open access

Vol 21, No 3 (2016)
Original research articles
Published online: 2016-05-01
Submitted: 2014-07-24
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Can we obtain planning goals for conformal techniques in neoadjuvant and adjuvant radiochemotherapy for gastric cancer patients?

Wojciech Leszczyński, Paweł Polanowski, Paulina Leszczyńska, Leszek Hawrylewicz, Iwona Brąclik, Rafał Kawczyński, Jerzy Wydmański
DOI: 10.1016/j.rpor.2015.11.008
·
Rep Pract Oncol Radiother 2016;21(3):149-155.

open access

Vol 21, No 3 (2016)
Original research articles
Published online: 2016-05-01
Submitted: 2014-07-24

Abstract

Aim

The purpose of this study was to compare conformal radiotherapy techniques used in the treatment of gastric cancer patients. The study is dedicated to radiotherapy centres that have not introduced dynamic techniques in clinical practice.

Background

The implementation of multi-field technique can minimise the toxicity of treatment and improve dose distribution homogeneity in the target volume with simultaneous protection of organs at risk (OaRs). Treatment plan should be personalised for each patient by taking into account the planning target volume and anatomical conditions of the individual patient.

Materials and methods

For each patient, four different three dimensional conformal plans were compared: 2-field plan, 3-field plan, non-coplanar 3-field plan and non-coplanar 4-field plan. Dose distributions in a volume of 107% of the reference dose, and OaRs such as the liver, kidneys, intestines, spinal cord, and heart were analysed.

Results

The mean volume of the patient body covered using the isodose of 107% was 3004.73[[ce:hsp sp="0.25"/]]cm3, 1454.28[[ce:hsp sp="0.25"/]]cm3, 1426.62[[ce:hsp sp="0.25"/]]cm3, 889.14[[ce:hsp sp="0.25"/]]cm3 for the 2-field, 3-field, non-coplanar 3-field and non-coplanar 4-field techniques, respectively. For all plans the minimum dose in the PTV volume was at least 95% of the reference dose. The QUANTEC protocol was used to investigate doses in OaRs.

Conclusions

Comparison of 3D conformal radiotherapy techniques in gastric cancer patients indicates that none of the plans can fulfil simultaneously all of the criteria of the tolerance dose in the organs at risk. The implementation of the multi-field technique can minimise the toxicity of treatment and improve dose distribution homogeneity in the target volume with additional protection of organs at risk (OaRs).

Abstract

Aim

The purpose of this study was to compare conformal radiotherapy techniques used in the treatment of gastric cancer patients. The study is dedicated to radiotherapy centres that have not introduced dynamic techniques in clinical practice.

Background

The implementation of multi-field technique can minimise the toxicity of treatment and improve dose distribution homogeneity in the target volume with simultaneous protection of organs at risk (OaRs). Treatment plan should be personalised for each patient by taking into account the planning target volume and anatomical conditions of the individual patient.

Materials and methods

For each patient, four different three dimensional conformal plans were compared: 2-field plan, 3-field plan, non-coplanar 3-field plan and non-coplanar 4-field plan. Dose distributions in a volume of 107% of the reference dose, and OaRs such as the liver, kidneys, intestines, spinal cord, and heart were analysed.

Results

The mean volume of the patient body covered using the isodose of 107% was 3004.73[[ce:hsp sp="0.25"/]]cm3, 1454.28[[ce:hsp sp="0.25"/]]cm3, 1426.62[[ce:hsp sp="0.25"/]]cm3, 889.14[[ce:hsp sp="0.25"/]]cm3 for the 2-field, 3-field, non-coplanar 3-field and non-coplanar 4-field techniques, respectively. For all plans the minimum dose in the PTV volume was at least 95% of the reference dose. The QUANTEC protocol was used to investigate doses in OaRs.

Conclusions

Comparison of 3D conformal radiotherapy techniques in gastric cancer patients indicates that none of the plans can fulfil simultaneously all of the criteria of the tolerance dose in the organs at risk. The implementation of the multi-field technique can minimise the toxicity of treatment and improve dose distribution homogeneity in the target volume with additional protection of organs at risk (OaRs).

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Keywords

Treatment plan comparison; Gastric cancer; Conformal radiotherapy

About this article
Title

Can we obtain planning goals for conformal techniques in neoadjuvant and adjuvant radiochemotherapy for gastric cancer patients?

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 21, No 3 (2016)

Pages

149-155

Published online

2016-05-01

DOI

10.1016/j.rpor.2015.11.008

Bibliographic record

Rep Pract Oncol Radiother 2016;21(3):149-155.

Keywords

Treatment plan comparison
Gastric cancer
Conformal radiotherapy

Authors

Wojciech Leszczyński
Paweł Polanowski
Paulina Leszczyńska
Leszek Hawrylewicz
Iwona Brąclik
Rafał Kawczyński
Jerzy Wydmański

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