Abstract
The aim of the study was to investigate the effect of the Hybrid technique which was
created by combining of intensity modulated radiotherapy (IMRT) and volumetric modulated
arc therapy (VMAT) for the treatment of nasopharyngeal cancer (NPC) patients. 7 to
9 field IMRT, triple arc VMAT, and Hybrid plans were generated for 10 advanced stage
NPC patients. The homogeneity index (HI) and the conformity index (CI) of planning
target volumes (PTVs) were calculated for each technique to evaluate the plan quality.
The techniques were compared in terms of plan quality, sparing of organs at risk (OARs),
monitor units (MUs), and delivery time. Hybrid technique significantly improved the
target dose homogeneity and the conformity for PTV70 and PTV60 compared to IMRT and
VMAT. Hybrid plans significantly reduced the maximum dose of the brainstem sparing
compared to the VMAT plans and also improved the sparing of spinal cord compared to
IMRT and VMAT. The MUs and the delivery time of Hybrid plans were found to be between
values for IMRT and VMAT plans. Hybrid technique can be useful when IMRT and VMAT
techniques are not adequate alone in the treatment of NPC patients.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Medical DosimetryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Nasopharynx.in: Barrett A. Dobbs J. Morris S. Roques T. Practical Radiotherapy Planning. 4th Edition. Hodder Arnold, London2009: 156-164
- Volumetric intensity-modulated arc therapy vs. conventional IMRT in head-and-neck cancer: A Comparative Planning and Dosimetric Study.Int J Radiat Oncol Biol Phys. 2009; 74: 252-259
- Intensity-modulated radiation therapy, protons, and the risk of second cancers.Int J Radiat Oncol Biol Phys. 2006; 65: 1-7
- Volumetric modulated arc radiotherapy for carcinomas of the oro-pharynx, hypo-pharynx and larynx: A treatment planning comparison with fixed field IMRT.Radiother Oncol. 2009; 92: 111-117
- A comprehensive dosimetric evaluation of using RapidArc volumetric-modulated arc therapy for the treatment of early-stage nasopharyngeal carcinoma.J Appl Clin Med Phys. 2012; 13: 189-202
- Comparison of whole-field simultaneous integrated boost VMAT and IMRT in the treatment of nasopharyngeal cancer.Med Dosim. 2013; 38: 418-423
- Volumetric modulated arc therapy: A review of current literature and clinical use in practice.Br J Radiol. 2011; 84: 967-996
- The American Joint Committee on Cancer: The 7th edition of the AJCC cancer staging manual and the future of TNM.Ann Surg Oncol. 2010; 17: 1471-1474
- 3. Special considerations regarding absorbed-dose and dose-volume prescribing and reporting in IMRT.J ICRU. 2010; 10: 27-40
- Conformity index: a review.Int J Radiat Oncol Biol Phys. 2006; 64: 333-342
- A conformation number to quantify the degree of conformality in brachytherapy and external beam irradiation: Application to the prostate.Int J Radiat Oncol Biol Phys. 1997; 37: 731-736
ICRU Report 62. Prescribing, Recording, and Reporting Photon Beam Therapy (Supplement to ICRU Report 50). International Commission on Radiation Units and Measurements, Bethesda, MD; 1999.
- Nasopharyngeal carcinoma treated by radical radiotherapy alone: Ten-year experience of a single institution.Int J Radiat Oncol Biol Phys. 2006; 65: 161-168
- Novel Method for the Planning and Delivery of Radiation Therapy.United States Patent Application Publication, 2004 (2004/0071261)
- FusionArc optimization: A hybrid volumetric modulated arc therapy (VMAT) and intensity modulated radiation therapy (IMRT) planning strategy.Med Phys. 2013; 40071713
- A hybrid IMRT/VMAT technique for the treatment of nasopharyngeal cancer.Biomed Res Int. 2015; 2015: 1-8
- Volumetric intensity-modulated arc therapy vs conventional intensity-modulated radiation therapy in nasopharyngeal carcinoma: A dosimetric study.J Radiat Res. 2013; 54: 532-545
- Single arc volumetric-modulated arc therapy is sufficient for nasopharyngeal carcinoma: A dosimetric comparison with dual arc VMAT and dynamic MLC and step-and-shoot intensity-modulated radiotherapy.Radiat Oncol. 2013; 8: 1-9
- Intensity modulated therapy and inhomogeneous dose to the tumor: A note of caution.Int J Radiat Oncol Biol Phys. 1996; 36: 519-522
- Advanced nasopharyngeal carcinoma radiotherapy with volumetric modulated arcs and the potential role of flattening filter-free beams.Radiat Oncol. 2013; 8: 1-9
- HybridArc: A novel radiation therapy technique combining optimized dynamic arcs and intensity modulation.Med Dosim. 2012; 37: 358-368
- Quality of treatment plans and accuracy of in vivo portal dosimetry in hybrid intensity-modulated radiation therapy and volumetric modulated arc therapy for prostate cancer.Radiother Oncol. 2016; 120: 320-326
- Clinical application of a hybrid rapidarc radiotherapy technique for locally advanced lung cancer.Technol Cancer Res Treat. 2016; 2016: 1-7
- An IMRT/VMAT technique for nonsmall cell lung cancer.Biomed Res Int. 2015; 2015: 1-7
- Dual arc volumetric-modulated arc radiotherapy (VMAT) of nasopharyngeal carcinomas: A simultaneous integrated boost treatment plan comparison with intensity-modulated radiotherapies and single arc VMAT.Clin Oncol. 2012; 24: 196-207
- The in vivo study on the radiobiologic effect of prolonged delivery time to tumor control in C57BL mice implanted with lewis lung cancer.Radiat Oncol. 2011; 6: 1-6
- In vitro and in vivo studies on radiobiological effects of prolonged fraction delivery time in A549 cells.J Radiat Res. 2012; 54: 230-234
- Recovery from sublethal damage during intermittent exposures in cultured tumor cells: Implications for dose modification in radiosurgery and IMRT.Int J Radiat Oncol Biol Phys. 2004; 59: 1484-1490
- Clinical consequences of changing the sliding window IMRT dose rate.J Appl Clin Med Phys. 2012; 13: 4-12
Article info
Publication history
Published online: October 23, 2018
Accepted:
September 24,
2018
Received in revised form:
September 19,
2018
Received:
July 2,
2018
Identification
Copyright
© 2018 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.