Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
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Randomized Controlled Trial
Volumetric modulated arc radiotherapy for carcinomas of the oro-pharynx, hypo-pharynx and larynx: a treatment planning comparison with fixed field IMRT.
A planning study was performed to evaluate the performance of volumetric modulated arc radiotherapy on head and neck cancer patients. Conventional fixed field IMRT was used as a benchmark. ⋯ RapidArc was investigated for head and neck cancer. RA1 and RA2 showed some improvements in organs at risk and healthy tissue sparing, while only RA2 offered improved target coverage with respect to conventional IMRT.
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Comparative Study
Volumetric-modulated arc radiotherapy for carcinomas of the anal canal: A treatment planning comparison with fixed field IMRT.
A treatment planning study was performed to compare volumetric-modulated arc radiotherapy against conventional fixed field IMRT. ⋯ RapidArc showed improvements in organs at risk and healthy tissue sparing with uncompromised target coverage when double arcs are applied. Optimal results were also achieved anyway with IMRT plans.
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Comparative Study
Pulmonary toxicity following IMRT after extrapleural pneumonectomy for malignant pleural mesothelioma.
The combination of chemotherapy, surgery, and radiotherapy has improved the prognosis for patients with malignant pleural mesothelioma (MPM). Intensity-modulated radiotherapy (IMRT) has allowed for an increase in dose to the pleural cavity and a reduction in radiation doses to organs at risk. The present study reports and analyses the incidence of fatal pulmonary toxicity in patients treated at Rigshospitalet, Copenhagen. ⋯ Significant differences in MLD and V10 for patients with fatal pulmonary toxicity compared to patients without fatal lung toxicity have been demonstrated. Based on the presented data local lung dose constraints have been modified in order to avoid unacceptable toxicity.
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Comparative Study
Evaluation of the dosimetric impact of non-exclusion of the rectum from the boost PTV in IMRT treatment plans for prostate cancer patients.
In dose escalation trial, for prostate cancer patients, zero CTV-PTV margins towards the rectum are often applied in the boost phase in order to avoid excessive dose delivery to the rectum. In this study, the dosimetric impact of non-exclusion of the rectum from the boost PTV is evaluated. Treatment plans created according to the protocol used in our institute for patients in a Dutch hypofractionated trial (HYPO), where the rectum is excluded from the boost PTV, were compared to plans designed with a modified version of this protocol (HYPO-exp) for which the rectal exclusion was not performed. Differences in target coverage and rectum dose were quantified. ⋯ By omitting the zero margin towards the rectum, underdosages in the target volume are reduced significantly, while a clinically relevant increase in rectum exposure is not observed.