Dosimetric Comparison of Radiotherapy Techniques for Treating Early-stage Glottic Larynx Cancer
Journal Title: Journal of Academic Research in Medicine - Year 2020, Vol 10, Issue 1
Abstract
Objective: As early-stage larynx carcinoma is considered curable, we have investigated the possible differences among treatments with the contribution of advanced technology for maximum prevention of the development of secondary malignancies, and for the long-term quality of life. We compared the doses to the organs at risk, the Conformity indexes (CI), and the total monitor units of patients with early-stage glottic laryngeal cancer with the patients’ physical planning for 3-dimensional conformal radiotherapy (3DCRT), intensity-modulated radiotherapy (IMRT), and volumetric modulated arc radiotherapy (VMAT) using the Eclipse treatment planning system. Methods: Radiotherapy planning tomography sections of patients with early-stage (T1N0M0) glottic larynx cancer who underwent only radiotherapy were used. The sections were used for target volume and critical organ descriptions. Plans for 3DCRT, VMAT, 5-field IMRT, and 7-field IMRT were made and were compared after the procedures. The patients did not receive elective nodal irradiation. A total of 63 Gy in 28 fractions was described for all patients for the planning target volume (PTV). Results: There was no difference between the mean PTV dose for VMAT and 5-field and 7-field IMRT. VMAT had the best results for the heterogeneity index and CI; 7-field IMRT had the best results for the mean dose and carotid artery volume receiving (V35 Gy) values. Although very low doses were detected for the medulla spinalis for 3DCRT, the doses of the other three plans were acceptable. Conclusion: Due to the higher conformality and better protection of the critical organs, VMAT or IMRT is more appropriate rather than 3DCRT in RT treatment of early-stage glottic larynx cancer. The use of 7-field IMRT yields positive results, particularly for the carotid arteries.
Authors and Affiliations
Tanju Berber , Birhan Demirhan
Keywords
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