open access

Vol 70, No 4 (2020)
Research paper (original)
Published online: 2020-07-27
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Overall and GTV subvolumes tumour control probability (TCP) for head and neck cancer treated by 3D-IMRT with inhomogeneous dose distribution

Leszek Hawrylewicz1, Bogusław Maciejewski2, Klaus Rudiger Trott3, Andrzej Tukiendorf4, Leszek Miszczyk2, Magdalena Markowska5
·
Nowotwory. Journal of Oncology 2020;70(4):127-134.
Affiliations
  1. Department RT Planning, M. Skłodowska-Curie National Research Institute of Oncology, Gliwice Branch, Poland
  2. Department Radiotherapy, M. Skłodowska-Curie National Research Institute of Oncology, Gliwice Branch, Poland
  3. Klinik und Poliklinik für Strahlentherapie der Technischen Universität München, Germany
  4. Faculty of Health Sciences, Department of Public Health Medical University, Wroclaw, Poland
  5. Division Research Programmes, M. Skłodowska-Curie National Research Institute of Oncology, Gliwice Branch, Poland

open access

Vol 70, No 4 (2020)
Original article
Published online: 2020-07-27

Abstract

Introduction.  In this study, an original model has been developed to estimate the real TCP that is a product of the TCPs calculated for GTV subvolumes of head and neck cancer based on 3D-IMRT dose planning.

Material and methods.  Retrospective pilot group consist of 16 cases of oropharyngeal cancer in stage T1–2N0 previously treated with 3D-IMRT with at least 3-year follow-up. The total dose (TD) was 60–70 Gy in 2.0 Gy fractions delivered over 42–49 days. Within GTV two subvolumes were marked out: SVA with the planned 100% TD, and underdosed (90–95%) SVB. The TCP for both was calculated using the original formula developed by Withers and Maciejewski.

Results.  During 3-year follow-up, 8 local recurrences (LR) occurred. In about 70% of SVB “dose cold spots” encompassed more than 50% GTV volume. This resulted in the TCPSVB decrease to 60%. Thus, the real overall TCP was much lower than a priori predicted, and in these cases local recurrences occurred.

Discussion.Both cold spot SVB volumes and their dose deficit strongly correlated with a high risk of LR.

Conclusions.In conclusion the magnitude of dose deficit and the size of cold subvolume within GTV have an indepen­dent negative impact on real TCP and demand dose re-planning.

Abstract

Introduction.  In this study, an original model has been developed to estimate the real TCP that is a product of the TCPs calculated for GTV subvolumes of head and neck cancer based on 3D-IMRT dose planning.

Material and methods.  Retrospective pilot group consist of 16 cases of oropharyngeal cancer in stage T1–2N0 previously treated with 3D-IMRT with at least 3-year follow-up. The total dose (TD) was 60–70 Gy in 2.0 Gy fractions delivered over 42–49 days. Within GTV two subvolumes were marked out: SVA with the planned 100% TD, and underdosed (90–95%) SVB. The TCP for both was calculated using the original formula developed by Withers and Maciejewski.

Results.  During 3-year follow-up, 8 local recurrences (LR) occurred. In about 70% of SVB “dose cold spots” encompassed more than 50% GTV volume. This resulted in the TCPSVB decrease to 60%. Thus, the real overall TCP was much lower than a priori predicted, and in these cases local recurrences occurred.

Discussion.Both cold spot SVB volumes and their dose deficit strongly correlated with a high risk of LR.

Conclusions.In conclusion the magnitude of dose deficit and the size of cold subvolume within GTV have an indepen­dent negative impact on real TCP and demand dose re-planning.

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Keywords

3D-IMRT planning; cold spots within GTV; estimates of partial TCPs within GTV subvolumes

About this article
Title

Overall and GTV subvolumes tumour control probability (TCP) for head and neck cancer treated by 3D-IMRT with inhomogeneous dose distribution

Journal

Nowotwory. Journal of Oncology

Issue

Vol 70, No 4 (2020)

Article type

Research paper (original)

Pages

127-134

Published online

2020-07-27

Page views

454

Article views/downloads

563

DOI

10.5603/NJO.2020.0027

Bibliographic record

Nowotwory. Journal of Oncology 2020;70(4):127-134.

Keywords

3D-IMRT planning
cold spots within GTV
estimates of partial TCPs within GTV subvolumes

Authors

Leszek Hawrylewicz
Bogusław Maciejewski
Klaus Rudiger Trott
Andrzej Tukiendorf
Leszek Miszczyk
Magdalena Markowska

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