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Pigorsch, S.U.* ; Kampfer, S.* ; Oechsner, M.* ; Mayinger, M.C.* ; Mozes, P.* ; Devecka, M.* ; Kessel, K.K.* ; Combs, S.E. ; Wilkens, J.J.*

Report on planning comparison of VMAT, IMRT and helical tomotherapy for the ESCALOX-trial pre-study.

Radiat. Oncol. 15:253 (2020)
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Background: The ESCALOX trial was designed as a multicenter, randomized prospective dose escalation study for head and neck cancer. Therefore, feasibility of treatment planning via different treatment planning systems (TPS) and radiotherapy (RT) techniques is essential. We hypothesized the comparability of dose distributions for simultaneous integrated boost (SIB) volumes respecting the constraints by different TPS and RT techniques. Methods: CT data sets of the first six patients (all male, mean age: 61.3 years) of the pre-study (up to 77 Gy) were used for comparison of IMRT, VMAT, and helical tomotherapy (HT). Oropharynx was the primary tumor location. Normalization of the three step SIB (77 Gy, 70 Gy, 56 Gy) was D95% = 77 Gy. Coverage (CVF), healthy tissue conformity index (HTCI), conformation number (CN), and dose homogeneity (HI) were compared for PTVs and conformation index (COIN) for parotids. Results: All RT techniques achieved good coverage. For SIB77Gy, CVF was best for IMRT and VMAT, HT achieved highest CN followed by VMAT and IMRT. HT reached good HTCI value, and HI compared to both other techniques. For SIB70Gy, CVF was best by IMRT. HTCI favored HT, consequently CN as well. HI was slightly better for HT. For SIB56Gy, CVF resulted comparably. Conformity favors VMAT as seen by HTCI and CN. Dmean of ipsilateral and contralateral parotids favor HT. Conclusion: Different TPS for dose escalation reliably achieved high plan quality. Despite the very good results of HT planning for coverage, conformity, and homogeneity, the TPS also achieved acceptable results for IMRT and VMAT. Trial registration ClinicalTrials.gov Identifier: NCT 01212354, EudraCT-No.: 2010-021139-15. ARO: ARO 14-01
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Publication type Article: Journal article
Document type Scientific Article
Keywords Combined Chemoradiation Therapy ; Dose Escalation ; Head And Neck Cancer ; Helical Tomotherapy ; Imrt ; Rt Planning Comparison ; Sib ; Vmat; Simultaneous Integrated Boost; Modulated Radiation-therapy; Target Volume Delineation; Squamous-cell Carcinoma; Locally Advanced Head; Neck-cancer; Dose-escalation; Arc Therapy; Oropharyngeal Cancer; Radiotherapy
ISSN (print) / ISBN 1748-717X
e-ISSN 1748-717X
Quellenangaben Volume: 15, Issue: 1, Pages: , Article Number: 253 Supplement: ,
Publisher BioMed Central
Publishing Place Campus, 4 Crinan St, London N1 9xw, England
Reviewing status Peer reviewed
Grants Deutsche Forschungsgemeinschaft (DFG)