Browse > Article
http://dx.doi.org/10.3857/roj.2016.01935

Dosimetric comparison of intensity-modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) in total scalp irradiation: a single institutional experience  

Ostheimer, Christian (Department of Radiation Oncology, Faculty of Medicine, Martin Luther University Halle-Wittenberg)
Hubsch, Patrick (Department of Radiation Oncology, Faculty of Medicine, Martin Luther University Halle-Wittenberg)
Janich, Martin (Department of Radiation Oncology, Faculty of Medicine, Martin Luther University Halle-Wittenberg)
Gerlach, Reinhard (Department of Radiation Oncology, Faculty of Medicine, Martin Luther University Halle-Wittenberg)
Vordermark, Dirk (Department of Radiation Oncology, Faculty of Medicine, Martin Luther University Halle-Wittenberg)
Publication Information
Radiation Oncology Journal / v.34, no.4, 2016 , pp. 313-321 More about this Journal
Abstract
Purpose: Total scalp irradiation (TSI) is a rare but challenging indication. We previously reported that non-coplanar intensity-modulated radiotherapy (IMRT) was superior to coplanar IMRT in organ-at-risk (OAR) protection and target dose distribution. This consecutive treatment planning study compared IMRT with volumetric-modulated arc therapy (VMAT). Materials and Methods: A retrospective treatment plan databank search was performed and 5 patient cases were randomly selected. Cranial imaging was restored from the initial planning computed tomography (CT) and target volumes and OAR were redelineated. For each patients, three treatment plans were calculated (coplanar/non-coplanar IMRT, VMAT; prescribed dose 50 Gy, single dose 2 Gy). Conformity, homogeneity and dose volume histograms were used for plan. Results: VMAT featured the lowest monitor units and the sharpest dose gradient (1.6 Gy/mm). Planning target volume (PTV) coverage and homogeneity was better in VMAT (coverage, 0.95; homogeneity index [HI], 0.118) compared to IMRT (coverage, 0.94; HI, 0.119) but coplanar IMRT produced the most conformal plans (conformity index [CI], 0.43). Minimum PTV dose range was 66.8%-88.4% in coplanar, 77.5%-88.2% in non-coplanar IMRT and 82.8%-90.3% in VMAT. Mean dose to the brain, brain stem, optic system (maximum dose) and lenses were 18.6, 13.2, 9.1, and 5.2 Gy for VMAT, 21.9, 13.4, 14.5, and 6.3 Gy for non-coplanar and 22.8, 16.5, 11.5, and 5.9 Gy for coplanar IMRT. Maximum optic chiasm dose was 7.7, 8.4, and 11.1 Gy (non-coplanar IMRT, VMAT, and coplanar IMRT). Conclusion: Target coverage, homogeneity and OAR protection, was slightly superior in VMAT plans which also produced the sharpest dose gradient towards healthy tissue.
Keywords
Total scalp irradiation; Intensity-modulated radiotherapy; Volumetric-modulated arc therapy; Angiosarcoma; Mycosis fungoides; Lymphoma of the scalp; Dosimetry;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Mendenhall WM, Mendenhall CM, Werning JW, Reith JD, Mendenhall NP. Cutaneous angiosarcoma. Am J Clin Oncol 2006;29:524-8.   DOI
2 Samant RS, Fox GW, Gerig LH, Montgomery LA, Allan DS. Total scalp radiation using image-guided IMRT for progressive cutaneous T cell lymphoma. Br J Radiol 2009;82:e122-5.   DOI
3 Wojcicka JB, Lasher DE, McAfee SS, Fortier GA. Dosimetric comparison of three different treatment techniques in extensive scalp lesion irradiation. Radiother Oncol 2009;91:255-60.   DOI
4 Tung SS, Shiu AS, Starkschall G, Morrison WH, Hogstrom KR. Dosimetric evaluation of total scalp irradiation using a lateral electron-photon technique. Int J Radiat Oncol Biol Phys 1993;27:153-60.
5 Locke J, Low DA, Grigireit T, Chao KS. Potential of tomotherapy for total scalp treatment. Int J Radiat Oncol Biol Phys 2002;52:553-9.   DOI
6 Mellenberg DE, Schoeppel SL. Total scalp treatment of mycosis fungoides: the 4 x 4 technique. Int J Radiat Oncol Biol Phys 1993;27:953-8.   DOI
7 Able CM, Mills MD, McNeese MD, Hogstrom KR. Evaluation of a total scalp electron irradiation technique. Int J Radiat Oncol Biol Phys 1991;21:1063-72.   DOI
8 Sagar SM, Pujara CM. Radical treatment of angiosarcoma of the scalp using megavoltage electron beam therapy. Br J Radiol 1992;65:421-4.   DOI
9 Akazawa C. Treatment of the scalp using photon and electron beams. Med Dosim 1989;14:129-31.   DOI
10 Bedford JL, Childs PJ, Hansen VN, Warrington AP, Mendes RL, Glees JP. Treatment of extensive scalp lesions with segmental intensity-modulated photon therapy. Int J Radiat Oncol Biol Phys 2005;62:1549-58.   DOI
11 Chan MF, Song Y, Burman C, Chui CS, Schupak K. The treatment of extensive scalp lesions combining electrons with intensity-modulated photons. Conf Proc IEEE Eng Med Biol Soc 2006;1:152-5.
12 Paddick I. A simple scoring ratio to index the conformity of radiosurgical treatment plans: technical note. J Neurosurg 2000;93 Suppl 3:219-22.
13 Ostheimer C, Janich M, Hubsch P, Gerlach R, Vordermark D. The treatment of extensive scalp lesions using coplanar and non-coplanar photon IMRT: a single institution experience. Radiat Oncol 2014;9:82.   DOI
14 Kinard JD, Zwicker RD, Schmidt-Ullrich RK, Kaufman N, Pieters R. Short communication: Total craniofacial photon shell technique for radiotherapy of extensive angiosarcomas of the head. Br J Radiol 1996;69:351-5.   DOI
15 Kelly PJ, Mannarino E, Lewis JH, Baldini EH, Hacker FL. Total dural irradiation: RapidArc versus static-field IMRT: a case study. Med Dosim 2012;37:175-81.   DOI
16 Stang K, Alite F, Steber J, Emami B, Surucu M. Leukemia cutis of the face, scalp, and neck treated with non-coplanar split field volumetric modulated arc therapy: a case report. Cureus. 2015;7:e430.
17 Feuvret L, Noel G, Mazeron JJ, Bey P. Conformity index: a review. Int J Radiat Oncol Biol Phys 2006;64:333-42.   DOI
18 Hodapp N. The ICRU Report 83: prescribing, recording and reporting photon-beam intensity-modulated radiation therapy (IMRT). Strahlenther Onkol 2012;188:97-9.   DOI
19 Gregoire V, Mackie TR. State of the art on dose prescription, reporting and recording in Intensity-Modulated Radiation Therapy (ICRU report No. 83). Cancer Radiother 2011;15:555-9.   DOI
20 The International Commission on Radiation Units and Measurements. J ICRU 2010;10:NP. http://doi.org/10.1093/jicru/ndq001.   DOI
21 Hata M, Wada H, Ogino I, et al. Radiation therapy for angiosarcoma of the scalp: treatment outcomes of total scalp irradiation with X-rays and electrons. Strahlenther Onkol 2014;190:899-904.   DOI
22 Gondi V, Tome WA, Mehta MP. Why avoid the hippocampus? A comprehensive review. Radiother Oncol 2010;97:370-6.   DOI
23 Jumeau R, Renard-Oldrini S, Courrech F, et al. High dose rate brachytherapy with customized applicators for malignant facial skin lesions. Cancer Radiother 2016;20:341-6.   DOI
24 Inoue M, Konno M, Ogawa H, et al. A simpler method for total scalp irradiation: the multijaw-size concave arc technique. J Appl Clin Med Phys 2014;15:4786.
25 Song JH, Jung JY, Park HW, et al. Dosimetric comparison of three different treatment modalities for total scalp irradiation: the conventional lateral photon-electron technique, helical tomotherapy, and volumetric-modulated arc therapy. J Radiat Res 2015;56:717-26.   DOI
26 Hu J, Xiao W, He Z, Kang D, Chen A, Qi Z. Target splitting non-coplanar RapidArc radiation therapy for a diffuse sebaceous carcinoma of the scalp: a novel delivery technique. Radiat Oncol 2014;9:204.   DOI
27 Mizumatsu S, Monje ML, Morhardt DR, Rola R, Palmer TD, Fike JR. Extreme sensitivity of adult neurogenesis to low doses of X-irradiation. Cancer Res 2003;63:4021-7.