity to PTVs whereas reducing dose to the optic structures. Clinical implications are discussed.

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KW - Ocular toxicity

KW - Sinonasal

KW - Tomotherapy

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