Unilateral and bilateral neck SIB for head and neck cancer patients: Intensity-modulated proton therapy, tomotherapy, and RapidArc [Unilateraler und bilateraler zervikaler SIB für Patienten mit Kopf-Hals-Tumoren: Intensitätsmodulierte Protonentherapie, Tomotherapie und RapidArc]
Stromberger C.,ChariteUniversitatsmedizin Berlin |
Cozzi L.,Humanitas Cancer Center Milan |
Budach V.,ChariteUniversitatsmedizin Berlin |
Fogliata A.,Humanitas Cancer Center Milan |
And 6 more authors.
Strahlentherapie und Onkologie | Year: 2016
Aim: To compare simultaneous integrated boost plans for intensity-modulated proton therapy (IMPT), helical tomotherapy (HT), and RapidArc therapy (RA) for patients with head and neck cancer. Patients and methods: A total of 20 patients with squamous cell carcinoma of the head and neck received definitive chemoradiation with bilateral (n = 14) or unilateral (n = 6) neck irradiation and were planned using IMPT, HT, and RA with 54.4, 60.8, and 70.4 GyE/Gy in 32 fractions. Dose distributions, coverage, conformity, homogeneity to planning target volumes (PTV)s and sparing of organs at risk and normal tissue were compared. Results: All unilateral and bilateral plans showed excellent PTV coverage and acceptable dose conformity. For unilateral treatment, IMPT delivered substantially lower mean doses to contralateral salivary glands (< 0.001–1.1 Gy) than both rotational techniques did (parotid gland: 6–10 Gy; submandibular gland: 15–20 Gy). Regarding the sparing of classical organs at risk for bilateral treatment, IMPT and HT were similarly excellent and RA was satisfactory. Conclusion: For unilateral neck irradiation, IMPT may minimize the dry mouth risk in this subgroup but showed no advantage over HT for bilateral neck treatment regarding classical organ–at-risk sparing. All methods satisfied modern standards regarding toxicity and excellent target coverage for unilateral and bilateral treatment of head and neck cancer at the planning level. © 2016, Springer-Verlag Berlin Heidelberg. Source