The dose to the parotid glands with IMRT for oropharyngeal tumors: the effect of reduction of positioning margins
Purpose: The aim of this paper is to quantify the importance of the reduction of positioning margins applied to the clinical target volume (CTV) on the dose distribution of the parotid gland for different intensity-modulated radiotherapy (IMRT) strategies for the treatment of oropharyngeal cancer. M...
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| Veröffentlicht in: | Radiotherapy and oncology 2002-08, Vol.64 (2), p.197-204 |
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| creator | van Asselen, Bram Dehnad, Homan Raaijmakers, Cornelis P.J Roesink, Judith M Lagendijk, Jan J.W Terhaard, Chris H.J |
| description | Purpose: The aim of this paper is to quantify the importance of the reduction of positioning margins applied to the clinical target volume (CTV) on the dose distribution of the parotid gland for different intensity-modulated radiotherapy (IMRT) strategies for the treatment of oropharyngeal cancer.
Methods and materials: CTVs and organs at risk were delineated in the planning computed tomographic (CT) scans of three patients. Margins of 0, 3, 6 and 9
mm were applied to the CTVs in order to obtain the planning target volumes (PTVs). Three IMRT strategies were used to optimize the dose distribution.
Results: The analysis of the three IMRT strategies resulted in: (1) an optimal dose distribution in the PTV; (2) optimal dose distribution in the PTV while sparing the parotid gland and (3) more parotid gland sparing but at expense of the dose homogeneity in the PTV. The mean parotid dose increased linearly with increasing margin by approximately 1.3
Gy per mm. As a result, the normal complication probability (NTCP) for xerostomia decreased when smaller margins were applied. Reducing the margin from 6 to 3
mm resulted in an NTCP reduction of approximately 20%.
Conclusion: Reducing the CTV–PTV margin by improving the patient position accuracy may lead to a significant reduction of NTCP for the IMRT treatment of the oropharyngeal tumors and lymph nodes level II. |
| doi_str_mv | 10.1016/S0167-8140(02)00152-4 |
| format | Article |
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Methods and materials: CTVs and organs at risk were delineated in the planning computed tomographic (CT) scans of three patients. Margins of 0, 3, 6 and 9
mm were applied to the CTVs in order to obtain the planning target volumes (PTVs). Three IMRT strategies were used to optimize the dose distribution.
Results: The analysis of the three IMRT strategies resulted in: (1) an optimal dose distribution in the PTV; (2) optimal dose distribution in the PTV while sparing the parotid gland and (3) more parotid gland sparing but at expense of the dose homogeneity in the PTV. The mean parotid dose increased linearly with increasing margin by approximately 1.3
Gy per mm. As a result, the normal complication probability (NTCP) for xerostomia decreased when smaller margins were applied. Reducing the margin from 6 to 3
mm resulted in an NTCP reduction of approximately 20%.
Conclusion: Reducing the CTV–PTV margin by improving the patient position accuracy may lead to a significant reduction of NTCP for the IMRT treatment of the oropharyngeal tumors and lymph nodes level II.</description><identifier>ISSN: 0167-8140</identifier><identifier>EISSN: 1879-0887</identifier><identifier>DOI: 10.1016/S0167-8140(02)00152-4</identifier><identifier>PMID: 12242130</identifier><language>eng</language><publisher>Ireland: Elsevier Ireland Ltd</publisher><subject>Head and neck ; Humans ; Intensity-modulated radiotherapy ; Margin ; Oropharyngeal Neoplasms - diagnostic imaging ; Oropharyngeal Neoplasms - radiotherapy ; Oropharynx ; Parotid gland ; Parotid Gland - diagnostic imaging ; Parotid Gland - physiopathology ; Parotid Gland - radiation effects ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted - methods ; Radiotherapy, Conformal - methods ; Tomography, X-Ray Computed ; Xerostomia - prevention & control</subject><ispartof>Radiotherapy and oncology, 2002-08, Vol.64 (2), p.197-204</ispartof><rights>2002 Elsevier Science Ireland Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c390t-1590b0e5534d0a2f48643c64feffce11dbba633c00fad1ce3faead82a5cc00733</citedby><cites>FETCH-LOGICAL-c390t-1590b0e5534d0a2f48643c64feffce11dbba633c00fad1ce3faead82a5cc00733</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0167-8140(02)00152-4$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3548,27923,27924,45994</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12242130$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>van Asselen, Bram</creatorcontrib><creatorcontrib>Dehnad, Homan</creatorcontrib><creatorcontrib>Raaijmakers, Cornelis P.J</creatorcontrib><creatorcontrib>Roesink, Judith M</creatorcontrib><creatorcontrib>Lagendijk, Jan J.W</creatorcontrib><creatorcontrib>Terhaard, Chris H.J</creatorcontrib><title>The dose to the parotid glands with IMRT for oropharyngeal tumors: the effect of reduction of positioning margins</title><title>Radiotherapy and oncology</title><addtitle>Radiother Oncol</addtitle><description>Purpose: The aim of this paper is to quantify the importance of the reduction of positioning margins applied to the clinical target volume (CTV) on the dose distribution of the parotid gland for different intensity-modulated radiotherapy (IMRT) strategies for the treatment of oropharyngeal cancer.
Methods and materials: CTVs and organs at risk were delineated in the planning computed tomographic (CT) scans of three patients. Margins of 0, 3, 6 and 9
mm were applied to the CTVs in order to obtain the planning target volumes (PTVs). Three IMRT strategies were used to optimize the dose distribution.
Results: The analysis of the three IMRT strategies resulted in: (1) an optimal dose distribution in the PTV; (2) optimal dose distribution in the PTV while sparing the parotid gland and (3) more parotid gland sparing but at expense of the dose homogeneity in the PTV. The mean parotid dose increased linearly with increasing margin by approximately 1.3
Gy per mm. As a result, the normal complication probability (NTCP) for xerostomia decreased when smaller margins were applied. Reducing the margin from 6 to 3
mm resulted in an NTCP reduction of approximately 20%.
Conclusion: Reducing the CTV–PTV margin by improving the patient position accuracy may lead to a significant reduction of NTCP for the IMRT treatment of the oropharyngeal tumors and lymph nodes level II.</description><subject>Head and neck</subject><subject>Humans</subject><subject>Intensity-modulated radiotherapy</subject><subject>Margin</subject><subject>Oropharyngeal Neoplasms - diagnostic imaging</subject><subject>Oropharyngeal Neoplasms - radiotherapy</subject><subject>Oropharynx</subject><subject>Parotid gland</subject><subject>Parotid Gland - diagnostic imaging</subject><subject>Parotid Gland - physiopathology</subject><subject>Parotid Gland - radiation effects</subject><subject>Radiotherapy Dosage</subject><subject>Radiotherapy Planning, Computer-Assisted - methods</subject><subject>Radiotherapy, Conformal - methods</subject><subject>Tomography, X-Ray Computed</subject><subject>Xerostomia - prevention & control</subject><issn>0167-8140</issn><issn>1879-0887</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkE9PGzEQxS1UBCnlI1D5VNHDwtjezW64IBT1DxIIqU3PltceJ0bJerG9rfLt8SZROXKZGVvv-Xl-hFwwuGLApte_c6mLhpVwCfwrAKt4UR6RCWvqWQFNU38gk_-SU_IxxmcA4CDqE3LKOC85EzAhL4sVUuMj0uRpynOvgk_O0OVadSbSfy6t6P3jrwW1PlAffL9SYdstUa1pGjY-xJudDa1Fnai3NKAZdHK-Gw-9j26cXbekGxWWroufyLFV64jnh35G_nz_tpj_LB6eftzP7x4KLWaQClbNoAWsKlEaUNyWzbQUelranKSRMdO2aiqEBrDKMI3CKlSm4arS-a4W4ox82b_bB_8yYExy46LGdd4L_RBlzVnG04zCai_UwccY0Mo-uPzZrWQgR9Zyx1qOICVwuWMty-z7fAgY2g2aN9cBbhbc7gWY1_zrMMioHXYajQsZljTevRPxCoomkA0</recordid><startdate>20020801</startdate><enddate>20020801</enddate><creator>van Asselen, Bram</creator><creator>Dehnad, Homan</creator><creator>Raaijmakers, Cornelis P.J</creator><creator>Roesink, Judith M</creator><creator>Lagendijk, Jan J.W</creator><creator>Terhaard, Chris H.J</creator><general>Elsevier Ireland Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20020801</creationdate><title>The dose to the parotid glands with IMRT for oropharyngeal tumors: the effect of reduction of positioning margins</title><author>van Asselen, Bram ; Dehnad, Homan ; Raaijmakers, Cornelis P.J ; Roesink, Judith M ; Lagendijk, Jan J.W ; Terhaard, Chris H.J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c390t-1590b0e5534d0a2f48643c64feffce11dbba633c00fad1ce3faead82a5cc00733</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Head and neck</topic><topic>Humans</topic><topic>Intensity-modulated radiotherapy</topic><topic>Margin</topic><topic>Oropharyngeal Neoplasms - diagnostic imaging</topic><topic>Oropharyngeal Neoplasms - radiotherapy</topic><topic>Oropharynx</topic><topic>Parotid gland</topic><topic>Parotid Gland - diagnostic imaging</topic><topic>Parotid Gland - physiopathology</topic><topic>Parotid Gland - radiation effects</topic><topic>Radiotherapy Dosage</topic><topic>Radiotherapy Planning, Computer-Assisted - methods</topic><topic>Radiotherapy, Conformal - methods</topic><topic>Tomography, X-Ray Computed</topic><topic>Xerostomia - prevention & control</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>van Asselen, Bram</creatorcontrib><creatorcontrib>Dehnad, Homan</creatorcontrib><creatorcontrib>Raaijmakers, Cornelis P.J</creatorcontrib><creatorcontrib>Roesink, Judith M</creatorcontrib><creatorcontrib>Lagendijk, Jan J.W</creatorcontrib><creatorcontrib>Terhaard, Chris H.J</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Radiotherapy and oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>van Asselen, Bram</au><au>Dehnad, Homan</au><au>Raaijmakers, Cornelis P.J</au><au>Roesink, Judith M</au><au>Lagendijk, Jan J.W</au><au>Terhaard, Chris H.J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The dose to the parotid glands with IMRT for oropharyngeal tumors: the effect of reduction of positioning margins</atitle><jtitle>Radiotherapy and oncology</jtitle><addtitle>Radiother Oncol</addtitle><date>2002-08-01</date><risdate>2002</risdate><volume>64</volume><issue>2</issue><spage>197</spage><epage>204</epage><pages>197-204</pages><issn>0167-8140</issn><eissn>1879-0887</eissn><abstract>Purpose: The aim of this paper is to quantify the importance of the reduction of positioning margins applied to the clinical target volume (CTV) on the dose distribution of the parotid gland for different intensity-modulated radiotherapy (IMRT) strategies for the treatment of oropharyngeal cancer.
Methods and materials: CTVs and organs at risk were delineated in the planning computed tomographic (CT) scans of three patients. Margins of 0, 3, 6 and 9
mm were applied to the CTVs in order to obtain the planning target volumes (PTVs). Three IMRT strategies were used to optimize the dose distribution.
Results: The analysis of the three IMRT strategies resulted in: (1) an optimal dose distribution in the PTV; (2) optimal dose distribution in the PTV while sparing the parotid gland and (3) more parotid gland sparing but at expense of the dose homogeneity in the PTV. The mean parotid dose increased linearly with increasing margin by approximately 1.3
Gy per mm. As a result, the normal complication probability (NTCP) for xerostomia decreased when smaller margins were applied. Reducing the margin from 6 to 3
mm resulted in an NTCP reduction of approximately 20%.
Conclusion: Reducing the CTV–PTV margin by improving the patient position accuracy may lead to a significant reduction of NTCP for the IMRT treatment of the oropharyngeal tumors and lymph nodes level II.</abstract><cop>Ireland</cop><pub>Elsevier Ireland Ltd</pub><pmid>12242130</pmid><doi>10.1016/S0167-8140(02)00152-4</doi><tpages>8</tpages></addata></record> |
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| subjects | Head and neck Humans Intensity-modulated radiotherapy Margin Oropharyngeal Neoplasms - diagnostic imaging Oropharyngeal Neoplasms - radiotherapy Oropharynx Parotid gland Parotid Gland - diagnostic imaging Parotid Gland - physiopathology Parotid Gland - radiation effects Radiotherapy Dosage Radiotherapy Planning, Computer-Assisted - methods Radiotherapy, Conformal - methods Tomography, X-Ray Computed Xerostomia - prevention & control |
| title | The dose to the parotid glands with IMRT for oropharyngeal tumors: the effect of reduction of positioning margins |
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