open access

Vol 24, No 1 (2019)
Original research articles
Published online: 2019-01-01
Submitted: 2017-07-04
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Feasibility of intensity-modulated radiotherapy to treat gastric cancer

Agnieszka Skrobala, Marta Adamczyk, Aldona Karczewska-Dzionk
DOI: 10.1016/j.rpor.2018.10.006
·
Rep Pract Oncol Radiother 2019;24(1):68-73.

open access

Vol 24, No 1 (2019)
Original research articles
Published online: 2019-01-01
Submitted: 2017-07-04

Abstract

Aim

To present a proposed gastric cancer intensity-modulated radiotherapy (IMRT) treatment planning protocol for an institution that have not introduced volumetric modulated arc therapy in clinical practice. A secondary aim was to determine the impact of 2DkV set-up corrections on target coverage and organ at risk (OAR).

Methods and Materials

Twenty consecutive patients were treated with a specially-designed non-coplanar 7-field IMRT technique. The isocenter-shift method was used to estimate the impact of 2DkV-based set-up corrections on the original base plan (BP) coverage. An alternative plan was simulated (SP) by taking into account isocenter shifts. The SP and BP were compared using dose-volume histogram (DVH) plots calculated for the internal target volume (ITV) and OARs.

Results

Both plans delivered a similar mean dose to the ITV (100.32 vs. 100.40%), with no significant differences between the plans in internal target coverage (5.37 vs. 4.96%). Similarly, no significant differences were observed between the maximal dose to the spinal cord (67.70 and 67.09%, respectively) and volume received 50% of the prescribed dose of: the liver (62.11 vs. 59.84%), the right (17.62 vs. 18.58%) and left kidney (29.40 vs. 30.48%). Set-up margins (SM) were computed as 7.80mm, 10.17mm and 6.71mm in the left-right, cranio-caudal and anterior-posterior directions, respectively.

Conclusion

Presented IMRT protocol (OAR dose constraints with selected SM verified by 2DkV verification) for stomach treatment provided optimal dose distribution for the target and the critical organs. Comparison of DVH for the base and the modified plan (which considered set-up uncertainties) showed no significant differences.

Abstract

Aim

To present a proposed gastric cancer intensity-modulated radiotherapy (IMRT) treatment planning protocol for an institution that have not introduced volumetric modulated arc therapy in clinical practice. A secondary aim was to determine the impact of 2DkV set-up corrections on target coverage and organ at risk (OAR).

Methods and Materials

Twenty consecutive patients were treated with a specially-designed non-coplanar 7-field IMRT technique. The isocenter-shift method was used to estimate the impact of 2DkV-based set-up corrections on the original base plan (BP) coverage. An alternative plan was simulated (SP) by taking into account isocenter shifts. The SP and BP were compared using dose-volume histogram (DVH) plots calculated for the internal target volume (ITV) and OARs.

Results

Both plans delivered a similar mean dose to the ITV (100.32 vs. 100.40%), with no significant differences between the plans in internal target coverage (5.37 vs. 4.96%). Similarly, no significant differences were observed between the maximal dose to the spinal cord (67.70 and 67.09%, respectively) and volume received 50% of the prescribed dose of: the liver (62.11 vs. 59.84%), the right (17.62 vs. 18.58%) and left kidney (29.40 vs. 30.48%). Set-up margins (SM) were computed as 7.80mm, 10.17mm and 6.71mm in the left-right, cranio-caudal and anterior-posterior directions, respectively.

Conclusion

Presented IMRT protocol (OAR dose constraints with selected SM verified by 2DkV verification) for stomach treatment provided optimal dose distribution for the target and the critical organs. Comparison of DVH for the base and the modified plan (which considered set-up uncertainties) showed no significant differences.

Get Citation

Keywords

Gastric cancer; IMRT; 2DkV image; Set-up errors; Patient positioning

About this article
Title

Feasibility of intensity-modulated radiotherapy to treat gastric cancer

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 24, No 1 (2019)

Pages

68-73

Published online

2019-01-01

DOI

10.1016/j.rpor.2018.10.006

Bibliographic record

Rep Pract Oncol Radiother 2019;24(1):68-73.

Keywords

Gastric cancer
IMRT
2DkV image
Set-up errors
Patient positioning

Authors

Agnieszka Skrobala
Marta Adamczyk
Aldona Karczewska-Dzionk

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