| Yang Jiming,Lu Ting,Ma Min,et al.Comparison of three fixed-field IMRT plans for nasal cavity and paranasal sinus tumors[J].Chinese Journal of Radiological Medicine and Protection,2022,42(12):950-957 |
| Comparison of three fixed-field IMRT plans for nasal cavity and paranasal sinus tumors |
| Received:August 24, 2022 |
| DOI：10.3760/cma.j.cn12271-20220824-00342 |
| KeyWords:Nasal cavity and paranasal sinus tumor|Non-coplanar|Fixed-field intensity-modulated radiotherapy|C-arm LINAC|O-ring LINAC|Dosimetry |
| FundProject: |
| Author Name | Affiliation | E-mail | | Yang Jiming | Radiotherapy and Chemotherapy Center, Ningbo First Hospital, Ningbo 315000, China | | | Lu Ting | Radiation Oncology Department, Qinghai Red Cross Hospital, Xining 810000, China | | | Ma Min | Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China | | | Wu Yong | Radiotherapy Department, Xingyi People's Hospital, Xingyi 562400, China | | | Zhou Yingying | Radiotherapy and Chemotherapy Center, Ningbo First Hospital, Ningbo 315000, China | | | Ren Jiangping | Radiotherapy and Chemotherapy Center, Ningbo First Hospital, Ningbo 315000, China | | | Wang Xun | Radiotherapy Technology Department, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo 315000, China | | | Guo Jianxin | Radiotherapy and Chemotherapy Center, Ningbo First Hospital, Ningbo 315000, China | gjx1696@yeah.net |
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| Abstract:: |
| Objective To compare three fixed-field intensity-modulated radiotherapy (IMRT) plans for nasal cavity and paranasal sinus tumors, including the coplanar IMRT (C-IMRT) plan and the non-coplanar IMRT(NC-IMRT) plan which were based on a conventional C-arm LINAC (Trilogy), and the coplanar IMRT (H-IMRT) plan based on an O-ring LINAC (Halcyon).Methods Based on the data of 10 patients in the Ningbo First Hospital from December 2018 to December 2021 with nasal cavity and paranasal sinus tumors who underwent postoperative radiotherapy, this study redesigned three IMRT plans with the same prescribed doses and optimization objectives. Then, this study compared the doses of target volumes and organ at risks(OARs), the validation pass rates, and the execution time of these plans. Friedman test was employed in this study, and multiple comparisons were further made in cases of different results.Results The differences in the conformal index (CI) of PTV and PTVboost of the three plans were statistically significant (χ2 = 7.51, 9.69, P < 0.05). The multiple comparisons showed that the median CI of the H-IMRT plan was higher than that of the NC-IMRT plan (Z = 2.53, 2.68, P < 0.05). The differences in other parameters of target volumes were not statistically significant. Compared with the C-IMRT plan, the H-IMRT plan reduced the Dmax of bilateral lenses, bilateral corneas, ipsilateral optic nerve, and ipsilateral eyeball (Z = 2.80, 2.80, 2.80, 2.80, 2.81, 2.09, P < 0.05). Compared with the C-IMRT plan, the NC-IMRT reduced the Dmax of bilateral lenses, corneas, and eyeballs and contralateral optic nerve (Z = 2.80, 2.66, 2.80, 2.70, 2.29, 2.29, 2.65, P < 0.05) and reduced the Dmean of bilateral eyeballs (Z = 2.80, 2.80, P < 0.05). Compared with the NC-IMRT plan, the H-IMRT plan reduced the Dmax of the ipsilateral lens and cornea (Z = 2.50, 2.08, P < 0.05), but increased the Dmax of the contralateral optic nerve and the Dmean of bilateral eyeballs (Z = 2.80, 2.80, 2.80, P < 0.05). The validation pass rate of the three plans met the institutional standards, and the differences were not statistically significant. Moreover, the H-IMRT plan had the shortest median execution time (172.00 s), followed by the C-IMRT plan (337.50 s), and the NC-IMRT plan (388.00 s).Conclusions The verification pass rate of the three plans can achieve the requirements of treatment implementation. The three plans had similar dosimetric differences in target volumes. However, the H-IMRT and NC-IMRT plans can protect the normal tissues (especially optical organs) more effectively than the C-IMRT plan, which is conducive to reducing the toxicity after radiotherapy and provides space for local dose increase or the radiotherapy for the treatment of tumor recurrence. The execution efficiency of the three plans is in the order of H-IMRT > C-IMRT > NC-IMRT. It is necessary to select appropriate radiotherapy equipment and technology according to actual situations. |
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