DOI QR코드

DOI QR Code

The impact of beam angle configuration of intensity-modulated radiotherapy in the hepatocellular carcinoma

  • Kim, Sung Hoon (Department of Radiation Oncology, Yeungnam University College of Medicine) ;
  • Kang, Min Kyu (Department of Radiation Oncology, Yeungnam University College of Medicine) ;
  • Yea, Ji Woon (Department of Radiation Oncology, Yeungnam University College of Medicine) ;
  • Kim, Sung Kyu (Department of Radiation Oncology, Yeungnam University College of Medicine) ;
  • Choi, Ji Hoon (Department of Radiation Oncology, Yeungnam University College of Medicine) ;
  • Oh, Se An (Department of Physics, Yeungnam University)
  • Received : 2012.04.16
  • Accepted : 2012.06.13
  • Published : 2012.09.30

Abstract

Purpose: This treatment planning study was undertaken to evaluate the impact of beam angle configuration of intensity-modulated radiotherapy (IMRT) on the dose of the normal liver in hepatocellular carcinoma (HCC). Materials and Methods: The computed tomography datasets of 25 patients treated with IMRT for HCC were selected. Two IMRT plans using five beams were made in each patient; beams with equidistance of $72^{\circ}$ (Plan I), and beams with a $30^{\circ}$ angle of separation entering the body near the tumor (Plan II). Both plans were generated using the same constraints in each patient. Conformity index (CI), homogeneity index (HI), gamma index, mean dose of the normal liver (Dmean_NL), Dmean_NL difference between the two plans, and percentage normal liver volumes receiving at least 10, 20, and 30 Gy (V10, V20, and V30) were evaluated and compared. Results: Dmean_NL, V10, and V20 were significantly better for Plan II. The Dmean_NL was significantly lower for peripheral (p = 0.001) and central tumors (p = 0.034). Dmean_NL differences between the two plans increased in proportion to gross tumor volume to normal liver volume ratios (p = 0.002). CI, HI, and gamma indices were not significantly different for the two plans. Conclusion: The IMRT plan based on beams with narrow separations reduced the irradiated dose of the normal liver, which would allow radiation dose escalation for HCC.

Keywords

Acknowledgement

Supported by : Chunma Medical Research Foundation

References

  1. Park W, Lim DH, Paik SW, et al. Local radiotherapy for patients with unresectable hepatocellular carcinoma. Int J Radiat Oncol Biol Phys 2005;61:1143-50. https://doi.org/10.1016/j.ijrobp.2004.08.028
  2. Krishnan S, Dawson LA, Seong J, et al. Radiotherapy for hepatocellular carcinoma: an overview. Ann Surg Oncol 2008;15:1015-24. https://doi.org/10.1245/s10434-007-9729-5
  3. Dawson LA. The evolving role of radiation therapy in hepatocellular carcinoma. Cancer Radiother 2008;12:96-101. https://doi.org/10.1016/j.canrad.2007.12.007
  4. Ben-Josef E, Normolle D, Ensminger WD, et al. Phase II trial of high-dose conformal radiation therapy with concurrent hepatic artery floxuridine for unresectable intrahepatic malignancies. J Clin Oncol 2005;23:8739-47. https://doi.org/10.1200/JCO.2005.01.5354
  5. Seong J, Park HC, Han KH, Chon CY. Clinical results and prognostic factors in radiotherapy for unresectable hepatocellular carcinoma: a retrospective study of 158 patients. Int J Radiat Oncol Biol Phys 2003;55:329-36. https://doi.org/10.1016/S0360-3016(02)03929-9
  6. Liu MT, Li SH, Chu TC, et al. Three-dimensional conformal radiation therapy for unresectable hepatocellular carcinoma patients who had failed with or were unsuited for transcatheter arterial chemoembolization. Jpn J Clin Oncol 2004;34:532-9. https://doi.org/10.1093/jjco/hyh089
  7. Seong J. Challenge and hope in radiotherapy of hepatocellular carcinoma. Yonsei Med J 2009;50:601-12. https://doi.org/10.3349/ymj.2009.50.5.601
  8. Pan CC, Kavanagh BD, Dawson LA, et al. Radiation-associa ted liver injury. Int J Radiat Oncol Biol Phys 2010;76(3 Suppl):S94-100. https://doi.org/10.1016/j.ijrobp.2009.06.092
  9. Jiang ZQ, Yang K, Komaki R, et al. Long-term clinical outcome of intensity-modulated radiotherapy for inoperable non-small cell lung cancer: the MD Anderson experience. Int J Radiat Oncol Biol Phys 2012;83:332-9. https://doi.org/10.1016/j.ijrobp.2011.06.1963
  10. McIntosh A, Hagspiel KD, Al-Osaimi AM, et al. Accelerated treatment using intensity-modulated radiation therapy plus concurrent capecitabine for unresectable hepatocellular carcinoma. Cancer 2009;115:5117-25. https://doi.org/10.1002/cncr.24552
  11. Jang JW, Kay CS, You CR, et al. Simultaneous multitarget irradiation using helical tomotherapy for advanced hepatocellular carcinoma with multiple extrahepatic metastases. Int J Radiat Oncol Biol Phys 2009;74:412-8. https://doi.org/10.1016/j.ijrobp.2008.08.034
  12. Kang MK, Kim MS, Kim SK, et al. High-dose radiotherapy with intensity-modulated radiation therapy for advanced hepatocellular carcinoma. Tumori 2011;97:724-31.
  13. Paddick I. A simple scoring ratio to index the conformity of radiosurgical treatment plans: technical note. J Neurosurg 2000;93 Suppl 3:219-22.
  14. Hsieh CH, Liu CY, Shueng PW, et al. Comparison of coplanar and noncoplanar intensity-modulated radiation therapy and helical tomotherapy for hepatocellular carcinoma. Radiat Oncol 2010;5:40. https://doi.org/10.1186/1748-717X-5-40
  15. Srivastava SP, Das IJ, Kumar A, Johnstone PA. Dosimetric comparison of manual and beam angle optimization of gantry angles in IMRT. Med Dosim 2011;36:313-6. https://doi.org/10.1016/j.meddos.2010.07.001

Cited by

  1. Loss of EGF‐dependent cell proliferation ability on radioresistant cell HepG2‐8960‐R vol.33, pp.2, 2012, https://doi.org/10.1002/cbf.3090
  2. Dosimetric comparison of volumetric modulated arc therapy with robotic stereotactic radiation therapy in hepatocellular carcinoma vol.33, pp.3, 2012, https://doi.org/10.3857/roj.2015.33.3.233
  3. Technical advances in external radiotherapy for hepatocellular carcinoma vol.22, pp.32, 2012, https://doi.org/10.3748/wjg.v22.i32.7311
  4. The response of thrombosis in the portal vein or hepatic vein in hepatocellular carcinoma to radiation therapy vol.34, pp.3, 2012, https://doi.org/10.3857/roj.2016.01669