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A comparative planning study of step-and-shoot IMRT versus helical tomotherapy in a model patient

Authors
 Yong Nam Kim  ;  Soo Kon Kim  ;  Kyoungkeun Jeong  ;  Chang Geol Lee  ;  Ki Chang Keum  ;  Ik Jae Lee  ;  Jaeho Cho 
Citation
 JOURNAL OF THE KOREAN PHYSICAL SOCIETY, Vol.63(7) : 1481-1485, 2013 
Journal Title
 JOURNAL OF THE KOREAN PHYSICAL SOCIETY 
ISSN
 0374-4884 
Issue Date
2013
Keywords
Radiation therapy ; Step-and-shoot IMRT ; Helical tomotherapy ; Noncoplanar beam
Abstract
In order to assess the potential benefit of being able to use non-coplanar beams in a step-andshoot intensity-modulated radiotherapy (ssIMRT) differently from helical tomotherapy (HT), we performed a comparative planning evaluation in a model patient whose clinical target volumes enclosed critical normal tissue lying in the same plane. A patient with extensively relapsed malignant lymphoma in the circumferential chest wall was selected for comparison. Multiple, separated gross tumors were delineated, and the clinical target volume included the circumferential chest wall containing gross tumor volumes so that the critical organ, the right lung was fully enclosed. Three types of plans were analyzed; the first one was ssIMRT using only coplanar beams, the second was ssIMRT using non-coplanar beams, and the third was HT. The obtained results showed that dose homogeneity inside the gross tumor volume was better in the case of HT than noncoplanar ssIMRT and coplanar ssIMRT. However, the volume fraction of the right lung receiving a high dose was much smaller in the noncoplanar ssIMRT. As far as the dose to the clinical target volume (CTV) fully enclosing the right lung is concerned, not only the dose coverage of the CTV but also the dose homogeneity and conformity in the noncoplanar ssIMRT was better than in both of HT and the coplanar ssIMRT. We can conclude that appropriate isodose coverage for a complex target, which fully encloses a critical organ lying in the same plane, can be achieved by using a non-coplanar beam arrangement with no enforced penalty of higher dose to a critical organ.
Full Text
http://link.springer.com/article/10.3938%2Fjkps.63.1481
DOI
10.3938/jkps.63.1481
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Keum, Ki Chang(금기창) ORCID logo https://orcid.org/0000-0003-4123-7998
Lee, Ik Jae(이익재) ORCID logo https://orcid.org/0000-0001-7165-3373
Lee, Chang Geol(이창걸) ORCID logo https://orcid.org/0000-0002-8702-881X
Cho, Jae Ho(조재호) ORCID logo https://orcid.org/0000-0001-9966-5157
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/88076
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