Dosimetry Analysis of Three Kinds of Radiation Technique for Postoperative Gastric Cancer

Abstract:

Objective: To compare dose-volume histograms (DVHs) and the dose distribution of three-dimensional conformal radiotherapy(3DCRT),7 fields radiotherapy(7FRT) and intensity-modulated radiotherapy (IMRT) of treatment planning in gastric cancer. Methods: We selected 5 patients with gastric cancer, they were pathologically confirmed stage T3,T4 or N+ gastric cancer. All patients underwent radical gastrectomy. A dosimetry study was carried out on these five patients. For each patient, three kinds of treatment planning were designed with a prescribed dose of 45Gy to 95％of PTV.Many kinds of parameters of these plans in each patient were compared: isodose distributions line、dose-volume histogram(DVH)、V95%、V110%、CI、HI、EI of target volume and the dose of related critical organs. Results: IMRT was superior to 3DCRT and 7F-RT in dose uniformity（p＜0.05）, there was no statistical difference between 3DCRT and 7FRT in CI（p>0.05）.IMRT had better dose conformity than 3DCRT and 7FRT（p＜0.05）, and 3DCRT was better than 7FRT in CI（p＜0.05）.IMRT showed better EI than 3DCRT and 7FRT（p＜0.05）,there was no statistical difference between 3DCRT and 7FRT in EI（p>0.05）.IMRT had advantage at sparing liver compared with 3DCRT and 7FRT（p＜0.05）,7FRT showed better D1/3 of liver than 3DCRT（p＜0.05）,but there was no statistical difference between 3DCRT and 7FRT in Dmean of liver（p>0.05）.IMRT expressed better Dmax of spinal cord than 3DCRT and 7F-RT（p＜0.05）, and 7FRT was better than IMRT in Dmax of spinal cord（p＜0.05）.But the dose received by the both kidneys were not significantly different. Conclusion: IMRT is superior to 3DCRT and 7FRT,and 3DCRT plans showed better CI and Dmax of spinal cord composed to 7FRT,and 7FRT was superior to 3DCRT in D1/3 of liver. IMRT for gastric cancer had physics advantage for clinical application.

• Periodical: Advanced Materials Research (Volumes 641-642)
• Pages: 725-731
• DOI: https://doi.org/10.4028/www.scientific.net/AMR.641-642.725
• Online since: January 2013
• Authors: Hua Tang, Ju Dong Luo, Xu Jing Lu, Ling Chen, Yan Ma, Jian Ping Cao, Shu Yu Zhang, Yang Ling, Xi Fa Zhou
• Keywords: Dosimetry, Gastric Cancer, Radiotherapy, Technology

References

[1] Mengchao Wu, Meilin Liao, Jiade Lu. Jiade Lu. The therapy development of common malignant tumors[M]. Shanghai Scientific Publish, 2007, 289-327.

[2] Macdonald JS, Smalley SR, Benedetti J, et al. Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction[J]. N Engl J Med, 2001, 345: 725-730.

DOI: 10.1056/nejmoa010187

[3] Kim S, Lim DH, Lee J, et al. An observational study suggesting clinical benefit for adjuvant postoperative chemoradiation in a population of over 500 cases after gastric resection with D2 nodal dissection for adenocarcinoma of the stomach[J]. Int J Radiat Oncol Biol Phys, 2005, 63: 1279-1285.

DOI: 10.1016/j.ijrobp.2005.05.005

[4] Leong T, Willis D, Jcon DL, et al. 3D conformal radiotherapy for gastric cancer-results of a comparative planning study[J]. Radiother Oncol, 2005, 74: 301-306.

DOI: 10.1016/j.radonc.2005.01.006

[5] Weigang Hu, Zhen Zhang, Zhiyong Xu, et al. Comparison of dosimetry between three-dimension conformal and intensity modulated plan in postoperative radiotherapy for gastric cance[J]r. Chinese Journal of Radiation Oncology. 2007, 16: 273-276.

[6] Jing Jin. Gastric cancer. [M]. Chief: Weibo Yin. Raiotherapy(3th edition). Beijing: Publish of Xiehe Medical University, 2008, 799-828.

[7] Wieland P, Dobler B, Mai S, et al. IMRT for postoperative treatment of gastric cancer: covering large target volumes in the upper abdomen: a comparison of a step-and-shoot and an arc therapy approach[J]. Int J Radiat Oncol Biol Phys, 2004, 59: 1236-1244.

DOI: 10.1016/j.ijrobp.2004.02.051

[8] Ringash J, Khaksart SJ, Oza A. Post-operative radiochemotherapy for gastric cancer: adoption and adaptation[J]. Clinical Oncology, 2005, 17: 91-95.

DOI: 10.1016/j.clon.2004.09.017

[9] Dawei Jin, Jianrong Dai, Yexiong Li, et al. Comparison of seven intensity modulated radiation therapy plans for prostate cancer[J]. Chinese Journal of Radiation Oncology. 2005, 14: 47-51.

[10] Murshed H, Liu HL, Liao Z, et al. Dose and volume reduction for nomal lung using intensitymodulated radiot herapy for advanced stage non-small-cell lung cancer[J]. Int J Radiat Oncol Biol Phys, 2004, 58: 1258-1267.

[11] Tibor Major, János Fodor, Zoltán Takácsi-Nagy, et al. Evaluation of HDR interstitial breast implants planned by conventional and optimized CT-based dosimetry systems with respect to dose homogeneity and conformality[J]. Strahlenther Onkol, 2005, 181: 89-96.

DOI: 10.1007/s00066-005-1350-6

[12] Carlcs AP, Jame AP. Three-dimensional treatment planning and conformal radiation therapy, preliminary evaluation[J]. Radiother Oncol, 1995, 36: 32-43.

[13] Ringash J, Khaksary SJ, Oza A, et al. Post-operative Radiochemotherapyfor Gastric Cancer: Adoption and Adaptation[J]. Clinical Oncology, 2005, 17: 91–95.

[14] Zahra Kassam, Gina Lockwood, Catherine O'Brien, et al. Conformal radiotherapy in the adjuvant therapy of gastric cancer: review of 82 cases[J]. Int J Radiat Oncol Biol Phys, 2006, 65: 713–719.

[15] Zelefsky MJ, Fuks Z, Hunt M, et al. High-dose intensity modulated radiation therapy for prostate cancer: early toxicity and biochemical outcome in 772 patients[J]. Int J Radiat Oncol Biol Phys, 2002, 53: 1111-1116.

DOI: 10.1016/s0360-3016(02)02857-2

[16] 16 Milano MT, Garofalo MC, Chmura SJ, et al. Intensity-modulated radiation therapy in the treatment of gastric cancer: early clinical outcome and dosimetric comparison with conventional techniques[J]. The British Journal of Radiology, 2006, 79: 497.

DOI: 10.1259/bjr/43441736

[17] 2011 Gastric Cancer guideline Chinese edition.