1
|
Revolutionizing cancer treatment in India: Evaluating the unmet need, economics, and a roadmap for project implementation of particle therapy. Cancer 2024. [PMID: 38373062 DOI: 10.1002/cncr.35233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 01/01/2024] [Accepted: 01/17/2024] [Indexed: 02/21/2024]
Abstract
INTRODUCTION This study aims to quantitatively assess eligible patients and project the demand for particle therapy facilities in India from 2020 to 2040. In addition, an economic analysis evaluates the financial feasibility of implementing this technology. The study also examines the prospective benefits and challenges of adopting this technology in India. METHODOLOGY Cancer incidence and projected trends were analyzed for pediatric patients using the Global Childhood Cancer microsimulation model and adult patients using the Globocan data. Economic cost evaluation is performed for large-scale combined particle (carbon and proton-three room fixed-beam), large-scale proton (one gantry and two fixed-beam), and small-scale proton (one gantry) facility. RESULTS By 2040, the estimated number of eligible patients for particle therapy is projected to reach 161,000, including approximately 14,000 pediatric cases. The demand for particle therapy facilities is projected to rise from 81 to 97 in 2020 to 121 to 146 by 2040. The capital expenditure is estimated to be only 3.7 times that of a standard photon linear accelerator over a 30-year period. Notably, the treatment cost can be reduced to USD 400 to 800 per fraction, substantially lower than that in high-income countries (USD 1000 to 3000 per fraction). CONCLUSION This study indicates that, in the Indian scenario, all particle therapy models are cost-beneficial and feasible, with large-scale proton therapy being the most suitable. Despite challenges such as limited resources, space, a skilled workforce, referral systems, and patient affordability, it offers substantial benefits. These include the potential to treat many patients and convenient construction and operational costs. An iterative phased implementation strategy can effectively overcome these challenges, paving the way for the successful adoption of particle therapy in India. PLAIN LANGUAGE SUMMARY In India, eligible patients benefiting from high-precision particle therapy technology projected to rise till 2040. Despite high upfront costs, our study finds the long-term feasibility of all particle therapy models, potentially offering a substantial reduction in treatment cost compared to high-income countries. Despite challenges, India can succeed with an iterative phased approach.
Collapse
|
2
|
PO-1561 Low Dose Radiation Therapy for COVID-19 Pneumonia: Risk of Cancer with AP-PA fields and IMRT. Radiother Oncol 2022. [PMCID: PMC9153900 DOI: 10.1016/s0167-8140(22)03525-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
|
3
|
Dosimetric impact of dwell time deviation constraint on inverse brachytherapy treatment planning and comparison with conventional optimization method for interstitial brachytherapy implants. J Cancer Res Ther 2021; 17:463-470. [PMID: 34121693 DOI: 10.4103/jcrt.jcrt_749_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Purpose High-dose rate remote afterloading brachytherapy machine and advanced treatment planning system help in getting optimum dose to tumor and low dose to normal structures. Inverse planning simulated annealing (IPSA) optimization technique has a unique feature of dwell time deviation constraint (DTDC). In this study, six IPSA-based plans having different DTDC values with routinely practiced geometric plus graphical optimization (GO + GrO) have been compared using various dosimetric parameters. Materials and Methods For this retrospective study, we have generated IPSA-optimized interstitial brachytherapy plans for ten cancer cervix patients. Routinely practiced GO + GrO-based plans were compared with six different IPSA plans having varying DTDC values from 0.0 to 1.0 using different dosimetric indices. Results Conformity index and homogeneity index (HI) were higher in GO + GrO plans, compared to IPSA-optimized plans. However, HI of IPSA plans was increasing with increasing DTDC values. High-dose volumes were well controllable using DTDC parameter in IPSA-optimized plans. Dose to the rectum and bladder was smaller for IPSA-optimized plans than GO + GrO plans. Conclusions One of the benefits of applying DTDC in IPSA-optimized plan is that it reduces high-dose volumes. Another advantage is the reduction in rectum and bladder dose.
Collapse
|
4
|
Study of the effects of dwell time deviation constraints on inverse planning simulated annealing optimized plans of intracavitary brachytherapy of cancer cervix. J Cancer Res Ther 2020; 15:1370-1376. [PMID: 31898675 DOI: 10.4103/jcrt.jcrt_246_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Purpose High Dose Rate (HDR) remote afterloading brachytherapy machine and advanced treatment planning system have made it possible to make variations in individual dwell times across a catheter according to tumour density and for sparing normal structures. New inverse planning technique such as Inverse Planning Simulated Annealing (IPSA) has also been introduced. But very few institutions are venturing towards volume based IPSA optimised intracavitary brachytherapy. This study focuses on dwell time deviation constraint (DTDC) feature of IPSA based optimization which restricts the large variation of dwell time across the catheter. Methods and Material For this retrospective study we have generated IPSA optimised intracavitary brachytherapy plans for 20 cancer cervix applications. The initial DTDC value of each IPSA plan was kept 0.0. Later on gradual increment was made in DTDC values in step of 0.2. Plan modulation index (M) defined by Ryan L. Smith et al was used for characterising the variation of dwell time modulation with respect to gradual increase in DTDC parameter. Results Plan modulation index gradually decreases with increasing value of DTDC from 0.0 to 1.0. There was the 83% decrease in M value from IPSA of DTDC 0.0 to fully constrained IPSA of DTDC1.0. There is reduction of 8.26% and 6.95% for D2cc values of rectum and bladder respectively for DTDC 1.0 compared to DTDC 0.0. Conclusions One of the benefits of applying DTDC constrained in IPSA plan is that, it removes local hot spots. It's another advantage is the reduction in rectum and bladder dose.
Collapse
|
5
|
|
6
|
EP-1498: IMRT and VMAT commissioning for Versa HD linear accelerator using AAPM TG-119. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31933-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
7
|
PO-0831: Multi isocentric 4-pi volumetric modulated arc therapy approach for head and neck cancer. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31268-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
8
|
SU-F-P-46: Comparative Study Between Two Normalization Prescriptions for Accelerated Partial Breast Irradiation: A Dosimetric Study. Med Phys 2016. [DOI: 10.1118/1.4955753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
9
|
Evaluation and Correlation of Vaginal Dose and Toxicity Following Magnetic Resonance Image Guided Brachytherapy in Cervical Cancer. Brachytherapy 2016. [DOI: 10.1016/j.brachy.2016.04.181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
10
|
Cost Comparison of Pulsed-Dose-Rate versus High-Dose-Rate Intracavitary Brachytherapy for Cervical Carcinoma: A Mono-Institutional Economic Analysis. Brachytherapy 2016. [DOI: 10.1016/j.brachy.2016.04.384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
11
|
SU-E-T-319: Dosimetric Evaluation of IMRT with Mix-Energy Beam for Deep Seated Targets. Med Phys 2015. [DOI: 10.1118/1.4924680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
12
|
SU-E-T-492: Influence of Clipping PTV in Build-Up Region On IMRT Plan Quality and Deliverability. Med Phys 2015. [DOI: 10.1118/1.4924854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
13
|
Real-Time Gall Bladder Motion and Deformation During Fractionated Stereotactic Body Radiation Therapy. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.2638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
14
|
SU-E-T-199: How Number of Control Points Influences the Dynamic IMRT Plan Quality and Deliverability. Med Phys 2014. [DOI: 10.1118/1.4888529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
15
|
SU-E-T-636: Impact of Different Intensity Levels On Step and Shoot IMRT Plan Quality and Deliverability. Med Phys 2013. [DOI: 10.1118/1.4815064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
16
|
SU-E-T-423: Effect of X-Ray Source Spot Size Modeling in AcurosXB Dose Calculation Algorithm On VMAT Based SBRT Treatments. Med Phys 2013. [DOI: 10.1118/1.4814857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
17
|
SU-E-T-638: Influence of Dose Rate On Step and Shoot IMRT Plan Quality and Deliverability. Med Phys 2013. [DOI: 10.1118/1.4815066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
18
|
Indigenously developed multipurpose acrylic head phantom for verification of IMRT using film and gel dosimetry. J Appl Clin Med Phys 2013; 14:4041. [PMID: 23470932 PMCID: PMC5714371 DOI: 10.1120/jacmp.v14i2.4041] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2012] [Revised: 09/19/2012] [Accepted: 10/16/2012] [Indexed: 11/23/2022] Open
Abstract
The purpose of this study was to validate the newly designed acrylic phantom for routine dosimetric purpose in radiotherapy. The phantom can be used to evaluate and compare the calculated dose and measured dose using film and gel dosimetric methods. In this study, a doughnut-shaped planning target volume (8.54 cm3) and inner organ at risk (0.353 cm3) were delineated for an IMRT test plan using the X-ray CT image of the phantom. The phantom consists of acrylic slabs which are integrated to form a human head with a hole in the middle where several dosimetric inserts can be positioned for measurement. An inverse planning with nine coplanar intensity-modulated fields was created using Pinnacle TPS. For the film analysis, EBT2 film, flatbed scanner, in-house developed MATLAB codes and ImageJ software were used. The 3D dose distribution recorded in the MAGAT gel dosimeter was read using a 1.5 T MRI scanner. Scanning parameters were CPMG pulse sequence with 8 equidistant echoes, TR = 5600, echo step = 22 ms, pixel size = 0.5 × 0.5, slice thickness = 2 mm. Using a calibration relationship between absorbed dose and spin-spin relaxation rate (R2), R2 images were converted to dose images. The dose comparison was accomplished using in-house MATLAB-based graphical user interface named "IMRT3DCMP". For gel measurement dose grid from the TPS was extracted and compared with the measured dose grid of the gel. Gamma index analysis of film measurement for the tolerance criteria of 2%/2mm, 1%/1 mm showed more than 90% voxels pass rate. Gamma index analysis of 3D gel measurement data showed more than 90% voxels pass rate for different tolerance criteria of 2%/2 mm and 1%/1 mm. Overall both 2D and 3D measurement were in close agreement with the Pinnacle TPS calculated dose. The phantom designed is cost-effective and the results are promising, but further investigation is required to validate the phantom with other 3D conformal techniques for dosimetric purpose.
Collapse
|
19
|
EP-1207: Influence of dose rate on dynamic IMRT plan quality and deliverability. Radiother Oncol 2013. [DOI: 10.1016/s0167-8140(15)33513-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
20
|
PD-0597: Is 5mm Millennium MLC adequate for VMAT based SBRT?- A comparative study with 2.5mm high definition MLC. Radiother Oncol 2013. [DOI: 10.1016/s0167-8140(15)32903-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
21
|
EP-1152: Dosimetric verification of small field IMRT at extended SSDs Using two-dimensional arrays. Radiother Oncol 2013. [DOI: 10.1016/s0167-8140(15)33458-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
22
|
PO-0787: Clinical validation of Gated RapidArc using aS1000 Electronic Portal Imaging Device. Radiother Oncol 2013. [DOI: 10.1016/s0167-8140(15)33093-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
23
|
PO-0801: Grid size based dosimetric comparison of dose calculation algorithms for brain cases using VMAT technology. Radiother Oncol 2013. [DOI: 10.1016/s0167-8140(15)33107-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
24
|
Early Clinical Outcomes of Intensity Modulated Versus Conventional Pelvic Radiation Therapy for Locally Advanced Carcinoma Cervix: A Prospective Randomized Study. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.050] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
25
|
Image Guided Radiation Therapy in Head-and-Neck Cancer: Static Dose Versus Dynamic Volumes -- The Need for Adaptive Innovation. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.1278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
26
|
Acute Gastrointestinal and Genitourinary Toxicities in Locally Advanced Carcinoma Cervix Treated With Intensity Modulated Versus Conventional Pelvic Radiation Therapy: Results From a Prospective Randomized Study. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.1153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
27
|
SU-E-T-597: Influence of Smoothing Parameters on Dynamic IMRT Plan Quality and Deliverability. Med Phys 2012; 39:3843. [DOI: 10.1118/1.4735686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
28
|
SU-E-T-268: Evaluation of Photoneutron Contamination in Elekta Synergy-S High-Energy Linear Accelerator and Indigenous Novel Solution: The AIIMS Experience. Med Phys 2012; 39:3765. [PMID: 28517258 DOI: 10.1118/1.4735335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE The photoneutron contamination problem was encountered due to laminated barrier wall and short maze. The purpose of this study was to report our experience in evaluating the photoneutron contamination during radiation safety survey and solution. METHODS The photoneutron contamination measurement was carried out in Elekta Synergy-S high-energylinear accelerator for 15MV beam. A NE Neutron survey meter and for photon, Victoreen and RADOS survey meters were used. The laminated barrier wall composed of 37cm steel with 30cm concrete both side and short maze length of 5 meter. During safety survey, higher photoneutron levels for 15MV X-rays at treatment room door found. The effect of photoneutron contamination as function of neutron shielding materials of wood, polyethylene and boron and thickness, distance, locations and directions to the control console at distance upto 7 meter were investigated for 4 gantry angles at locations of treatment room entry doors namely door1(A), door2(B), console(C), conduit (D) and above-ceiling(G) for 15MV. RESULTS The initial safety survey showed that neutron level of 47mR/h and photon leakage of 3.2mR/hr at the treatment entry room door1. The neutron values could bring down to the level of acceptance at the treatment entry door2, but the photon values are not acceptable. Therefore, 30cm concrete wall block was made at the location of door2 and another bend was taken. Finally, treatment entrance room door was made using 3cm polyethylene neutron shielding materials in order to achieve the both neutron contamination and photon leakage within the acceptable levels. CONCLUSIONS The neutron sliding-door is operated manually in finger-push by technologist for day-to-day usage. This simple solution is cost effective and increases the patient throughput. This study underlines that one needs to take appropriate safety measures prior to facility design whenever the space constraints situations arises for high energy linear accelerator.
Collapse
|
29
|
SU-E-T-587: Whole IMRT, Hybrid IMRT and 3D Conformal Plan a Dosimetric Comparison for Large Target. Med Phys 2012; 39:3840-3841. [PMID: 28517101 DOI: 10.1118/1.4735676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To dosimetrically compare the whole-IMRT, hybrid-IMRT (combination of IMRT and 3D-CRT) and 3D-conformal radiotherapy (3D- CRT) plans for larger targets. METHODS Five previously treated patients of carcinoma cervix with para-aortic lymph-nodes (target length 33-34cm) were selected. PTV-P (PTV-Primary), PTV-PA (PTV-para-aortic) and organ at risks (OARs) were defined. Three plans were generated using Eclipse TPS for Varian CL2300C/D linear accelerator using 6MV photon beam. Three plans were: (i) Whole-IMRT: IMRT for both PTV-P and PTV-PA (ii) Hybrid-IMRT: IMRT for PTV-P and 3D-CRT for PTV-PA (iii) 3D-CRT: 3D-CRT for both PTV-P and PTV-PA. Prescription dose for PTV-P is 50.4Gy and PTV-PA is 45Gy in 28 fractions. Coverage index (CI=Target volume covered by prescription dose/Target volume), mean doses to bladder, rectum and bowel were used for plan comparison by using DVH. Integral dose (liter-Gray) to normal tissue (i.e., patient volume minus PTV-P and PTV-PA) and total monitor units (MUs) required to deliver a plan was also noted. RESULTS The CI for PTV-P is 0.98±0.20, 0.96±0.09, and 0.95±0.01 for Whole-IMRT, Hybrid-IMRT and 3D-CRT plan and for PTV- PA is 0.98±0.01, 0.98±0.01, and 0.97±0.20. Maximum doses to PTV-P are 5660.85±90.85cGy, 5640.35±70.35cGy and 5813.80±97.40cGy. Maximum doses to PTV-PA are 5000.60±109.10cGy, 5079.85±20.25cGy and 5092.25±19.75cGy. Mean doses to the bladder are 3810±225.80cGy, 3842.10±182.70cGy and 5204±98.25cGy for Whole-IMRT, Hybrid-IMRT and 3D-CRT plan, respectively. Mean doses to rectum are 3955.35±324.95cGy, 3971.15±354.15cGy and 4741.20±371.60cGy. Mean doses to bowel are 2623.35±320.85cGy, 2855.30±371.05cGy and 3011.7±433.80cGy. Average MUs required to deliver one fraction is 1285±87, 1585±186, 485±46 for Whole-IMRT, Hybrid-IMRT and 3D-CRT plans, respectively. Higher integral doses to normal tissue were observed for whole-IMRT (267.60±76 liter-Gy) followed by hybrid-IMRT (259.20±53 liter-Gy) and 3D-CRT (186.30±33 liter-Gy). CONCLUSIONS Whole-IMRT is useful for larger targets compared to hybrid-IMRT in terms of dose conformity, lesser MUs and reduced critical organ doses with little compromise on integral dose, where 3D-CRT sacrificed the OAR sparing.
Collapse
|
30
|
PO-0730 IMAGE GUIDED ADAPTIVE RADIOTHERAPY (IGART) OF HEAD AND NECK CANCER: VOLUMETRIC AND CLINICAL EVIDENCE. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)71063-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
31
|
PO-338 VAGINAL CUFF BRACHYTHERAPY USING OVOIDS: COMPARISON OF POINT BASED AND TARGET BASED PRESCRIPTION. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)72304-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
32
|
Static versus dynamic intensity-modulated radiotherapy: Profile of integral dose in carcinoma of the nasopharynx. J Med Phys 2011; 34:66-72. [PMID: 20098539 PMCID: PMC2805892 DOI: 10.4103/0971-6203.51932] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2008] [Revised: 02/02/2009] [Accepted: 04/25/2009] [Indexed: 01/18/2023] Open
Abstract
This study is aimed to evaluate the impact of static and dynamic intensity modulated radiotherapy (IMRT) delivery techniques planned with Eclipse TPS on the integral dose to the healthy normal tissue surrounding the tumor-bearing area and to the volume receiving doses < 5 Gy in patients with carcinoma nasopharynx treated with Simultaneous Integrated Boost IMRT (SIB-IMRT). Ten patients with carcinoma nasopharynx were chosen for this dosimetric study. IMRT plans were generated with 6X using dynamic multileaf collimator (DMLC) and static multileaf collimator (SMLC) with 5, 10 and 15 intensity levels (L). Integral dose, volume receiving 5 Gy, number of monitor units (MU) is compared against DMLC. The mean difference in the MU delivered per fraction between 5, 10 and 15 L SMLC and DMLC was -13.25% (P < 0.001, with paired t test), -11.82% (P < 0.001) and -10.81% (P < 0.001), respectively. The mean difference in the integral dose with 5, 10 and 15 L compared to DMLC was -2.96% (P < 0.001), -2.67% (P = 0.016) and -0.39% (P = 0.430), respectively. However, the difference in low-dose volume (V5Gy) was statistically insignificant with mean difference of 0.60% (P = 0.23), 1.18% (P = 0.017) and 1.70% (P = 0.078), respectively for 5, 10 and 15 L compared to DMLC. Our results show that while choosing the IMRT delivery technique using conventional MLC the concerns about integral dose and volume receiving very low doses such as 5 Gy can be ignored.
Collapse
|
33
|
SU-E-T-610: Investigation on Four-Dimensional Computed Tomography Imaging for Stereotactic Body Radiotherapy: The Patient and Programmable Respiratory Motion Phantom Study. Med Phys 2011. [DOI: 10.1118/1.3612573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
34
|
SU-E-T-749: Effect of Different Optimization Techniques on Interstitial Breast Brachytherapy. Med Phys 2011. [DOI: 10.1118/1.3612713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
35
|
SU-E-T-167: IMRT Pre-Treatment Verification in the Build-Up Region: Comparison of IˈmatriXX and EDR-2 Film. Med Phys 2011. [DOI: 10.1118/1.3612117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
36
|
SU-E-T-562: MAGAT Gel and EBT2 Film Based Dosimetry for Evaluating Source Plugging Based Treatment Plan in Gamma Knife Stereotactic Radiosurgery. Med Phys 2011. [DOI: 10.1118/1.3612524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
37
|
SU-E-T-198: Evaluation of Dosimetric Characteristics of MOSFET Dosimeter for the Quality Assurance of Photon and Electron Beams. Med Phys 2011. [DOI: 10.1118/1.3612148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
38
|
SU-E-T-481: Dosimetric Verification of Large IMRT Fields at Shorter SSDs Using Two-dimensional Arrays - a Comparison to EDR-2 Films. Med Phys 2011. [DOI: 10.1118/1.3612434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
39
|
How Collimator Rotation Influence IMRT Dose Distribution and Dose Delivery: Assessment in Case of Carcinoma Parotid. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.1776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
40
|
Volumetric Modulated Arc Therapy vs. Conventional Stereotactic Radiotherapy Techniques for Benign Intracranial Tumors. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.1813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
41
|
High Dose Rate Interstitial Brachytherapy using Two Weekly Sessions of 10 Gy Each for Patients with Locally Advanced Cervical Carcinoma. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
42
|
SU-GG-T-310: Dose Perturbation Caused by MOSFET Dosimeter during in Vivo Dosimetry of Photon and Electron Beam Radiotherapy - a Film Dosimetry Study. Med Phys 2010. [DOI: 10.1118/1.3468706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
43
|
74 poster: PET Scan Guided Interstitial Brachytherapy in Cervical Cancer Patients with Clinically Suspected Residual Disease. Radiother Oncol 2010. [DOI: 10.1016/s0167-8140(15)34493-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
44
|
Does Patient Positioning Affect Radiotherapy Dose Distribution in Target Volumes and Organs at Risk: Assessment in Parotid Tumor. Int J Radiat Oncol Biol Phys 2009. [DOI: 10.1016/j.ijrobp.2009.07.1373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
45
|
Abstract
PURPOSE Field matching poses challenges in craniospinal irradiation (CSI) as it leads either to underdosage or overdosage in the junctional area. A simple technique for CSI in pediatric patients is proposed. MATERIALS AND METHODS Computed tomography scans were performed in the prone position. Two lateral cranial fields and a direct posterior spinal field were planned with a common central axis. Half-beam-blocked cranial fields with zero collimator rotation were used for treating the cranium. A half-beam-blocked field defined with jaws was used to treat the spinal column at an extended source-to-surface distance. Before treating the patient, matching of the cranial and spinal field junction along the central axis was verified with an extended dose range film. RESULTS AND CONCLUSION The technique described is simple and easy to implement and can be applied to pediatric patients undergoing CSI. This method has the potential to reduce daily setup time and setup errors. This technique is ideally suitable for patients with spinal fields less than 30 cm.
Collapse
|
46
|
SU-FF-T-515: NCTP Of Bladder And Rectum : Does Simultaneous Integrated Boost IMRT Score Over Other Techniques. Med Phys 2009. [DOI: 10.1118/1.3182013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
47
|
Interstitial brachytherapy guided intensity modulated radiation therapy (IBGIMRT) in cervical cancer: a dosimetric study. J Contemp Brachytherapy 2009; 1:87-91. [PMID: 27795717 PMCID: PMC5075993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2009] [Accepted: 06/29/2009] [Indexed: 11/10/2022] Open
Abstract
PURPOSE Interstitial brachytherapy (IBT) is used as an alternative to intracavitary radiotherapy in the management of cervical carcinoma. We have devised a new technique called interstitial brachytherapy guided intensity modulated radiotherapy (IBGIMRT) which can potentially reduce doses to organs at risk (OaRs). It utilizes IMRT planning on the target volume (TV) defined by implantation of IBT needles. This study compares the dosimetry of IBT and IBGIMRT. MATERIAL AND METHODS CT scan images of 18 patients with cervical cancer, who have been already treated by HDR-BT, were used to generate two rival plans, IBT and IBGIMRT, for a prescription dose of 10 Gy. Following dosimetric factors were used for comparison: volume receiving 95% of prescription dose (V95), conformity index (COIN) and external volume index (EI) for target and for OaR, dose received by volume of 1 cm3 (D1cc), 2 cm3 (D2cc), 5 cm3 (D5cc) and also volume receiving 50% and 75% of prescription dose (V50 and V75). RESULTS The two plans resulted in COIN difference of 49.8% (p < 0.0001) and EI difference of 36.4% (p < 0.0028) in favor of IBGIMRT. Mean D1cc, D2cc and D5cc values for bladder were 8.3 Gy, 7.6 Gy and 6.4 Gy; and 7.8 Gy, 7.3 Gy and 5.8 Gy with IBT and IBGIMRT, respectively (p > 0.05). Similar figures for rectum with IBT vs. IBGIMRT were 11.2 Gy vs. 7.02 Gy, 10.5 Gy vs. 6.4 Gy and 9.1 Gy vs. 4.8 Gy respectively (p < 0.01). CONCLUSIONS Our novel technique, IBGIMRT, has shown its dosimetric superiority and therefore needs to be studied in clinical set up.
Collapse
|
48
|
SU-FF-T-537: MRI-Based Polymer Gel Dosimetry for Validating Plans with Multiple Matrices in Gamma Knife Stereotactic Radiosurgery. Med Phys 2009. [DOI: 10.1118/1.3182035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
49
|
Normal tissue complication probability: Does simultaneous integrated boost intensity-modulated radiotherapy score over other techniques in treatment of prostate adenocarcinoma. J Cancer Res Ther 2009; 5:78-84. [DOI: 10.4103/0973-1482.52789] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
50
|
Normal tissue complication probability of fibrosis in radiotherapy of breast cancer: accelerated partial breast irradiation vs conventional external-beam radiotherapy. J Cancer Res Ther 2008; 4:126-30. [PMID: 18923205 DOI: 10.4103/0973-1482.43143] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIMS Radiotherapy forms an integral part of breast-conserving treatment in early-stage breast cancer. Subcutaneous fibrosis of the treated breast is an important late effect in whole-breast irradiation. The aim of this study was to compare the normal tissue complication probability (NTCP) for radiation-induced fibrosis in treated breast using accelerated partial-breast irradiation (APBI) vs conventional treatment. MATERIALS AND METHODS Ten postoperative early-stage breast cancer patients (T1N0M0) were included in this dosimetric analysis. APBI treatment was planned using conformal radiotherapy technique and conventional treatment plans included two tangential portals. All the APBI treatment plans were made with five non-coplanar beams with 6 MV photons. The prescription dose was 38 Gy in 10 fractions for the APBI treatments and 50 Gy in 25 fractions, followed by a boost dose of 16 Gy in 8 fractions, for the conventional treatments. We used Lyman's relative-seriality model and the breast fibrosis NTCP model fitting parameters for the study. RESULTS The equivalent uniform dose (EUD) was 30.09 Gy and 50.79 Gy in APBI and conventional treatment, respectively. The mean NTCP values for ipsilateral breast fibrosis in APBI and conventional treatment were 0.51 and 25.66%, respectively. Using the paired t-test, a statistically significant difference was seen in the breast fibrosis NTCP values for APBI vs conventional treatment (P < 0.001). CONCLUSIONS APBI reduces the ipsilateral breast fibrosis compared to conventional whole-breast treatment in early-stage breast cancer.
Collapse
|